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Jockenhofer F.,University of Duisburg - Essen | Gollnick H.,Otto Von Guericke University of Magdeburg | Herberger K.,University of Hamburg | Isbary G.,Allergology and Environmental Medicine | And 8 more authors.
JDDG - Journal of the German Society of Dermatology | Year: 2013

Background: In almost every chronic wound different bacteria species can be detected. Patients and methods: Retrospective, multicenter evaluation of bacterial swab results from 2010 and 2011 in patients with chronic leg ulcer treated in 10 dermatologic wound care centers from 5 regions in Germany. Results: Data of 970 patients were analyzed. Staphylococcus aureus was detected in 47.6 % of the patients, 8.6% of these were methicillin-resistant (MRSA). Pseudomonas aeruginosa was found in 31.1 %, enterobacteria in 28.6 % and Proteus mirabilis in 13.7 % of the patients. The regional comparison showed a significant south-north gradient for S. aureus, P. aeruginosa, and enterobacteria. Moreover, a highly significant west-east gradient for MRSA was found with detection rates of 13.5 % in the west to 4.0 % in the east. Furthermore, nationally there was a significant negative correlation between S. aureus and P. aeruginosa or P. mirabilis, respectively, as well as a positive correlation of P. aeruginosa with respect to wound size and duration. In addition to climatic and therapeutic conditions, different regional health care structures are discussed as potentially relevant reasons for these significantly different regional detection rates. Conclusions: Our data show the regional variability of the spectrum of currently detected bacteria in patients with chronic leg ulcers in Germany. © The Authors | Journal compilation © Blackwell Verlag GmbH, Berlin.

Kuhn A.,University of Munster | Kuhn A.,Heinrich Heine University Düsseldorf | Wozniacka A.,Medical University of Lódz | Szepietowski J.C.,Wroclaw Medical University | And 12 more authors.
Journal of Investigative Dermatology | Year: 2011

Photosensitivity is an important and distinguishing sign in various subtypes of cutaneous lupus erythematosus (CLE); however, it remains poorly defined. The purpose of this study was to evaluate whether standardized photoprovocation is a reproducible method to assess photosensitivity in subjects with CLE. A total of 47 subjects with CLE (subacute cutaneous lupus erythematosus (SCLE), n14; discoid lupus erythematosus (DLE), n20; lupus erythematosus tumidus (LET), n13) and 13 healthy volunteers underwent photoprovocation at seven European sites. Of these, 22 (47%) subjects (57% SCLE, 35% DLE, and 54% LET) and none of the healthy volunteers developed photoprovoked lesions according to clinical analysis. Of these 22 subjects, 19 (86%) developed lesions that were histopathologically confirmed as specific for lupus erythematosus (LE). In CLE subjects who developed UV-induced lesions, 86% had Fitzpatrick's phototypes I or II, and the mean minimal erythema dose (MED) was significantly lower compared with subjects without UV-induced lesions (P0.004). No significant differences in photoprovocation results were observed between study sites. Safety parameters showed no clinically meaningful differences between CLE subjects and healthy volunteers after photoprovocation. In conclusion, a standardized, safe, and reproducible protocol for photoprovocation using UVA and UVB radiation induced skin lesions in approximately half of all CLE subjects and showed comparable results across multiple sites. This method may therefore be used for future diagnostic testing and clinical trials. © 2011 The Society for Investigative Dermatology.

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