Bullous pemphigoid antigen concentration in normal human skin in relation to body area and age.

The amount of bullous pemphigoid antigen (BPA) in normal human skin on different areas of the body and in bodies of different ages was determined by making endpoint titer estimations using the indirect immunofluorescence technique. Two sera with bullous pemphigoid antibodies were tested with 36 specimens of normal human skin from six cadavers. The greatest expression of BPA was found in plantar sites, whereas the lowest endpoint titers were seen in flexural arm biopsy specimens. Age-dependent differences in BPA expression were detected as well. The oldest individuals tested produced the highest endpoint titers in contrast to the lowest endpoint titers in the youngest. This study suggests that the amount of BPA depends not only on the body region where the biopsy specimen is taken but also on the age of the donor. This is important to know in connection with indirect immunofluorescence assays for BP antibodies on human skin.

[Experimental results of the optimization of external prednisolone therapy]. / Experimentelle Ergebnisse zur Optimierung der externen Prednisolontherapie.

The initial steps of any topical therapy are characterized by the degree of liberation of the agent from the ointment base and their penetration into different skin layers. A high percentage of the topically applied prednisolone does not penetrate into the skin and may be removed from the skin surface even after some time. By altering the functional structure of the horny layer and considerably increase of prednisolone liberation from ointment bases urea is a effective penetration promotor also for prednisolone. The increased prednisolone penetration into human skin from urea containing ointment correspond with the degree of blanching results by vasoconstriction test under in vivo conditions. The resulting penetration optimation of prednisolone has two possible applications in topical therapy: an increased therapeutic effect for a given prednisolone concentration and a given therapeutic effect could be obtained with a reduced prednisolone concentration.

[Skin permeation of liposomal incorporated hydrocortisone]. / Hautpermeation von liposomal inkorporiertem Hydrocortison.

With the liposomal incorporated hydrocortisone a very much improved concentration-time profile was obtained in the different layers of human skin after topical application when compared with conventional hydrocortisone in the ointment. The increased hydrocortisone penetration into human skin correspond with the degree of blanching results by vasoconstriction test. Under in vivo conditions the influence of liposomal hydrocortisone on percutaneous resorption was investigated. In guinea pigs a decreased serum concentration and urinary excretion of hydrocortisone could be demonstrated. Thus, hydrocortisone-loaded liposomes, when applied topically, act as a selective drug delivery system, it can be provide increased therapeutic efficacy and, simultaneously, decreased unwanted systemic effects. The significance of liposomal incorporated attenuative and higher potent glucocorticoids in external therapy is discussed.

[Significance of test results in drug hypersensitivity]. / Zur Bedeutung von Testergebnissen bei Arzneimittelallergie.

For the diagnostics of allergic drug reactions in 2,246 patients tests of the skin and in vitro tests were carried out. As causes of the drug rashes analgetics/antipyretics, antibiotics, sulfonamides, local anaesthetics, oral anticonceptive drugs, remedies for the circulation, psychopharmaca and many others have been established. In these cases by means of skin test in 81.5%, by means of the lymphocyte transformation test in 42.9% and by means of the migration inhibition test in 35.9% of the patients a concordant result could be achieved concerning the clinical course of the disease. Relevant to practice from the results must be derived that in sensibilisation proved the avoidance of the pharmacon and of immunochemical related substances is necessary as well as principally in every anamnesis the question for drug tolerances must be asked. The possibility of the development of side effects of pharmaca when these facts are not taken into consideration is emphasized with the help of examples.

[Relationship between accidental injuries and the course of malignant melanoma]. / Zum Zusammenhang von Unfalltrauma und Verlauf des malignen Melanoms der Haut.

On a case report the possible role of traumatisation in acceleration of progress of malignant melanoma was demonstrated. The factors determining the clinical course of malignant melanoma are in the majority unknown. In the individual case with a provable causality of trauma on the acceleration of tumor progress a pretension for insurance es legal. This decision takes into consideration the special aspects of each particular case.

[Persistance of epidermal sensitizations in occupational allergic contact eczemas (author's transl)]. / Zur Persistenz epidermaler Sensibilisierungen bei professionellen allergischen Kontaktekzemen.

Allergic contact eczemas occur in the region of Halle (DDR) in the chemical industry, in health services, in architecture, in the metal industry and in local logistics. In 732 cases of occupational eczemas, "para"-substances, chromates, plastic materials and adhesives, technical oils and fats, turpentine oil, dyestuffs and disinfectants were the principal noxious substances. Phenothiazine, synthetic resins and adhesives, nickel, turpentine oil, chromates, iodine, p-phenylendiamine, mercury compounds, etc. cause epidermal sensitizations that persist up to 10-12 years. Sensitized persons must strictly avoid these noxious substances, even in their para-professional shere; repeated tests should be abandoned because the epidermal sensitization might be "boosted".

[Analyses of the mycological flora of the mouth cavity]. / Untersuchungen zur mykologischen Flora der Mundhöhle.

The paper reports on mycologic cross-sectional explorations of the oral cavity in patients considered to be particularly susceptible to the attack of blastomycetes. 1,333 swabs taken from the cavities of 385 patients have been analysed. The analysis revealed that it were not the patients regarded as high-risk group who showed the highest incidence, but a group of denture (made of polymethacrylate) wearers, not regarded under this aspect so far, was found to have an increased disposition to oral blastomycete population. The paper presents a therapy conception for the elimination of these blastomycetes through appropriate mouth and denture hygiene and conclusions for medical and dental practice.

[Significance of skin changes in diabetes mellitus]. / Zur Bedeutung von Hautveränderungen beim Diabetes mellitus.

500 patients of a dispensaire of diabetes were inspected dermatologically. 335 patients had a duration of the glucose metabolism intoleration less than 10 years and 165 patients more than 10 years. 215 patients stated a striking family case history according diabetes. 54 per cent (273) of the cases showed an adiposity, 418 patients (83.6 percent) had pathological changes of the skin and mucosal changes. It is clear that dermatomycoses, eczema and pyodermias occur more often with acute metabolic disorder and adiposity. Neurovascular changes of the skin occur with long persistent glucose metabolism intoleration. Bad healing tendencles of wounds, pruritus, intensive dermatomycoses, balanitis, vulvitis, furunculosis and pyodermias are important references to a glucose metabolism intoleration. They should give rise to look for a diabetes irrespective of the age of the patient.

[The importance of prognostic factors in malignant melanoma of the skin]. / Zur Bedeutung der Prognosefaktoren des malignen Melanoms der Haut.

122 primary malignant melanomas of the skin were investigated to estimate the histologically and clinical criteria of melanoma for the prognostic evaluation of the disease. As result the tumor thickness (Breslow) in mm is the best prognostic value. The prognostic index allows an assay to determine the risk of metastases. On this basis it is possible to distinguish between melanomas with high and low risk of metastases. This is important as a criteria for the determination for the adjuvant treatment.

[Allergic contact eczema and vitiliginous depigmentations caused by paratertiary butylphenol]. / Allergisches Kontaktekzem und vitiligoartige Depigmentierungen durch paratertiäres Butylphenol.

Allergic contact eczema and vitiliginous depigmentations caused by paratertiary butylphenol. In a case of allergic contact eczemas due to an occupational contact with paratertiary butylphenol, vitiliginous depigmentations appeared after a latency period of several years. Disorders of cellular immune reactions, struma and hepatosis were absent. Paratertiary butylphenol might have been absorbed by the epidermis. It is suggested for prophylactic purposes to declare the components of adhesives in order to avoid occupational contacts with dangerous substances.

[Development and significance of occupational and iatrogenic contact sensitization in nummular microbial eczema]. / Zur Entstehung und Bedeutung von professionellen und iatrogenen Kontaktsensibilisierungen beim nummulären mikrobiellen Ekzem.

The pathogenesis of the epidermal and cutaneous reactions to a microbic invasion comprises many criteria for the diagnosis of a nummular microbial eczema. Detection of the focus, healing of the eczema after focal sanitation, positive reactions to bacterial antigens, decrease of Igm and IgG, and other parameters represent the cutaneous component of the disease, while the lack of epidermal sensitizations to low-molecular haptenes and the predominantly negative epicutaneous tests constitue the accentuating criteria. The results obtained in 95 patients with nummular microbic eczema show the part played by epidermal alterations in the development of occupational an iatrogenic contact sensitizations. Moreover, these alterations allow to recognize to what extent these dermatoses are due to occupational causes.

[Epidermal reaction kinetics following benzol contact]. / Epidermale Reaktionskinetik nach Benzol-Kontakt.

With benzene as model substance the reaction of the epidermis to different concentrations of harmful substances is examined in animal experiments. This shows that with biometrically unobtrusive results dependent on benzene concentration and penetration time, distinct changes take place in the function of the epidermis cells. These results are essential for the pathogenesis and prophylaxis of skin damaged by exposure to harmful substances at industrially permissible concentrations of noxa.

[Reaction of skin and various cell systems after contact with sodium hypochlorite as a model substance (author's transl)]. / Untersuchungen zur Wirkung von Natriumhypochlorit als Modellsubstanz auf die Haut und verschiedene Zellsysteme.

The efficacy of an externally applied substance is possible by the combination of various experimental methods for investigation of the reaction of the skin and other cell systems. After different contact time of skin or epidermal cells with NaOCl solution under in vivo and in vitro conditions, an influence on the processes of epidermal proliferation, development and differentiation was not provable. On the other hand alterations in other cell systems could be observed. In lymphocytes the content of incorporated 3H-thymidine after in vitro cultivation remained unchanged, however, the possibility of stimulation with PHA was decreased. After external skin contact a comparative analysis of different metabolic processes for interpretation of substance efficacy is necessary.

[Experiments for physiologic improvement of disinfectants]. / Experimente zur physiologischen Verbesserung von Desinfektionsmitteln.

The use of customary trade disinfectants lead to occupational disease no. 80 in many employers of public health. For that reason our aim is to improve the skin compatibility of this disinfectants. Its possible to achieve a pH-shift to a more physiological level eighter by buffer salt addition or by neutralization. Following this, disinfectants were investigated in a microbiological test.

[Effect of the chemical structure of low molecular weight hapten carriers on immunoreactivity]. / Zum Einfluss der chemischen Struktur niedermolekularer Hapten-Träger auf die Immunreaktivität.

Patients with demonstrated contact dermatitis to DNCB (dinitrochlorobenzene) were patch-tested using various dinitrophenyl (DNP) derivatives. These investigations revealed the varying sensitivities to the structural isomers DNP-L-alpha-alanine (59% positive) and DNP-beta-alanine (4% positive). These results are discussed both in connection with various sensitivity rates to other DNP compounds and published findings from the literature concerning the influence of structural factors on immune reactivity.

[Ketotifen treatment of chronic urticaria. An open study of therapeutically difficult courses]. / Ketotifen-Behandlung der chronischen Urtikaria. Eine offene Studie therapeutisch schwieriger Verlaufsformen.

21 patients suffering from chronic urticaria were treated with Ketotifen (2 X 1 mg/d) for 4 weeks. The suppression of weals and pruritus, the side effects in comparison with antihistamines, as well as the effect after finishing therapy have been studied. Ketotifen has a good suppressing effect on weals and pruritus. The general tolerance of the preparation is good, as well. Thus Ketotifen may be regarded as an additional possibility concerning treatment of chronic urticaria.

[Model antigens and their significance for occupational dermatology]. / Modellantigene und ihre Bedeutung für die Arbeitsdermatologie.

By means of epicutaneous tests we studied the contact hypersensitivity to DNP-amino acids in individuals sensitized to dinitrochlorobenzene (DNCB). We found a high incidence of positive skin responses to DNP-glycine, di-DNP-L-cystine, and DNP-L-alpha-alanine, but only in some cases DNP-beta-alanine induced skin reactivity. The results are discussed both in connection with the influence of varying molecular sizes and chemical structure on the immunological reactivity and the possibility to develop a beta-alanine containing protective ointment against protein-reactive haptens.

[Results of a randomized polychemotherapy study in malignant melanoma]. / Ergebnisse einer randomisierten Polychemotherapiestudie beim malignen Melanom.

A polychemotherapy (DTIC, vincristine, ftorafur, hydroxycarbamide) devised with reference to the results of short-term sensitivity tests in cell culture is compared with single-agent chemotherapy with DTIC in malignant melanoma. Effectiveness was investigated in a randomized prospective study in cases of high-risk melanoma in clinical stage I, in clinical stage II after lymphadenectomy and in clinical stage III after tumour debulking. The results recorded allow no positive effects of either form of chemotherapy in stage I disease compared with surgical treatment only in a control group. In contrast, a statistically significant advantage of the polychemotherapy was noted in stage II compared with a control group. There was no significant difference in the results of treatment between the two forms of chemotherapy in stage III. No complete remissions of long duration have been achieved.