Biomedical subjects
Publications and source records attributed to W Keilig.
A simple and reliable staining technique is described using the fluorescent brightener Blankophor BA which binds specifically to fungal cell wall components. Potential diagnostic applications are shown.
We report on a 60-year-old female patient with an ulcer on the left lower leg, which was treated for 2 years without success. Histologically, a biopsy specimen showed a partly fibrotic and partly solid basal cell epithelioma. When all of the patient's skin was examined, a small skin-colored nodule was found on her right lower leg that histologically also turned out to be a basal cell epithelioma. The patient had no history of predisposing factors like exposure to arsenic or actinic skin damage. Our case is compared with the literature and briefly discussed.
Fungal cultures, unstained smears and histological assessment of endoscopically obtained particles from ulcers in rectum, colon or terminal ileum were obtained in a prospective study of possible fungal infection in 78 patients with colitis of various aetiologies (Crohn's disease - 46; ulcerative colitis - 21; infectious colitis - 5; ischaemic colitis - 2; radiation colitis - 1; non-classifiable colitis - 3). Positive fungal culture was obtained in 13 patients (16.7%). The germ count was low (2--8 colonies per biopsy piece). The demonstrated fungi were almost exclusively Candida or Torulopsis. The potentially pathogenic mycelia phase of the fungi were never seen, either histologically or in unstained preparations. Stool specimens, obtained at the same time, were examined in 54 patients: positive cultures were obtained in 14 (25.9%). Only rarely were there concordance of positive fungal findings in both ulcer particles and faeces. It is concluded that (1) there is little danger of secondary fungal infection in colitis of various aetiologies; (2) positive faecal fungal culture is apparently of no pathogenic significance if the germ count is less than 10(6) per gram stool; (3) in the lower as well as the upper gastro-intestinal tract pathogenic fungal infection can be demonstrated only by endoscopy and biopsy.
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Contact allergic investigations in 2064 patch tested patients (1977-1981) showed that 3,9% had a contact allergy from cetylstearylalcohol (Lanette O). 453 of these patients suffered from stasis dermatitis and leg ulcer. 15% of these 453 patients had a contact allergy from Lanette O, whereas 85% of all patients with Lanette allergy suffered from stasis dermatitis with and without leg ulcers. A closer association between this contact-allergy and these diseases is therefore indicated. Further problems arise due to the presence of cetylstearylalcohol in numerous topical preparations (examples are given) and the often incomplete declaration of the bases and ingredients.
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A case report is given of a 56-year-old female patient with a postthrombotic leg ulcer and stasis dermatitis, in whom contact dermatitis to a dexpanthenol-containing ointment was first described in 1965. Recent allergy testing confirmed this finding and revealed positive reactions to the pure substance dexpanthenol as well as to two additives. Based on this case history the importance of dexpanthenol as an allergen is discussed.