Praxis fur Dermatologie

München, Germany

Praxis fur Dermatologie

München, Germany
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Leidinger P.,Saarland University | Keller A.,Febit Biomedical gmbh | Keller A.,Biomarker Discovery Center Heidelberg | Borries A.,Febit Biomedical gmbh | And 5 more authors.
BMC Cancer | Year: 2010

Background: MicroRNA (miRNA) signatures are not only found in cancer tissue but also in blood of cancer patients. Specifically, miRNA detection in blood offers the prospect of a non-invasive analysis tool.Methods: Using a microarray based approach we screened almost 900 human miRNAs to detect miRNAs that are deregulated in their expression in blood cells of melanoma patients. We analyzed 55 blood samples, including 20 samples of healthy individuals, 24 samples of melanoma patients as test set, and 11 samples of melanoma patients as independent validation set.Results: A hypothesis test based approch detected 51 differentially regulated miRNAs, including 21 miRNAs that were downregulated in blood cells of melanoma patients and 30 miRNAs that were upregulated in blood cells of melanoma patients as compared to blood cells of healthy controls. The tets set and the independent validation set of the melanoma samples showed a high correlation of fold changes (0.81). Applying hierarchical clustering and principal component analysis we found that blood samples of melanoma patients and healthy individuals can be well differentiated from each other based on miRNA expression analysis. Using a subset of 16 significant deregulated miRNAs, we were able to reach a classification accuracy of 97.4%, a specificity of 95% and a sensitivity of 98.9% by supervised analysis. MiRNA microarray data were validated by qRT-PCR.Conclusions: Our study provides strong evidence for miRNA expression signatures of blood cells as useful biomarkers for melanoma. © 2010 Leidinger et al; licensee BioMed Central Ltd.

Leupold D.,LTB Lasertechnik Berlin | Scholz M.,LTB Lasertechnik Berlin | Stankovic G.,LTB Lasertechnik Berlin | Reda J.,LTB Lasertechnik Berlin | And 7 more authors.
Pigment Cell and Melanoma Research | Year: 2011

Malignant transformation of melanocytes is associated with changes in melanogenesis. Therefore, fluorescence of melanin may be an informative indicator of this process. But the conventionally excited autofluorescence of melanin in skin tissue is ultra-weak and its main part in the visible spectral region is hidden by the much stronger fluorescence from other endogenous fluorophores. Here, using a new mode of stepwise two-photon excitation, melanin-dominated fluorescence spectra of pigmented skin lesions are reported. From these, pure melanin fluorescence spectra of normal pigmented skin, melanocytic nevi and malignant pigmented melanoma were analyzed. They show distinctly different spectral shapes: melanoma gave a characteristic fingerprint with a fluorescence band peaking at 640nm, independent of the melanoma subtype. The melanin fluorescence spectra peaked at 590nm for all types of common melanocytic nevi. These differences in the fluorescence spectra are probably based on different contents of eumelanin and pheomelanin. In a series of 167 cases with melanocytic nevi and melanomas, the sensitivity of this new method to diagnose melanoma was 93.5%, the specificity 80.0% and the diagnostic accuracy 82.6%. The two-photon excitation fluorescence method is a new diagnostic tool which may in future supplement conventional dermatohistopathology. © 2011 John Wiley & Sons A/S.

Prager W.,Prager and Partner | Bee E.K.,Praxis fur Dermatologie | Havermann I.,Prager and Partner | Zschocke I.,SCIderm GmbH
Dermatologic Surgery | Year: 2015

METHODS: Subjects (n = 23) with 2 to 4 platysmal bands (scoring ≥1 on a newly validated 5-point assessment scale) were enrolled. IncobotulinumtoxinA (15 U) was administered to each band. Assessments, using the 5-point scale, occurred at 6 posttreatment visits over 5 months. Adverse events were recorded and subjects self-Assessed the appearance of their platysmal bands versus baseline.RESULTS: At maximum tension, a response (≥1-point improvement from baseline score) was observed in 65.2% of subjects 3 (±1) days posttreatment, rising to 100% on Day 8 (±1). The change from baseline in the mean score was significant at each time point, including the final visit (Weeks 20-21). Response rates were higher at maximum tension than at rest. The peak effect occurred later at rest than at maximum tension. No serious adverse event occurred. At maximum tension, 69.6%, 73.9%, and 68.2% of subjects rated their platysmal bands as "improved" or "markedly improved" at Visits 2, 3, and 4, respectively.CONCLUSION: IncobotulinumtoxinA is an effective and well-tolerated treatment for platysmal bands, with a rapid onset and long duration of effect.BACKGROUND: IncobotulinumtoxinA improves the appearance of facial rhytides and the aging neck.OBJECTIVE: To investigate the efficacy, safety, and subject satisfaction of incobotulinumtoxinA for platysmal band treatment. © 2014 by the American Society for Dermatologic Surgery, Inc.

Blum J.,Swiss Tropical and Public Health Institute | Pletscher M.,Praxis fur Dermatologie
Therapeutische Umschau | Year: 2013

The most frequently observed skin lesions in travellers returning from tropical countries are insect bite reactions, bacterial skin diseases, creeping eruption and allergic reactions. The article describes these most relevant diseases and their differential diagnosis focussing on the diseases, which are potentially dangerous and which should not be missed, such as resistant staphylococci, chancre of rickettsia or sleeping sickness, cutaneous leishmaniasis or worms, which are not limited to the skin. © 2013 Verlag Hans Huber, Hogrefe AG, Bern.

Excision of a facial tumor may result in a wound that affects multiple aesthetic units. It is advisable to approach such a complicated defect by planning the wound closure for each aesthetic unit individually. In a second step these distinct designs should be integrated into a master plan. This method facilitates the restoration of the important borders between the aesthetic units. We illustrate this concept by reconstructing a defect of the nasal ala, the cheek and the upper lip. © GeorgThieme Verlag KG. Stuttgart. New York.

Diagnosis and therapy of toenail fungus is usually based on diagnosis by sight and external therapy measures using antifungal solutions, cream or nail polish. Despite this, onychomycosis is very often not successfully treated and onycholysis, onychodystrophy and secondary complications like infections and erysipelas can occur. As final consequence internal therapy regimens with mid- to long-term systemic antifungals are necessary. Today, for rapid diagnosis a novel method by optical coherence tomography (OCT) and a new therapy regimen applying the pinpointe footlaser with infrared emission (1064 nm) can be seen as a revolutionary step. The authors have treated more than 300 patients successfully and offer here their optimized therapy regimen using the pinpointe footlaser for total cure of severe cases with onychomycosis. No adverse effects have been observed. For fast recovery, a long term external application of antifungal cream - every other day - is recommended to protect the compromised nails from re-infec-tion. The monitoring by use of optical coherence tomography (OCT) is highly advantageous to observe and prevent from minimal disease.

Prager W.,Dermatologikum Hamburg | Bee E.K.,Praxis fur Dermatologie | Havermann I.,Dermatologikum Hamburg | Zschocke I.,SCIderm
Clinical Interventions in Aging | Year: 2013

Background: IncobotulinumtoxinA (Bocouture®) is free from complexing proteins and effective for treating glabellar frown lines. Purpose: To determine the efficacy, onset, and duration of action of incobotulinumtoxinA for the treatment of glabellar frown lines. Patients and methods: In this single-arm, prospective, proof-of-concept study, 23 patients were treated with 25 U incobotulinumtoxinA, equally split between five injection sites in the glabella. Severity of glabellar frown lines was rated by an independent rater from standardized photographs using the validated Merz 5-point scale at several visits over 5 months following treatment. To assess patient satisfaction, patients completed a questionnaire before and 2 weeks after treatment. Results: The percentage of responders at maximum frown 2-4 days after treatment was 95.2% and 85.0% when responders were defined as patients with $1-point and $2-point improvement on the 5-point scale compared with baseline, respectively. At this time point, 84% of the maximum effect had occurred. The responder rate at maximum frown, according to both definitions, was 100% for at least the next two visits (days 8 ± 1 and 14 ± 2). At all visits, the change from baseline in the mean glabellar frown-line score at maximum frown was statistically significant, with on average an almost 1-point improvement from baseline 5 months after treatment. Conclusion: IncobotulinumtoxinA is an effective and well-tolerated treatment for glabellar frown lines, with a rapid onset of action and a long duration of effect lasting for more than 5 months. © 2013 Prager et al, publisher and licensee Dove Medical Press Ltd.

Sattler G.,Rosenpark Klinik | Callander M.J.,Face and Body Clinic | Grablowitz D.,Medizinisch Isthetisches Zentrum | Walker T.,Privatpraxis fur Hautkrankheiten | And 4 more authors.
Dermatologic Surgery | Year: 2010

Background Use of botulinum toxin for esthetic purposes has rapidly expanded over the last 20 years. IncobotulinumtoxinA, also known as NT 201, is a new botulinum toxin type A (150 kDa) that is free from complexing proteins. ObjectiveS A prospective, multicenter, randomized, rater- and patient-blind, international Phase III trial to investigate the noninferiority of incobotulinumtoxinA to another botulinum toxin type A, onabotulinumtoxinA, in the treatment of glabellar frown lines. Methods A total of 381 patients were randomized in a 3:1 (incobotulinumtoxinA:onabotulinumtoxinA) ratio to receive 24 U incobotulinumtoxinA of or onabotulinumtoxinA. Efficacy end points included the percentage of responders (patients with an improvement of ≥1 point on a 4-point facial wrinkle scale) at maximum frown at weeks 4 and 12 as assessed by the investigators, and a panel of independent raters based on standardized digital photographs. Results Four weeks after injection, response rates at maximum frown were 96.4% in the incobotulinumtoxinA group and 95.7% in the onabotulinumtoxinA group as assessed by independent raters. Analysis of the data confirmed the noninferiority of incobotulinumtoxinA. Response rates at rest were lower for both products. The rate of adverse events was low. Conclusion IncobotulinumtoxinA is equally as effective as onabotulinumtoxinA in the treatment of glabellar frown lines. Both preparations were well tolerated. © 2010 by the American Society for Dermatologic Surgery, Inc.

In the course of the disease practically every diabetic patient will develop skin lesions that can be attributed to diabetes mellitus. On account of the reduced immune defense a diabetic patients is markedly more susceptible to mycotic and bacterial infections. Clinical changes due to dermatophytes initially appear mostly on the feet, whereby the colonization of yeasts occurs in particular in those areas of the body where there is skin to skin contact. Erythrasma constitutes the most common bacterial infection among diabetic patients. Triggering factors are, beside inadequate hygiene and heavy sweating, also overweight. The skin rash, erysipelas, manifests as a sharply delineated area, often tongue-shaped, of reddening. Starting point is a skin defect, e.g., a discrete interdigital mycosis, that may serve as entry point for the bacterial infection. Skin diseases that frequently occur together with diabetes mellitus are granulomatous inflammatory lesions such as necrobiosis lipoidica and annular granulomas. Severe itching due to a progressive drying out of the skin is also a common symptom among diabetic patients, for instance psoriasis as well as efflorescences and reddening of the skin. Antidiabetic agents very rarely lead to allergic exanthemas or local allergic reactions.

PubMed | University of Tübingen, UniversitAtsSpital Zurich, Deutscher Neurodermitisbund DNB e. V., Praxis fur Kinderpneumologie und Allergologie and 15 more.
Type: | Journal: Allergo journal international | Year: 2016

Atopic dermatitis (AD) represents a pruritic, non-contagious, chronic or chronically relapsing, inflammatory skin disease. The course of the disease may be complicated by bacterial or viral superinfections. The first manifestation of the disease and further flare-ups are due to genetic predisposition and also to a variety of further trigger factors. The therapy regimen should be adapted to disease symptoms that are actually present and consider individual features of the disease as reported by the patients or their parents. This short version of the German guideline on AD provides an overview of evidence-based diagnostic and treatment options. All recommendations made here are the result of a consensus of the scientific medical societies, working groups and support groups based on scientific data published to date. Abstracts and details of the studies cited are provided in the long version of this guideline (see:

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