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1.
Hautarzt ; 68(3): 199-203, 2017 Mar.
Artigo em Alemão | MEDLINE | ID: mdl-28074214

RESUMO

BACKGROUND: A giant condyloma acuminatum which shows destructive growth but lacking invasion is designated as a Buschke-Lowenstein tumor (BLT). OBJECTIVES: Classification of the BLT and therapeutic guidelines are provided. MATERIALS AND METHODS: A MEDLINE literature search from 2006-2016 was performed. RESULTS: Induction through low-risk mucosotropic human papillomavirus (HPV) infection separates BLT from verrucous carcinoma. In the last 10 years, slightly more than 100 new cases have been described. Invasion as a true sign of malignancy was described in 12% of cases. HIV infection was observed in 14%. As invasion often occurs only focally and may only be detected after complete resection, BLT must be treated and considered as a low grade in situ epithelial cancer that evolves from condylomata acuminata. Diagnosis is confirmed by HPV detection and typical histology. CT scans are recommended to rule out deeper invasion. Organ preservation surgery remains the recommended therapy. CONCLUSIONS: Buschke-Lowenstein tumors represent low grade epithelial in situ carcinomas which evolved from condylomata acuminata. Focal invasion is frequent but metastases occur only rarely. Organ preservation surgery is recommended.


Assuntos
Tumor de Buschke-Lowenstein/epidemiologia , Tumor de Buschke-Lowenstein/cirurgia , Procedimentos Cirúrgicos Dermatológicos/estatística & dados numéricos , Tratamentos com Preservação do Órgão/estatística & dados numéricos , Papillomaviridae/isolamento & purificação , Tumor de Buschke-Lowenstein/diagnóstico , Procedimentos Cirúrgicos Dermatológicos/métodos , Diagnóstico Diferencial , Medicina Baseada em Evidências , Humanos , Prevalência , Fatores de Risco , Resultado do Tratamento
2.
Hautarzt ; 68(Suppl 1): 6-10, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28197697

RESUMO

The second part of this publication deals with varicella zoster virus (VZV) and presents an overview of new, rare, and atypical clinical manifestations, including photolocalized varicella, hemorrhagic bullae during varicella, the implication of VZV in immunoglobulin A vasculitis, VZV-related alopecia, ulcerative varicella skin lesions, childhood herpes zoster (HZ), prolonged prodromal pains, recurrent HZ, VZV implication in burning mouth syndrome, verruciform VZV lesions, the significance of satellite lesions during HZ, and late HZ complications, either neurological or internal. Furthermore, certain associations between the occurrence of HZ and subsequent internal pathologies, as well as risk factors for HZ and new developments in vaccination against HZ will be addressed.


Assuntos
Herpesvirus Humano 3/patogenicidade , Infecção pelo Vírus da Varicela-Zoster/virologia , Adulto , Criança , Pré-Escolar , Citosina/análogos & derivados , Citosina/uso terapêutico , Vacina contra Herpes Zoster/uso terapêutico , Humanos , Lactente , Terapia com Luz de Baixa Intensidade , Pessoa de Meia-Idade , Organofosfonatos/uso terapêutico , Nucleosídeos de Pirimidina/uso terapêutico , Recidiva , Fatores de Risco , Infecção pelo Vírus da Varicela-Zoster/diagnóstico , Infecção pelo Vírus da Varicela-Zoster/tratamento farmacológico , Virulência
3.
Hautarzt ; 68(Suppl 1): 1-5, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28197698

RESUMO

This review on herpes simplex virus type I and type II (HSV­I, HSV­II) summarizes recent developments in clinical manifestations and treatment interventions for primary and recurrent orolabial and genital herpes, as well as those regarding vaccination issues. Among the clinical presentations, the relationship between pyogenic granuloma and chronic HSV­I infection; HSV-related folliculitis; verrucous HSV­I and HSV­II lesions; the role of recurrent HSV­I infection in burning mouth syndrome; HSV­I and HSV­II infection of the periareolar area; zosteriform HSV; the "knife-cut sign"; and the preferential colonization and infection of preexisting dermatoses by HSV­I or HSV­II are discussed. The usual antiviral treatment regimens for primary and recurrent orolabial and genital herpes are compared to short-term and one-day treatment options. New anti-HSV­I and anti-HSV­II agents include amenavir, pritelivir, brincidofovir, valomaciclovir, and FV-100. Therapeutic or preventive vaccination against HSV­I and HSV­II infections still remains a highly desirable treatment aim, which, unfortunately, has no clinically relevant applications to date.


Assuntos
Herpes Simples/virologia , Herpesvirus Humano 1/patogenicidade , Herpesvirus Humano 2/patogenicidade , Aciclovir/uso terapêutico , Antivirais/uso terapêutico , Síndrome da Ardência Bucal/diagnóstico , Síndrome da Ardência Bucal/tratamento farmacológico , Síndrome da Ardência Bucal/virologia , Herpes Genital/diagnóstico , Herpes Genital/tratamento farmacológico , Herpes Genital/virologia , Herpes Labial/diagnóstico , Herpes Labial/tratamento farmacológico , Herpes Labial/virologia , Herpes Simples/diagnóstico , Herpes Simples/tratamento farmacológico , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Recidiva , Estomatite Herpética/diagnóstico , Estomatite Herpética/tratamento farmacológico , Estomatite Herpética/virologia , Vacinação , Virulência , Zoster Sine Herpete/diagnóstico , Zoster Sine Herpete/tratamento farmacológico , Zoster Sine Herpete/virologia
4.
Hautarzt ; 68(3): 181-186, 2017 Mar.
Artigo em Alemão | MEDLINE | ID: mdl-28197699

RESUMO

This review on herpes simplex virus type I and type II (HSV-I, HSV-II) summarizes recent developments in clinical manifestations and treatment interventions for primary and recurrent orolabial and genital herpes, as well as those regarding vaccination issues. Among the clinical presentations, the relationship between pyogenic granuloma and chronic HSV-I infection; HSV-related folliculitis; verrucous HSV-I and HSV-II lesions; the role of recurrent HSV-I infection in burning mouth syndrome; HSV-I and HSV-II infection of the periareolar area; zosteriform HSV; the "knife-cut sign"; and the preferential colonization and infection of preexisting dermatoses by HSV-I or HSV-II are discussed. The usual antiviral treatment regimens for primary and recurrent orolabial and genital herpes are compared to short-term and one-day treatment options. New anti-HSV-I and anti-HSV-II agents include amenavir, pritelivir, brincidofovir, valomaciclovir, and FV-100. Therapeutic or preventive vaccination against HSV-I and HSV-II infections still remains a highly desirable treatment aim, which, unfortunately, has no clinically relevant applications to date.


Assuntos
Antivirais/administração & dosagem , Herpes Genital/diagnóstico , Herpes Genital/terapia , Herpesvirus Humano 1/isolamento & purificação , Herpesvirus Humano 2/isolamento & purificação , Vacinas Virais/administração & dosagem , Medicina Baseada em Evidências , Humanos , Resultado do Tratamento
5.
Hautarzt ; 68(3): 187-191, 2017 Mar.
Artigo em Alemão | MEDLINE | ID: mdl-28197700

RESUMO

The second part of this publication deals with varicella zoster virus (VZV) and presents an overview of new, rare, and atypical clinical manifestations, including photolocalized varicella, hemorrhagic bullae during varicella, the implication of VZV in immunoglobulin A vasculitis, VZV-related alopecia, ulcerative varicella skin lesions, childhood herpes zoster (HZ), prolonged prodromal pains, recurrent HZ, VZV implication in burning mouth syndrome, verruciform VZV lesions, the significance of satellite lesions during HZ, and late HZ complications, either neurological or internal. Furthermore, certain associations between the occurrence of HZ and subsequent internal pathologies, as well as risk factors for HZ and new developments in vaccination against HZ will be addressed.


Assuntos
Antivirais/administração & dosagem , Herpes Zoster/diagnóstico , Herpes Zoster/terapia , Herpesvirus Humano 3/isolamento & purificação , Dermatopatias Virais/diagnóstico , Dermatopatias Virais/terapia , Vacinas Virais/administração & dosagem , Medicina Baseada em Evidências , Herpes Zoster/virologia , Humanos , Dermatopatias Virais/virologia , Resultado do Tratamento
6.
Curr Oncol ; 23(2): e150-3, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-27122984

RESUMO

Merkel cell carcinoma (mcc) is a highly aggressive neuroendocrine tumour of the skin. Remission rates are high with chemotherapy in patients with metastasis, but without any improvement in overall survival. We present the case of a 90-year-old woman with facial mcc. After radiation and surgery, the mcc recurred with widespread cutaneous and regional lymph node metastases. The metastases were treated with weekly intralesional injections of 1-2×10(6) IU interferon alfa-2a, accompanied by topical imiquimod 5% cream 3 times weekly. After partial regression, subcutaneous pegylated interferon alfa-2b was added at a dose of 30 µg weekly, which was then increased to 50 µg weekly. At 4 months after the start of immunotherapy, all cutaneous metastases and the intralesionally treated lymph node metastases receded. Interruption or reduction of systemic interferon application resulted in locoregional relapses that were successfully treated with surgery or intralesional interferon injections. The patient remains alive 30 months after initiation of immunotherapy, suggesting that locally metastasized mcc might be able to be controlled with local and systemic immunotherapy.

9.
Hautarzt ; 68(3): 180, 2017 Mar.
Artigo em Alemão | MEDLINE | ID: mdl-28204836
10.
Hautarzt ; 63(8): 640-3, 2012 Aug.
Artigo em Alemão | MEDLINE | ID: mdl-22851295

RESUMO

Fibromata pendulantia often appear as small filiform skin tags with a narrow pedicle in the neck, axilla and groin areas. Hitherto, extensive fibromata pendulantia were resected either surgically (curette, scissors, scalpel) or by laser. The present case study of an adipose patient with disseminated fibromata pendulantia in the axillary region in the setting of pseudoacanthosis nigricans introduces the Versajet hydrosurgery technique as an alternative method. It is able to remove tissue and rinse the wound simultaneously by means of a high-pressure water jet.


Assuntos
Desbridamento/métodos , Fibroma/terapia , Hidroterapia/métodos , Neoplasias Cutâneas/terapia , Irrigação Terapêutica/métodos , Desbridamento/instrumentação , Humanos , Hidroterapia/instrumentação , Masculino , Pessoa de Meia-Idade , Irrigação Terapêutica/instrumentação , Resultado do Tratamento
11.
Hautarzt ; 62(1): 6-16, 2011 Jan.
Artigo em Alemão | MEDLINE | ID: mdl-21206989

RESUMO

Various human papillomavirus of the genera α-, ß-, γ-, µ- and η-papillomavirus induce type-specific extragenital warts. Plantar, common and plane warts are the most common types. The closely related Alpha-papillomaviruses HPV 2, 27 and 57 are responsible for the majority of therapy-resistant common warts. A wide armamentarium of surgical, physical, chemical or drug therapies is available but no modality cures all patients. In order to avoid overtreatment it is mandatory to differentiate between indolent warts which will spontaneously resolve, warts which cause acute discomfort and warts without any tendency to heal spontaneously. HPV type, wart type, localization, size, disease duration as well as age and immune status are parameters influencing self-healing and should be considered when choosing the appropriate wart therapy.


Assuntos
Algoritmos , Técnicas de Apoio para a Decisão , Papillomaviridae/isolamento & purificação , Infecções por Papillomavirus/diagnóstico , Infecções por Papillomavirus/terapia , Verrugas/diagnóstico , Verrugas/terapia , Humanos , Infecções por Papillomavirus/microbiologia , Verrugas/microbiologia
12.
Hautarzt ; 62(5): 329-32, 2011 May.
Artigo em Alemão | MEDLINE | ID: mdl-21445701

RESUMO

Cutaneous cytotoxic T-cell lymphoma is a rare variant of cutaneous T-cell lymphoma, which shows immunoreactivity for CD56+. We report on an 83-year old woman with numerous skin infiltrates and nodules mainly on her face and trunk. Histopathologic criteria lead to the diagnosis of cutaneous cytotoxic T-cell lymphoma. Bexarotene was not tolerated because of cardiac insufficiency, but treatment with methotrexate (7.5 mg once weekly) led to prompt regression of all lesions.


Assuntos
Linfoma Cutâneo de Células T/tratamento farmacológico , Linfoma Cutâneo de Células T/patologia , Metotrexato/uso terapêutico , Neoplasias Cutâneas/tratamento farmacológico , Neoplasias Cutâneas/patologia , Idoso de 80 Anos ou mais , Antimetabólitos Antineoplásicos/uso terapêutico , Feminino , Humanos , Resultado do Tratamento
13.
Hautarzt ; 61(5): 378-82, 2010 May.
Artigo em Alemão | MEDLINE | ID: mdl-20401455

RESUMO

Pagetoid reticulosis is a mycosis fungoides subtype. It is characterized by a prominent epidermotropism, localized lesions, slow progression and benign prognosis. We report on a 67-year-old patient with a history of classic mycosis fungoides, who developed pagetoid reticulosis on the right heel. Local electron beam therapy induced a complete remission, with no recurrence over three months of follow-up.


Assuntos
Doenças do Pé/radioterapia , Micose Fungoide/radioterapia , Recidiva Local de Neoplasia/radioterapia , Neoplasias Primárias Múltiplas/radioterapia , Reticulose Pagetoide/radioterapia , Neoplasias Cutâneas/radioterapia , Idoso , Biópsia , Terapia Combinada , Elétrons/uso terapêutico , Seguimentos , Doenças do Pé/patologia , Calcanhar , Humanos , Masculino , Micose Fungoide/patologia , Recidiva Local de Neoplasia/patologia , Neoplasias Primárias Múltiplas/patologia , Reticulose Pagetoide/patologia , Pele/patologia , Neoplasias Cutâneas/patologia
14.
Nephrologe ; 15(3): 191-204, 2020.
Artigo em Alemão | MEDLINE | ID: mdl-32351619

RESUMO

Systemic treatment with immune checkpoint inhibitors (ICI) has revolutionized the treatment of hematological and oncological diseases in recent years. The mechanism of action hinges on enhancing the natural ability of the immune system to eliminate malignant cells. The most important substances in this arena include inhibitors of PD­1, PD-L1 and CTLA­4. As a consequence, the spectrum of treatment-associated adverse reactions is shifting away from classical cytotoxic effects (e.g. pancytopenia and polyneuropathy) towards novel entities of immune-mediated complex diseases. These so-called immune-related adverse events (irAEs) can involve any organ system and mimic known classical autoimmune conditions. Timely recognition of irAEs is the key for rapid initiation of a suitable treatment and is especially challenging in the clinical routine as it requires an intensive interdisciplinary management. Nephrologists are particularly confronted with this kind of problem due to the highly interdisciplinary nature of their work. This article summarizes the broad spectrum of currently known renal and more frequently occuring non-renal forms of irAEs and aims to prime the reader on diagnostic and therapeutic options.

15.
Hautarzt ; 60(12): 954-6, 2009 Dec.
Artigo em Alemão | MEDLINE | ID: mdl-19921106

RESUMO

Anaplastic large cell lymphomas (ALCL) are characterized by large, pleomorphic cells with a strong expression of cytokine receptor CD 30. We present a 71-year-old patient with several nodules on the right temple extending to his right ear. Based on clinical, histological and immunophenotypic criteria, the diagnosis of a primary cutaneous CD30(+) ALK(-) anaplastic large cell lymphoma was made. After local excision and adjuvant radiotherapy no relapse occurred during a follow-up period of three months.


Assuntos
Neoplasias Faciais/patologia , Antígeno Ki-1/análise , Linfoma Anaplásico Cutâneo Primário de Células Grandes/patologia , Neoplasias Cutâneas/patologia , Idoso , Humanos , Masculino , Índice Mitótico , Pele/patologia
16.
Hautarzt ; 59(11): 879-83, 2008 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-18931983

RESUMO

A 67-year-old patient developed a subcutaneous, non-tender nodule in her left groin over a period of about seven years. The patient underwent surgery and 4 procedures were required to obtain complete excision. The histopathologic findings showed eccrine adenocarcinoma, a member of the heterogeneous group of sweat gland tumors which occur primarily in adults with a peak of 50-60 years of age. Sweat gland carcinomas are extremely rare neoplasms of the skin and exhibit a slow growth rate with a rather high local recurrence rate. The tumor has a disposition to metastasize and shows a poor response rate to adjuvant therapy regimens. Therefore wide, deep surgical excision with an excision margin of 2-3 cm is the treatment of choice. Nevertheless there are some case reports on successful therapy of a metastasized sweat gland carcinoma with 5-fluorouracil and tamoxifen. Here further studies are needed to achieve a better survival rate for patients with metastatic disease.


Assuntos
Adenocarcinoma/diagnóstico , Adenocarcinoma/secundário , Glândulas Écrinas/patologia , Neoplasias das Glândulas Sudoríparas/diagnóstico , Neoplasias das Glândulas Sudoríparas/secundário , Adenocarcinoma/tratamento farmacológico , Adenocarcinoma/patologia , Idoso , Analgésicos/uso terapêutico , Feminino , Humanos , Neoplasias das Glândulas Sudoríparas/tratamento farmacológico , Neoplasias das Glândulas Sudoríparas/genética , Tamoxifeno/uso terapêutico
18.
J Invest Dermatol ; 114(1): 14-20, 2000 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-10620109

RESUMO

Tumorigenesis and tumor progression can be considered an evolutionary process. In order to deduce information on the mutational and selective pressures during melanoma progression we performed microsatellite analysis at 42 autosomal and two X-linked loci in a microdissected primary melanoma and its nine metastases. Loss of heterozygosity at locus D9S259 was the only genetic change observed in all metastases. The pattern of loss of heterozygosity at loci D9S162 and D9S171 within the region of common loss on chromosome 9p21 which encompasses the tumor suppressor gene p16ink4 enabled the distinction of four genetically different tumor cell populations. Three cell lineages showed homozygous loss of the p16ink4 gene, which evolved independently in each tumor cell population within the primary tumor. Additional allele losses could be demonstrated at markers D14S53 and DXS998. The fourth lineage did not demonstrate loss of heterozygosity at loci D9S162 and D9S171 and contained the wild type p16ink4 gene but was characterized by abundant microsatellite instability. The evolutionary approach towards tumorigenesis and tumor progression used in this study thus confirms the role of p16ink4 inactivation for melanoma progression but not for melanoma initiation; it suggests the existence of additional putative tumor suppressor genes located on 9p as well as on the long arm of chromosome 14 and shows that microsatellite instability may represent an alternative pathway of tumor cell evolution in malignant melanoma.


Assuntos
Melanoma/patologia , Melanoma/fisiopatologia , Mutação/fisiologia , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/fisiopatologia , Proteínas de Transporte/genética , Cromossomos Humanos Par 9/genética , Inibidor p16 de Quinase Dependente de Ciclina , Progressão da Doença , Feminino , Antebraço , Regulação da Expressão Gênica/fisiologia , Humanos , Perda de Heterozigosidade , Melanoma/secundário , Repetições de Microssatélites , Pessoa de Meia-Idade , Mutação/genética , Neoplasias Cutâneas/secundário , Células Tumorais Cultivadas
19.
Biochem Pharmacol ; 56(9): 1105-10, 1998 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-9802319

RESUMO

In this study, cytochrome P450 (CYP; EC 1.14.14.1)-dependent activities and P450 isoenzyme patterns were determined in human monocytes and macrophages, which play a major role in antigen processing including small molecular weight compounds which cause contact dermatitis or drug-allergic reactions. Using reverse transcriptase-polymerase chain reaction (RT-PCR) we determined the mRNA expression of eight CYPs (1A1, 1A2, 1B1, 2B6/7, 2E1, 3A3/4, 3A7 and 4B1) in human blood monocytes and macrophage subsets 27E10 and RM3/1. To study the influence of known P450 inducers, monocytes were incubated in vitro with ethanol, dexamethasone, cyclosporin A (CSA), benzanthracene (BA), phenobarbital (PB), lipopolysaccharide (LPS) and 12-O-tetradecanoyl-phorbol-13-acetat (TPA) for 24 hr. Percoll density gradient isolated monocytes as well as the pro-inflammatory macrophage subtype 27E10 expressed 1B1, 2E1 and 2B6/7. On the other hand, in the anti-inflammatory macrophage subtype RM3/1, predominantly 1B1 and to some extent 2B6/7 were found. Treatment with cyclosporin A, phenobarbital, benzanthracene or ethanol resulted in induction of the expression of 3A3/4. CYP1B1 was the predominant isoenzyme in all monocytes and macrophages. In monocytes purified by adherence or induced by benzanthracene, lipopolysaccharide or 12-O-tetradecanoyl-phorbol-13-acetat, 1A1 was also expressed. Northern blot analysis confirmed the presence of CYP1B1 in monocytes and macrophages, a presence which was also demonstrated on the protein level by immunoblot and by immunohistochemical staining of the cells. The expression of several CYPs in monocytes/macrophages suggests that these cells may be important in the metabolism of small molecular weight compounds, which play a role in allergic contact dermatitis and drug reactions. Of particular interest is the remarkably strong expression of the recently identified dioxin inducible CYP1B1, known to be present in a wide range of malignant tumors.


Assuntos
Hidrocarboneto de Aril Hidroxilases , Sistema Enzimático do Citocromo P-450/genética , Macrófagos/enzimologia , Monócitos/enzimologia , Citocromo P-450 CYP1B1 , Humanos , RNA Mensageiro/análise , Reação em Cadeia da Polimerase Via Transcriptase Reversa
20.
Int J Oncol ; 9(4): 609-11, 1996 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-21541558

RESUMO

Human papillomavirus (HPV) type 16 and related types are frequently found in genital located Bowen's disease but they are only rarely identified in non-genital cutaneous Bowen's disease and squamous cell cancer (SCC). We used the polymerase chain reaction to detect HPV 16 and related DNA sequences in 205 formalin-fixed non-genital cutaneous Bowen's disease and SCC specimens from 159 non-immunosuppressed patients. HPV 16 and related DNA sequences could be detected in 12 of 198 cutaneous specimens from extra-genital sites other than the fingers and in 2 of 7 specimens from digital lesions. Our study suggests a minor but still not negligible role of HPV 16 and related HPV-types in the etiology of non-genital non-melanoma skin cancer of the general population.

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