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Fioravanti V.,University of Bremen | Chandrashekar S.,University of Bremen | Brandhoff L.,University of Bremen | Pucciarelli D.,Medical University of Vienna | And 5 more authors.
Progress in Biomedical Optics and Imaging - Proceedings of SPIE | Year: 2015

We present an infrared biopsymeter to assist pathologists in the diagnosis of melanoma presence in skin biopsies. The designed and realized system combines the features of visual inspection and physical sensing to reduce false positives and false negatives occurring during standard histopathological analyses. The biopsymeter determines the CH2-stretch ratio by infrared absorbance measurements of skin biopsies. Investigations conducted with the biopsymeter shows that malignant melanomas and melanoma metastases have higher CH2-stretch ratio values compared to healthy skin tissues. © 2015 SPIE.


Trautinger F.,Karl Landsteiner Institute of Dermatological Research | Trautinger F.,Medical University of Vienna | Just U.,Medical University of Vienna | Knobler R.,Medical University of Vienna
Photochemical and Photobiological Sciences | Year: 2013

Photopheresis is a form of phototherapy where specialized equipment is used to isolate a leukocyte fraction from the peripheral blood which is then exposed to photoactivated 8-methoxypsoralen and reinfused into the patient. At the time of its invention the treatment was conceptually based on the hypothesis of T cell vaccination, i.e. the observation in experimental studies that exposure of the immune system to physically modified T cell clones leads to a specific inhibition of T cell mediated autoimmunity. Consequently, photopheresis has been tried in a variety of conditions where T cells are thought to have a critical role and has shown clinical efficacy mainly in variants of cutaneous T cell lymphomas, graft-versus-host disease, systemic sclerosis, in solid organ transplant rejection and Crohn's disease. Evidence has accumulated that alterations in antigen presentation and the generation of regulatory T cells are induced by photopheresis and might be related to the observed clinical effects. Summarizing what has been published in the 25 years since its introduction into the clinic, photopheresis to date has found its place in the treatment of the above mentioned conditions as a well tolerated treatment option that can safely be combined with other established modalities. It can be expected that further research will help refine its clinical indications and close the gaps that still exist in our knowledge on when, how, and why photopheresis works. This journal is © 2013 The Royal Society of Chemistry and Owner Societies.


Eder J.,Health Science University | Eder J.,Karl Landsteiner Institute of Dermatological Research | Prillinger K.,Health Science University | Prillinger K.,Karl Landsteiner Institute of Dermatological Research | And 5 more authors.
British Journal of Dermatology | Year: 2014

Background Actinic keratoses (AKs) are common precursors of squamous cell carcinomas (SCCs) of the skin making them an important public health issue with information on their prevalence widely lacking. Objectives To define the prevalence of AK in dermatology outpatients in Austria and to identify more accurately the target population for AK screening, treatment and prevention. Methods Each of the 48 randomly selected Austrian office-based dermatologists simultaneously screened 100 consecutive patients (aged ≥ 30 years) for the presence of AK. Results In total, 4449 evaluable patients showed an overall AK prevalence of 31·0%, which was higher in men (39·2%) than in women (24·3%) and increased with age in both sexes. AK distribution among sun-exposed body sites and extent of disease varied with sex and region. Conclusions In Austria, AKs are common among dermatology outpatients, who have access to professional education and treatment. Investigations regarding the efficacy of routine AK screening in dermatology outpatients for the prevention of invasive SCC is warranted. What's already known about this topic? AKs are common precursor lesions of SCC with prevalence data originating mostly from Australia and the U.S.A. What does this study add? In Austria, one-third of dermatology outpatients have AK. Chronically sun-exposed body sites of older men are particularly affected. Adult dermatology outpatients are a suitable target population for AK screening, treatment and prevention. © 2014 British Association of Dermatologists.


Eder J.,Karl Landsteiner Institute of Dermatological Research | Hlavin G.,Medical University of Vienna | Haushofer A.,Institute of Laboratory Medicine | Trubert-Exinger D.,Institute of Laboratory Medicine | Trautinger F.,Karl Landsteiner Institute of Dermatological Research
JDDG - Journal of the German Society of Dermatology | Year: 2012

Background: Procalcitonin (PCT) is a specific biomarker for early detection of bacterial infections. While the usefulness of procalcitonin in severe conditions such as sepsis is well established, its relevance in the diagnosis and prognosis of localized cutaneous bacterial infections is unknown. Our aim was to initially evaluate if PCT is a useful parameter for predicting the severity of skin and skin structure infections (SSSI). Furthermore, the correlation of PCT levels with C-reactive protein (CRP), leukocyte counts, erythrocyte sedimentation rate (ESR), and body temperature was investigated. Patients and Methods: Serum PCT, routine laboratory parameters, and body temperature were regularly examined in 50 consecutive patients with SSSI requiring inpatient intravenous antibiotic treatment. Patients were classified into 2 groups according to the guidelines developed by the FDA (U.S. Food and Drug Administration) as having either an uncomplicated (SSSI) or a complicated skin and skin structure infection (cSSSI). Results: No significant correlation could be detected between the length of inpatient antibiotic treatment and PCT on days 1, 2, 3, and the maximum value on these days. The same result was found when uncomplicated SSSI and complicated SSSI (cSSSI) were evaluated separately. However, PCT levels were significantly higher in the latter. Furthermore, PCT levels showed a significant correlation with CRP, leukocyte count, ESR, and body temperature. Conclusion: PCT might be a useful additional tool for initial diagnosis and monitoring of patients with SSSI. © Blackwell Verlag GmbH, Berlin.


Ashjaei K.,Medical University of Vienna | Bublin M.,Medical University of Vienna | Smole U.,Medical University of Vienna | Lengger N.,Medical University of Vienna | And 4 more authors.
International Archives of Allergy and Immunology | Year: 2015

Background: Dendritic cells (DCs) play an important role in the induction and regulation of adaptive immune responses by polarizing T-helper (Th) cells. In allergic disease this response is dominated by Th2 cells. It is still unclear whether the activation of Th cells by DCs in atopic individuals is allergen specific. Methods: Monocyte-derived DCs (MoDCs) obtained from polysensitized patients were stimulated with purified Bet v 1, Phl p 5 and Act d 10, and the surface marker expression was analysed. Proliferation and cytokine profiles of autologous naïve CD4+ T cells co-cultured with allergen-pulsed MoDCs were assessed. Results: The addition of either Bet v 1 or Phl p 5 did not further increase the expression of surface markers from matured MoDCs in all study groups. In co-cultures, autologous naïve CD4+ T cells proliferated when DCs obtained from individuals allergic to birch and grass pollen were stimulated with Bet v 1 and Phl p 5, respectively. In the co-culture supernatants, significantly increased levels of IL-5 and IL-13 were detected. This effect correlated with the sensitization background and was absent when applying an unspecific allergen, Act d 10. The levels of IL-10 in supernatants of MoDCs and the levels of IL-10 and IFN-γ in supernatants of T cells remained unchanged upon stimulation with allergens. Conclusions: In this study we observed that allergen-specific stimulation of MoDCs induces T-cell proliferation and upregulation of Th2-type cytokines. Interestingly, this Th2 polarization was only observed in cells stimulated with the allergen to which the patients were sensitized. © 2015 S. Karger AG, Basel.


Der-Petrossian M.,Medical University of Vienna | Valencak J.,Medical University of Vienna | Jonak C.,Medical University of Vienna | Klosner G.,Medical University of Vienna | And 5 more authors.
Journal of the European Academy of Dermatology and Venereology | Year: 2011

Background The Langerhans cell (LC) hypothesis suggests that cutaneous T-cell lymphomas (CTCL) are diseases of chronic T-cell stimulation by LC-mediated antigen presentation. Objective To investigate a broad panel of CTCL and cutaneous B-cell lymphomas (CBCL) for the spatial association of langerin + dendritic cells (DC) with T and B cells in the skin, respectively. Methods Fifty-five specimens of CTCL and 10 of CBCL were double-stained with monoclonal antibodies against langerin and CD3 or CD20, respectively, and evaluated by confocal laser scan microscopy. Results Dermal infiltrates in mycosis fungoides (n = 38), primary cutaneous CD4+ small/medium-sized pleomorphic T-cell lymphoma (n = 3) and primary cutaneous peripheral T-cell lymphoma, unspecified (n = 3) were characterized by a high frequency of dermal langerin + DCs. These cells were exclusively present in the malignant infiltrates. No direct co-localization of CD3 and langerin could be resolved. Dermal langerin + cells were detected only in one of six primary cutaneous anaplastic large cell lymphomas (C-ALCL), characterized by epidermotropism. In other C-ALCL cases (five of six), in lymphomatoid papulosis (n = 3), subcutaneous panniculitis-like T-cell lymphoma (n = 2), and all variants of CBCL no dermal langerin + DCs could be found. Conclusions Langerin + DCs are abundant in the dermal infiltrates of T-cell lymphomas with specific involvement of the epidermis. This might indicate that immature LC and neoplastic T cells interact and gives rise to further studies to characterize the phenotype of the langerin + cell population described here and its role in the pathology of CTCL. © 2010 The Authors.


Eder J.,Karl Landsteiner Institute of Dermatological Research | Eder J.,Health Science University | Kern A.,Karl Landsteiner Institute of Dermatological Research | Kern A.,Health Science University | And 6 more authors.
Journal of the European Academy of Dermatology and Venereology | Year: 2015

Background Primary cutaneous lymphomas (PCL) are a heterogenous group of rare lymphoid neoplasms with incomplete information on global and regional prevalence. The recently introduced lymphoma classifications define distinctive clinicopathological disease entities that should allow for more accurate epidemiological assessment. Objective The aim of this study was to evaluate the prevalence and clinical spectrum of PCL diagnosed and treated at the Department of Dermatology and Venereology in St. Pölten, Lower Austria, a dermatology referral centre providing secondary and tertiary care for a population of about 600 000. Methods In this retrospective study pathology reports, electronically archived between 2006 and 2013, were screened for the terms lymphoma, mycosis fungoides (MF) and lymphomatoid papulosis (LyP). Patients were diagnosed according to the current WHO-EORTC classification for cutaneous lymphomas and results were compared with data from European, US and Asian centres. Results Among 86 patients with PCL (age 58.3 ± 17.35 years, mean ± SD; women 38%, n = 33; men 62%, n = 53) 83% (n = 71) were classified as cutaneous T-cell lymphomas (CTCL) and 17% (n = 15) as cutaneous B-cell lymphomas (CBCL). Nine patients with CTCL showed associated haematological disorders and malignomas. Among 47 MF patients following variants were observed: pilotropic MF (n = 2), follicular mucinosis (n = 1), unilesional MF (n = 1), large-cell transformation (n = 3), erythrodermic MF (n = 1), poikilodermatous MF (n = 2) and posttransplant lymphoproliferative disorder (CD8+ MF with gamma/delta phenotype after renal transplantation) (n = 1). One patient had MF concurrent with lymphomatoid papulosis. The group of CBCL comprised six cases (40%) of PCMZL and PCFCL each, 20% (n = 3) were classified as PCLBCL, LT. Conclusion This study for the first time provides data on the distribution of PCL clinicopathologic variants and stages according to the latest classification and staging systems in an Austrian referral centre. © 2015 European Academy of Dermatology and Venereology.


Eder J.,Karl Landsteiner Institute of Dermatological Research | Eder J.,Health Science University | Kammerstatter M.,Karl Landsteiner Institute of Dermatological Research | Kammerstatter M.,Health Science University | And 5 more authors.
Acta Dermato-Venereologica | Year: 2016

There is currently no information available on illness perception in primary cutaneous T-cell lymphomas (CTCL). The aim of this study was therefore to gather initial information on disease understanding and interpretation in patients with CTCL. Consecutive patients from a hospital-based primary cutaneous lymphoma ward completed the Revised Illness Perception Questionnaire (IPQ-R) on 2 consecutive visits. A total of 24 patients with different variants of CTCL were included in the study. Patients experienced their condition as being long-lasting, but not fundamentally affecting their lives. Patients had poor belief in personal control, but strong belief in treatment control. They did not show a good understanding of their disease, and had a moderately negative emotional response to their illness. In conclusion, the IPQ-R provides a feasible and reproducible tool for measurement and better understanding of illness perception in patients with CTCL. Knowledge of patients’ attitudes towards their disease should enable optimization of the patient-physician relationship and patient care. © 2016 The Authors.


Eder J.,Karl Landsteiner Institute of Dermatological Research | Simonitsch-Klupp I.,Medical University of Vienna | Trautinger F.,Karl Landsteiner Institute of Dermatological Research
European Journal of Dermatology | Year: 2013

Background: Non-melanoma skin cancer (NMSC), including squamous cell carcinoma (SCC) and basal cell carcinoma (BCC), is the most common malignancy. Unresectable or metatstaticSCCis rare and therapy can be difficult because of advanced age and comorbidities. Targeted therapy with monoclonal antibodies (mAbs) against EGFR is an option in these patients. Objective: The aim of this presentation is to provide additional evidence on the safety of anti-EGFR mAbs in long-term palliation and adjuvant treatment of advanced SCC. Materials and Methods: This is a retrospective analysis of 4 patients with locally advanced or metastatic SCC who received cetuximab and/or panitumumab. Results: 3 patients (2 females, 1 male, ages 86 to 93) received cetuximab for the treatment of unresectable SCC. In 2 patients partial remissions were achieved and maintained with continuous treatment for 17 and 18 months. Another patient achieved complete remission after 16 cetuximab treatments and is still free of disease with ongoing therapy after an overall observation period of 16 months. In a fourth patient, with recurrent loco-regional metastatic disease of the scalp and neck, adjuvant cetuximab followed by panitumumab was introduced after extensive surgery. 2 patients had a grade II-III skin rash successfully treated with topical erythromycin, systemic doxycyclin and dose modification. Conclusion: Cetuximab is suitable for palliation in elderly patients, able to maintain remissions and prevent disease progression over extended periods of continuing treatment without significant toxicity. Furthermore, adjuvant anti-EGFR therapy may be a promising treatment strategy in patients with a high risk of recurrence.


PubMed | Karl Landsteiner Institute of Dermatological Research
Type: Case Reports | Journal: European journal of dermatology : EJD | Year: 2013

Non-melanoma skin cancer (NMSC), including squamous cell carcinoma (SCC) and basal cell carcinoma (BCC), is the most common malignancy. Unresectable or metatstatic SCC is rare and therapy can be difficult because of advanced age and comorbidities. Targeted therapy with monoclonal antibodies (mAbs) against EGFR is an option in these patients.The aim of this presentation is to provide additional evidence on the safety of anti-EGFR mAbs in long-term palliation and adjuvant treatment of advanced SCC.This is a retrospective analysis of 4 patients with locally advanced or metastatic SCC who received cetuximab and/or panitumumab.3 patients (2 females, 1 male, ages 86 to 93) received cetuximab for the treatment of unresectable SCC. In 2 patients partial remissions were achieved and maintained with continuous treatment for 17 and 18 months. Another patient achieved complete remission after 16 cetuximab treatments and is still free of disease with ongoing therapy after an overall observation period of 16 months. In a fourth patient, with recurrent loco-regional metastatic disease of the scalp and neck, adjuvant cetuximab followed by panitumumab was introduced after extensive surgery. 2 patients had a grade II-III skin rash successfully treated with topical erythromycin, systemic doxycyclin and dose modification.Cetuximab is suitable for palliation in elderly patients, able to maintain remissions and prevent disease progression over extended periods of continuing treatment without significant toxicity. Furthermore, adjuvant anti-EGFR therapy may be a promising treatment strategy in patients with a high risk of recurrence.

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