51
|
Kendler M, Zajitschek J, Simon JC, Wetzig T. Phlebologische Diagnostik. J Dtsch Dermatol Ges 2010. [DOI: 10.1111/j.1610-0387.2010.07515_supp.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
52
|
Wetzig T, Averbeck M, Simon JC, Kendler M. Local anesthesia in dermatology. J Dtsch Dermatol Ges 2010; 8:1007-17; quiz 1018. [PMID: 20854452 DOI: 10.1111/j.1610-0387.2010.07529.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Local and regional anesthetic procedures are an integral part of daily dermatological practice. Safe and effective analgesia in skin and soft tissues is crucial for otherwise painful diagnostic or therapeutic interventions. Tumescent local anesthesia allows for pain-free interventions that previously had to be done by using general anesthesia. Older patients with multiple co-morbidities are especially suited for local anesthetic procedures, because they may significantly reduce surgical risks. For dermatologists, the knowledge of mode of action and toxicity of local anesthetics, as well as the emergency management of their potential complications, is essential.
Collapse
|
53
|
Kendler M, Zajitschek J, Simon JC, Wetzig T. Diagnostic procedures for venous problems. J Dtsch Dermatol Ges 2010; 8:903-10; quiz 911. [DOI: 10.1111/j.1610-0387.2010.07515.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
54
|
Wagner JA, Kendler M, Simon JC, Wetzig T. [Hirudo medicinalis - the use of leeches in dermatologic surgery]. J Dtsch Dermatol Ges 2010; 8:547-8. [PMID: 20642720 DOI: 10.1111/j.1610-0387.2010.07460.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
55
|
Kendler M, Bodendorf M, Grunewald S, Helbig D, Simon JC, Wetzig T, Paasch U. Band, forceps and depressor technique for laser excision. Dermatol Surg 2010; 36:1451-2. [PMID: 20626442 DOI: 10.1111/j.1524-4725.2010.01656.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
56
|
Scheibe P, Braumann UD, Kuska JP, Löffler M, Simon JC, Paasch U, Wetzig T. Image-processing chain for a three-dimensional reconstruction of basal cell carcinomas*†. Exp Dermatol 2010; 19:689-91. [DOI: 10.1111/j.1600-0625.2010.01100.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
57
|
Wetzig T, Woitek M, Eichhorn K, Simon JC, Paasch U. Surgical excision of basal cell carcinoma with complete margin control: outcome at 5-year follow-up. Dermatology 2010; 220:363-9. [PMID: 20484877 DOI: 10.1159/000300116] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2009] [Accepted: 03/09/2010] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The incidence of skin cancer and especially basal cell carcinoma (BCC) has increased in the last few decades. The gold standard of care is usually a surgical excision, but it also has the risk of local recurrence depending on tumor characteristics. OBJECTIVES We analyzed the 5-year cure rates after surgical excision of BCC with complete margin control using paraffin-embedded sections. METHODS A retrospective analysis of 671 patients (45.3% male, 54.7% female) with 777 primary and 85 with recurrent BCC were collected during 2001-2003. All patients underwent surgery with complete margin control using paraffin-embedded sections. When the histological examination revealed a positive margin, another surgical step was performed in the area of residual tumor. RESULTS Five-year follow-up examinations were possible in 630/862 (73.1%) of patients with BCC. In the group with primary BCC (n = 562), 3 tumor recurrences (0.5%) were identified; in the group with recurrent BCC (n = 68), 2 tumor recurrences (2.9%) were seen, resulting in an overall 5-year recurrence rate of 0.8% for all patients with BCC. The mean tumor recurrence time after surgery was 36.6 months. CONCLUSION Local complete tumor resection confirmed by complete margin control using paraffin-embedded sections can achieve excellent cure rates for both primary and recurrent BCC.
Collapse
|
58
|
Wetzig T, Kendler M, Maschke J, Paasch U, Simon JC. No clinical benefit of preoperative fluorescence diagnosis of basal cell carcinoma localized in the H-zone of the face. Br J Dermatol 2010; 162:1370-6. [PMID: 20302577 DOI: 10.1111/j.1365-2133.2010.09666.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Basal cell carcinoma (BCC) is the most common malignant skin carcinoma. Fluorescence diagnosis (FD) has been suggested as a promising method for noninvasive detection of subclinical tumour cell dissemination in BCC. OBJECTIVES In this prospective study, we evaluated the clinical performance of a preoperative definition of the lateral borders of BCC by FD in comparison with its definition by purely clinical diagnosis (CD). The fluorescence intensity on the skin was recorded using a digital light-emitting diode-based fluorescence imaging system. METHODS Twenty-six patients with BCC (22 with nodular subtype) of the H-zone were included. The tumour area was determined 3 h after application of methyl aminolaevulinate by inspection and photographic documentation (CD) and FD. Subsequently, BCCs were excised according to the complete area defined by CD and FD with a security margin of 3 mm; surgical specimens were sectioned horizontally and subjected to meticulous histological mapping. The tumour areas as determined by FD, CD and histology were superimposed to map the entire lateral tumour margin. RESULTS The tumour area could be visualized by FD in 24 of 26 patients. The mean tumour area as determined by FD was significantly smaller than the tumour area as determined by CD [80 mm(2) , 95% confidence interval (CI) 50-110 mm(2) vs. 101 mm(2) , 95% CI 76-125 mm(2) ; P < 0·012]. The superimposition of FD and histology showed in 10 of 26 patients a complete detection of the tumour margin by FD; thus sensitivity of FD was calculated as 38·5%. In only three of 26 patients FD revealed a tumour extent greater than determined by CD. Specificity of FD was calculated as 88·4%. CONCLUSIONS On aggregate, this study suggests that preoperative FD of nodular BCC localized in the H-zone offers no additional benefit to define subclinical tumour infiltration compared with CD alone.
Collapse
|
59
|
Helbig D, Simon JC, Wetzig T, Paasch U. [Desmoplastic fibroma on arm of 22-year-old woman]. Hautarzt 2010; 61:885-7. [PMID: 20082062 DOI: 10.1007/s00105-009-1899-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Desmoplastic fibroblastoma ("collagenous fibroma") is a rare benign, slowly progressive fibrous soft tissue tumor that ranges 1-20 cm in size. The tumor occurs in all ages, predominantly in the upper part of the body. Children are rarely affected. The tumor often infiltrates the subcutis; less often it invades the fascia and skeletal muscle or causes bone erosions. Histologically, the tumor is composed of spindle-shaped cells embedded in a densely collagenous stroma, sometimes forming a pseudo-capsule. Magnetic resonance imaging and computed tomography as well as ultrasonography are used to define the extensions of the tumor. Because it is clinically extremely difficult to determine if soft tissue tumors are benign or malignant, all should be excised with a margin of safety and examined histologically. We report a 22-year old woman with desmoplastic fibroblastoma located on the upper arm. Clinical and histopathological findings and treatment options are discussed.
Collapse
|
60
|
Kendler M, Makrantonaki E, Tzellos T, Kratzsch J, Anderegg U, Wetzig T, Zouboulis C, Simon JC. Elevated sex steroid hormones in great saphenous veins in men. J Vasc Surg 2010; 51:639-46. [PMID: 20045626 DOI: 10.1016/j.jvs.2009.07.128] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2009] [Revised: 07/14/2009] [Accepted: 07/18/2009] [Indexed: 11/30/2022]
Abstract
INTRODUCTION High serum levels of estradiol are associated with clinical evidence of varicose veins in women; however, the relationship between serum sex steroid hormones and varicose veins in men is unclear. To address this issue, serum levels of testosterone, estradiol, and androstenedione were determined in the great saphenous (GSV) and cubital veins of men with varicose veins. Messenger RNA (mRNA) expression of sex steroid hormones, metabolizing enzymes, and their receptors was investigated in tissue samples of leg veins. METHODS This prospective study included 40 men, comprising 20 with varicose veins and reflux of the GSV (VM) and 20 with healthy veins (HM). All limbs were assessed by duplex ultrasound scanning of selected superficial and deep leg veins. Blood samples were taken from the cubital vein and from the GSV. Quantitative reverse-transcription polymerase chain reaction (qRT-PCR) analysis for sex steroid hormones, their metabolizing enzymes, and receptors in saphenous veins was performed in tissue samples of varicose (n = 6) and healthy veins (n = 6). RESULTS The VM group had significantly higher (P < .001) mean levels for serum testosterone (44.9 nmol/L; range, 8.8-225.1) and estradiol (242.2 pmol/L; range, 79-941) in varicose saphenous veins compared with cubital veins (testosterone, 15.5 nmol/L; range, 8.4-23.3; estradiol, 93.2 pmol/L; range, 31-147). Moreover, significantly (P < .001) higher mean serum estradiol levels (133.2 pmol/L; range, 63-239) were detected in the saphenous veins of the HM group compared with cubital veins (88.15 pmol/L; range, 37-153). Both groups had similar blood counts and serum androstenedione levels in the upper and lower extremity. Interestingly, qRT-PCR revealed that the mRNA expression of 5alpha-reductase type 1, 5alpha-reductase type 2, 17, 20 lyase, 17beta-hydroxysteroid dehydrogenase (17beta-HSD), aromatase and 3beta-HSD type 2, androgen and estrogen receptor 1 was down-regulated (P < .05) in all samples of varicose veins vs veins obtained from healthy men. CONCLUSION Elevated serum estradiol and testosterone levels were detected in men with varicose veins and reflux in the GSV compared with the patient's own arm veins. Enzymes and hormonal receptors involved in steroid metabolism were down-regulated in patients with GSV reflux and varicose veins, suggestive of a negative feedback regulation. These data support the notion of a possible causal relationship between sex steroids and varicose veins in men.
Collapse
|
61
|
Wetzig T, Maschke J, Kendler M, Simon JC. Therapie des Basalzellkarzinoms. J Dtsch Dermatol Ges 2009. [DOI: 10.1111/j.1610-0387.2009.07097_supp.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
62
|
Gebhardt C, Averbeck M, Renner R, Maschke J, Simon JC, Wetzig T. [Sandwich dressing as an alternative to tie-over dressings on ear and nose after skin grafting]. J Dtsch Dermatol Ges 2009; 7:722-3. [PMID: 19708955 DOI: 10.1111/j.1610-0387.2009.07182.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
63
|
Eichstaedt H, Bolz A, Wetzig T, Dauer W, Schmid M, de Vivie E. Messung atrial und ventrikulär evozierter Myokardpotentiale zur Detektion neurohumoraler Erregung des Herzens. BIOMED ENG-BIOMED TE 2009. [DOI: 10.1515/bmte.1995.40.s1.449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
64
|
Meyer W, Wetzig T, Zrenner B, Koller B, Bolz A, Schaldach M. Analyse monophasischer Aktionspotentiale des isolierten Kaninchenherzens. BIOMED ENG-BIOMED TE 2009. [DOI: 10.1515/bmte.1995.40.s1.397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
65
|
Wetzig T, Bolz A, Göhl K, Richter P, Gottwik M, Fröhlich R, Schaldach M. Detektion sympathischer und parasympathischer Erregung durch Messung und Analyse monophasischer Aktionspotentiale mittels fraktaler Elektroden. BIOMED ENG-BIOMED TE 2009. [DOI: 10.1515/bmte.1995.40.s1.453] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
66
|
Heber G, Helbig D, Pönitzsch I, Wetzig T, Harth W, Simon JC. Vollständige Remission multipler kutaner und subkutaner Melanommetastasen am Kapillitium unter Therapie mit Imiquimod. J Dtsch Dermatol Ges 2009. [DOI: 10.1111/j.1610-0387.2009.07038_supp.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
67
|
|
68
|
|
69
|
Bodendorf MO, Grunewald S, Wetzig T, Simon JC, Paasch U. Fractional laser skin therapy. J Dtsch Dermatol Ges 2009; 7:301-8. [DOI: 10.1111/j.1610-0387.2008.06845.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
70
|
Renner R, Renner R, Simon JC, Wetzig T. [Modern therapeutic surgical options of venous leg ulcers]. MMW Fortschr Med 2009; 151:34-36. [PMID: 19472665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
|
71
|
Heber G, Helbig D, Pönitzsch I, Wetzig T, Harth W, Simon JC. Complete remission of cutaneous and subcutaneous melanoma metastases of the scalp with imiquimod therapy. J Dtsch Dermatol Ges 2009; 7:534-6. [PMID: 19250248 DOI: 10.1111/j.1610-0387.2009.07038.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Multiple cutaneous and subcutaneous melanoma metastases represent a therapeutic challenge. A 63-year-old man presented with multiple cutaneous and subcutaneous melanoma metastases on his right parieto-occipital region that appeared ten weeks after surgical excision of the primary tumor. Staging showed no further metastases. Because of the large area of cutaneous metastatic spread, the location and the limited possibility of a complete excision, we decided to begin immunomodulatory therapy with imiquimod applied for eight hours daily five days a week. After six weeks of imiquimod monotherapy, a partial remission of the cutaneous metastases had occurred. After 17 months, the remission of these metastases was complete. Four months later the patient is still free of cutaneous, visceral, cerebral and lymph node metastases.
Collapse
|
72
|
Wetzig T, Kendler M, Simon JC. [Nasolabial flap for nasal alar reconstruction]. J Dtsch Dermatol Ges 2009; 6:1091-2. [PMID: 19138275 DOI: 10.1111/j.1610-0387.2008.06948.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
73
|
Wetzig T, Gebhardt C, Simon JC. New Indications for Artificial Collagen-Elastin Matrices? Covering Exposed Tendons. Dermatology 2009; 219:272-3. [DOI: 10.1159/000232387] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2009] [Accepted: 05/20/2009] [Indexed: 11/19/2022] Open
|
74
|
Sohl S, Kendler M, Simon JC, Wetzig T. [Purse-string suture of circular defects in areas with minor skin mobility]. J Dtsch Dermatol Ges 2008; 6:981-2. [PMID: 19009688 DOI: 10.1111/j.1610-0387.2008.06913.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
75
|
Kendler M, Maschke J, Simon J, Wetzig T. Interdigital squamous cell carcinoma in situ (Bowen's disease): treatment with microscopically controlled surgery. J Eur Acad Dermatol Venereol 2008; 22:763-5. [DOI: 10.1111/j.1468-3083.2007.02466.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|