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Biomedical subjects

V Mahler

Publications and source records attributed to V Mahler.

At least 37 records · Page 2Linked to original sources
PubMed2000

In situ localization of latex allergens in 3 different brands of latex gloves by means of immunogold field emission scanning and transmission electron microscopy.

BACKGROUND: Latex proteins represent relevant allergens, particularly for those persons who are frequently exposed to latex products (eg, health care workers and patients with chronic disorders). Although several latex allergens have been characterized by biochemical and molecular biologic techniques, little information is available concerning the in situ localization of allergenic proteins in latex products. OBJECTIVE: The objective of the present study was the in situ localization of latex allergens. METHODS: Serum IgE from patients with latex allergy reacting with a broad range (5-200 kd) of latex allergens was used for the in situ localization of latex allergens. One surgical and 2 examination latex glove brands were investigated by using immunogold field emission scanning and transmission electron microscopy. RESULTS: Allergens were detected on the inner and outer surface of the gloves, particularly near the edges, crests, or folds of the bleb-like structures visible on the surface of the latex material at high magnifications. In ultrathin cross-sections, latex allergens were found throughout the sections. CONCLUSIONS: Latex allergens were localized on the outer and inner surface but also in the interior of latex gloves. The occurrence of latex allergens on the surface of latex products may be related to their potential to induce local reactions and, perhaps, to sensitize individuals by means of contact.

Allergens↗
PubMed2000

Autoallergy: a pathogenetic factor in atopic dermatitis?

Long before the discovery of IgE it was reported that human dander extract can elicit immediate-type skin reactions in patients with severe atopy and that this skin sensitivity can be passively transferred with serum. Several recent findings have rekindled the interest in this phenomenon and led to the concept that IgE autoreactivity may play a pathogenetic role in severe and chronic forms of atopy. The elucidation of the nature of several environmental allergens has revealed striking structural and immunologic similarities with human proteins. It was also reported that patients predominantly with severe and chronic manifestations of atopy (eg, atopic dermatitis) contain IgE autoantibodies against a wide variety of proteins expressed in histogenetically unrelated human cell types and tissue specimens. Last, complementary DNAs coding for autoallergens were isolated from human expression complementary DNA libraries and recombinant autoallergens were produced. The autoallergens characterized to date represent mainly intracellular proteins, but some of them could be detected as IgE immune complexes in sera of sensitized patients. We suggest that at least two pathomechanisms could play a role in autoallergy. First, autoallergens may cross-link effector cell-bound IgE autoantibodies and, by release of inflammatory mediators, lead to immediate-type symptoms. Second, IgE-mediated presentation of autoallergens may activate autoreactive T cells to release proinflammatory cytokines, contributing to the magnitude of the allergic tissue reaction.

Antibodies, Anti-Idiotypic↗
PubMed1999

[Digital ischemia as paraneoplastic marker of metastatic endometrial carcinoma].

Digital ischemia with gangrene of one or several fingertips has been described as a paraneoplastic syndrome associated with various malignant tumors, especially adenocarcinomas. Most often this paraneoplastic syndrome represents the first symptom of an occult neoplasia in an advanced stage. We present the case of an 83 year-old patient with digital ischemia and gangrenous fingertips in association with a latent adenocarcinoma of the uterus and metastatic involvement of the paraaortal lymph nodes. Acute occurrence of digital ischemia and gangrene without pathological laboratory findings and negative past medical history concerning cardiovascular-induced emboli, arteriosclerotic occlusion, or rheumatologic and autoimmune diseases should suggest this paraneoplastic syndrome and lead to thorough search for an underlying tumor.

Aged↗
PubMed1999

Component-resolved diagnosis (CRD) of type I allergy with recombinant grass and tree pollen allergens by skin testing.

The diagnosis of Type I allergy is based on the measurement of allergen-specific IgE antibodies and on provocation with allergens, most frequently conducted by skin testing. Both forms of diagnosis are currently performed with allergen extracts that are difficult to standardize regarding their allergen contents, and which contain additional undefined nonallergenic components. We report the expression in Escherichia coli and purification of some of the most relevant timothy grass- and birch pollen allergens. Recombinant timothy grass- (rPhl p 1, rPhl p 2, rPhl p 5) and birch pollen (rBet v 1, rBet v 2) allergens were purified and used for the measurement of allergen-specific IgE and IgG subclass responses as well as for skin prick testing in 55 pollen allergic patients and 10 nonatopic individuals. Results obtained showed that the recombinant allergens allowed in vivo allergy diagnosis in 52 of 54 of the grass pollen and in 35 of 36 of the birch pollen allergic patients. Positive skin reactions were observed almost exclusively in patients containing detectable allergen-specific IgE antibodies but not in the nonatopic group; however, sensitivity to a given allergen as measured by skin reactivity was weakly correlated with the levels of allergen-specific IgE. Our results demonstrate that recombinant allergens can be used for component-resolved skin test diagnosis (CRD) of the patients' allergen sensitization profile, whereas allergen extracts at best allow to identify allergen-containing sources. CRD may thus represent the basis for novel forms of patient-tailored immunotherapy.

Adult↗
PubMed1998

[Lupus erythematosus/lichen ruber planus overlap syndrome. 5 cases in a patient sample of the Erlangen University Dermatology Clinic (1894-1995)].

The simultaneous occurrence of lupus erythematosus (LE)- and lichen ruber (LP)-like symptoms is called LE/LP-overlap syndrome (LE/LP-OS). It is defined by concomitant clinical, histologic and immunhistologic features of both diseases. To date, 47 cases of this rare dermatosis have been reported with marked differences in the skin lesions: They are either of intermediate appearance between LE and LP (type I = intermediate type), or show a coexistence of LE- and LP-specific lesions (type II = polar type). To determine the frequency and characteristics of the LE/LP-OS we reviewed our LE-patients from 1984-1995. 5 cases were diagnosed. The frequency of LE/LP-OS in our patients is higher than generally assumed. Due to its variable clinical, histological and immunhistological appearance and the lack of unequivocal pathognomonic signs, this overlap-dermatosis may be underdiagnosed. Since therapeutic consequences result from the diagnosis, criteria are suggested to facilitate the recognition of the LE/LP-OS.

Adult↗
PubMed1998

[Value of psychotherapy in expert assessment of skin diseases. Recommendations and indications for additional psychotherapy evaluation in expert assessment from the viewpoint of dermatology].

Skin diseases, the psyche and psychological changes are often intertwined, especially in patients presenting for expert dermatologic opinion. In many cases an additional evaluation provided by psychotherapeutic medicine may be necessary. This resource may help with the diagnosis, explanation of the problem and estimation of the degree of disability. The different legal guidelines of the various evaluation boards must be considered. The role of psychotherapeutic evaluation is demonstrated through case examples. The evaluation of new possibly occupationally-related disorders such as multiple chemical sensitivity and mobbing is considered.

Adult↗
PubMed1998

[Papillary cystadenoma of the minor salivary glands].

Papillary cystadenoma of the minor salivary glands is a rare benign tumor that clinically resembles a mucous cyst. We demonstrate its histologic features and differential diagnosis by a case report. Benign and malignant neoplasms of the minor salivary glands are not well acknowledged in the dermatologic literature, but should be considered in the differential diagnosis for mucous cysts.

Adult↗
PubMed1998

Graft-versus-host-like mucocutaneous eruptions with serological features of paraneoplastic pemphigus and systemic lupus erythematosus in a patient with non-Hodgkin's lymphoma.

A 63-year-old male patient spontaneously developed severe erosive orogenital mucositis, palmoplantar and gluteal inflammatory lesions resistant to therapy. The skin lesions clinically and histologically resembled lichen-planus-like graft-versus-host disease. Investigation for an underlying autoimmune or malignant disorder revealed a centrocytic-centroblastic low-grade non-Hodgkin's lymphoma (according to the Kiel classification) in the bone marrow, mesenterial and iliacal lymphoma. Serological titers were intermittently positive for ANA, anti-Sm/U1RNP, anti-Ro and anti-dsDNA. Immunoprecipitation of lysates from radiolabeled human keratinocytes with the patient's serum revealed circulating antibodies against 210-kD (desmoplakin II), 190- and 170-kD antigens but none against the 230-kD antigen or 250-kD desmoplakin I. Under cytostatic chemotherapy the lymphomas showed complete and long-lasting remission, whereas the mucocutaneous lesions persisted. Six years after diagnosis, the mucocutaneous lesions are sufficiently controlled by immunosuppressive therapy. In the presented case, several features of lymphoma-associated dysimmunoreactivity are assumed that bring about the intrinsic production of various autoantibodies typical of paraneoplastic pemphigus and systemic lupus erythematosus.

Diagnosis, Differential↗
PubMed1997

[Metageria--clinical manifestations of a premature aging syndrome].

A 19-year old caucasian patient suffered from ulceration and scaring of his fingers since age two. During childhood, fibrosing contractures on the phalanges developed. Since puberty, his eunuch-like stature, bird-like face and exophthalmos had become under obvious. His hair was extraordinarily fine; his pubic hair rare. Radiological examination revealed ankylosis and osteoporosis of the phalanges and carpals. Angiography showed occlusion of multiple digital and interdigital arteries. Furthermore, a bilateral posterior cataract, restrictive respiratory disease, impaired glucose tolerance, hyperuricemia, proteinuria and primary hypogonadism were diagnosed. These findings are characteristic for the premature aging syndromes. The cardial symptoms of tall stature, bird-like face, pseudoexophthalmos, skleroderma-like and poikiloderma-like cutaneous lesions, scarce hair growth, early diabetes mellitus and arteriosclerosis led to the diagnosis of metageria.

Adult↗
PubMed1997

Ectopic respiratory epithelium associated with multiple malformations.

We report a patient with unique cutaneous plaques of ectopic respiratory epithelium. The epithelium was located superficially as raised erythematous plaques on the right lateral surface of the neck with some viscous secretion. Underlying branchial cysts or sinuses were excluded. The occurrence of ectopic respiratory epithelium was associated with congenital deafness and a hare-lip in our patient, suggesting multiple malformation during early embryonic development.

Abnormalities, Multiple↗
PubMed1996

[Glossitis granulomatosa symptom of oligosymptomatic Melkersson-Rosenthal syndrome].

Atypical forms of Melkersson-Rosenthal syndrome are difficult to diagnose, especially when occurring in uncommon facial locations. The clinical and histological characteristics of these forms are illustrated in a typical case. We report our experiences with a 59-year-old white male who had increasing swelling of his tongue for years and a recent onset of perioral swelling. A plicated tongue was present, while symptoms of facial and trigeminal nerve involvement were absent. Minor symptoms present were speech impediments, dysgeusia, episodes of hypersalivation and burning sensations on eating. Biopsies revealed sarcoid and lymphonodular-plasmocytic granulomatous infiltrates. These findings were consistent with a diagnosis of an oligosymptomatic Melkersson-Rosenthal syndrome. Swelling of the tongue and that of the perioral region was controlled with clofazimine therapy.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1994

[Snake bite by a poisonous snake. Report of an unusual case].

We report on a 31-year-old white woman, who was bitten in her right calf by a "spitting cobra" (Neia nigricollis) during a safari in Tansania. Minor initial systemic symptoms such as nausea and vomiting were followed by severe oedematous swelling of the extremity after 2-3 h and demarcation of a 2.75 x 2.75 in. area of necrotic skin. The patient returned to her home country, where 8 days after the snake-bite necrosectomy was performed. Antibiotics, anti-inflammatory agents and local therapy with hydrocolloidal wound dressings were administered. With this therapy the lesion healed completely with minor scarring within 5 months. A new Salmonella strain was isolated from the ground of the ulcer.

Adult↗
PubMed1994

[Unilateral eyelid swelling in naevus flammeus faciei. Problems in differential diagnosis of unilateral eyelid swelling].

A 32-year-old white woman presented with persistent swelling of the right upper eyelid for diagnosis and therapy. History and physical examination revealed a faint nevus flammeus on the right side of her face and neck and bilateral blepharochalasis, both of which can produce unilateral periorbital swelling. A biopsy taken for histology was diagnostic in this case, since it showed lymphoedema secondary to lymphangiectasias associated with the patient's port-wine stain. Many other possible causes of unilateral lid swelling have to be considered and excluded before a definite diagnosis can be established. The differential diagnosis is discussed.

Adult↗
PubMed1992

Somatic mosaicism for a deletion of the dystrophin gene in a carrier of Becker muscular dystrophy.

Duchenne muscular dystrophy (DMD) and the allelic milder form of Becker muscular dystrophy (BMD) are caused by mutations of the dystrophin gene on the short arm of the X chromosome. One third of affected individuals are expected to result from de novo mutations. Genetic counselling of families with sporadic cases is complicated by the potential meiotic origin of the mutation in the mother resulting in germline mosaicism. Here we present direct evidence for combined somatic and germline mosaicism for a deletion of the dystrophin gene, thereby proving the mitotic origin of this deletion and pinpointing a further potential pitfall for genetic counselling. The mother of a BMD son and a BMD carrier daughter, both carrying a deletion of dystrophin cDNA 7 (0.5 kb Hind III fragment) and cDNA 8, was herself clinically healthy and had normal creatine kinase levels. A muscle specimen of the mother showed mild overall pathology as well as focal dystrophin deficiency. In contrast chromosomal in situ suppression (CISS) hybridization of metaphase chromosomes using a cosmid clone of the corresponding cDNA deleted in her son revealed no evidence of somatic mosaicism in their lymphocytes. These results emphasize the value of an approach correlating genetic and immunological data for the definition of a carrier state in BMD or DMD. The possibility of somatic mosaicism should be considered when genetic counselling of a family with a sporadic case of BMD or DMD is performed.

Blotting, Southern↗