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Trautinger F, Schmidt J, Kopera D. In Memoriam Univ.‐Prof. Dr. Eva‐Maria Kokoschka. J Dtsch Dermatol Ges 2024; 22:633-634. [PMID: 38574032 DOI: 10.1111/ddg.15400_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2024]
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Wolf P, Trautinger F. Zum Gedenken an Prof. Dr. Herbert Hönigsmann. J Dtsch Dermatol Ges 2023; 21:1585-1586. [PMID: 38082512 DOI: 10.1111/ddg.15297_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Affiliation(s)
- Peter Wolf
- Präsident der Österreichischen Gesellschaft für Dermatologie und Venerologie
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Latzka J, Assaf C, Bagot M, Cozzio A, Dummer R, Guenova E, Gniadecki R, Hodak E, Jonak C, Klemke CD, Knobler R, Morrris S, Nicolay JP, Ortiz-Romero PL, Papadavid E, Pimpinelli N, Quaglino P, Ranki A, Scarisbrick J, Stadler R, Väkevä L, Vermeer MH, Wehkamp U, Whittaker S, Willemze R, Trautinger F. EORTC consensus recommendations for the treatment of mycosis fungoides/Sézary syndrome - Update 2023. Eur J Cancer 2023; 195:113343. [PMID: 37890355 DOI: 10.1016/j.ejca.2023.113343] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 07/28/2023] [Accepted: 08/23/2023] [Indexed: 10/29/2023]
Abstract
On behalf of the EORTC Cutaneous Lymphoma Tumours Group (EORTC-CLTG) and following up on earlier versions published in 2006 and 2017 this document provides an updated standard for the treatment of mycosis fungoides and Sézary syndrome (MF/SS). It considers recent relevant publications and treatment options introduced into clinical practice after 2017. Consensus was established among the authors through a series of consecutive consultations in writing and a round of discussion. Treatment options are assigned to each disease stage and, whenever possible and clinically useful, separated into first- and second line options annotated with levels of evidence. Major changes to the previous version include the incorporation of chlormethine, brentuximab vedotin, and mogamulizumab, recommendations on the use of pegylated interferon α (after withdrawal of recombinant unpegylated interferons), and the addition of paragraphs on supportive therapy and on the care of older patients. Still, skin-directed therapies are the most appropriate option for early-stage MF and most patients have a normal life expectancy but may suffer morbidity and impaired quality of life. In advanced disease treatment options have expanded recently. Most patients receive multiple consecutive therapies with treatments often having a relatively short duration of response. For those patients prognosis is still poor and only for a highly selected subset long term remission can be achieved with allogeneic stem cell transplantation. Understanding of the disease, its epidemiology and clinical course, and its most appropriate management are gradually advancing, and there is well-founded hope that this will lead to further improvements in the care of patients with MF/SS.
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Affiliation(s)
- Johanna Latzka
- Department of Dermatology and Venereology, University Hospital of St. Pölten, Karl Landsteiner University of Health Sciences, St. Pölten, Austria; Karl Landsteiner Institute of Dermatological Research, Department of Dermatology and Venereology, University Hospital of St. Pölten, St. Pölten, Austria.
| | - Chalid Assaf
- Department of Dermatology, HELIOS Klinikum Krefeld, Krefeld, Germany; Institute for Molecular Medicine, Medical School Hamburg, University of Applied Sciences and Medical University, Hamburg, Germany; Department of Dermatology, HELIOS Klinikum Schwerin, University Campus of The Medical School Hamburg, Schwerin, Germany
| | - Martine Bagot
- Department of Dermatology, Hopital Saint Louis, Université Paris Cité, INSERM U976, Paris, France
| | - Antonio Cozzio
- Department of Dermatology and Allergology, Kantonspital St. Gallen, St. Gallen, Switzerland
| | - Reinhard Dummer
- Department of Dermatology, University of Zurich, Zurich, Switzerland
| | - Emmanuella Guenova
- Department of Dermatology, University Hospital of Lausanne and Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Robert Gniadecki
- Department of Dermatology, University of Copenhagen, Copenhagen, Denmark; Division of Dermatology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Emmilia Hodak
- Cutaneous Lymphoma Unit, Davidoff Cancer Center, Rabin Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Constanze Jonak
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | | | - Robert Knobler
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - Stephen Morrris
- Guy's and St Thomas' NHS Foundation Trust, Guy's Hospital, London, UK
| | - Jan P Nicolay
- Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Mannheim, Germany
| | - Pablo L Ortiz-Romero
- Department of Dermatology, Hospital Universitario 12 de Octubre, Institute i+12, CIBERONC, Medical School, University Complutense, Madrid, Spain
| | - Evangelia Papadavid
- National and Kapodistrian University of Athens, 2nd Department of Dermatology and Venereology, Attikon General Hospital, University of Athens, Chaidari, Greece
| | - Nicola Pimpinelli
- Department of Health Sciences, Division of Dermatology, University of Florence, Florence, Italy
| | - Pietro Quaglino
- Department of Medical Sciences, Section of Dermatology, University of Turin, Turin, Italy
| | - Annamari Ranki
- Department of Dermatology and Allergology, Inflammation Center, Helsinki University Central Hospital, Helsinki, Finland
| | - Julia Scarisbrick
- Department of Dermatology, University Hospital Birmingham, Birmingham, UK
| | - Rudolf Stadler
- University Department of Dermatology, Venereology, Allergology and Phlebology, Skin Cancer Center, Johannes Wesling Medical Centre Minden, Ruhr University Bochum, Bochum, Germany
| | - Liisa Väkevä
- Department of Dermatology and Allergology, Inflammation Center, Helsinki University Central Hospital, Helsinki, Finland
| | - Maarten H Vermeer
- Department of Dermatology, Leiden University Medical Center, Leiden, the Netherlands
| | - Ulrike Wehkamp
- Department of Dermatology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany; Medical Department, Medical School of Hamburg, Hamburg, Germany
| | - Sean Whittaker
- St. John's Institute of Dermatology, School of Basic and Medical Biosciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Rein Willemze
- Department of Dermatology, Leiden University Medical Center, Leiden, the Netherlands
| | - Franz Trautinger
- Department of Dermatology and Venereology, University Hospital of St. Pölten, Karl Landsteiner University of Health Sciences, St. Pölten, Austria; Karl Landsteiner Institute of Dermatological Research, Department of Dermatology and Venereology, University Hospital of St. Pölten, St. Pölten, Austria
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Trautinger F. Obituary: Herbert Hönigsmann, M.D. Photochem Photobiol Sci 2023:10.1007/s43630-023-00491-5. [PMID: 37934334 DOI: 10.1007/s43630-023-00491-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 10/02/2023] [Indexed: 11/08/2023]
Affiliation(s)
- Franz Trautinger
- Department of Dermatology and Venereology, University Hospital of St. Pölten, Karl Landsteiner University of Health Sciences, Dunant-Platz 1, 3100, St. Pölten, Austria.
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Neudorfer C, Trautinger F, Prillinger K. Fulminant Demodex folliculitis in a patient with ulcerative colitis treated with tofacitinib. JAAD Case Rep 2023; 39:14-16. [PMID: 37554359 PMCID: PMC10404599 DOI: 10.1016/j.jdcr.2023.06.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/10/2023] Open
Affiliation(s)
- Carolina Neudorfer
- Department of Dermatology and Venereology, University Hospital of St. Pölten, Karl Landsteiner University of Health Sciences, St. Pölten, Austria
- Karl Landsteiner Institute of Dermatological Research, St. Pölten, Austria
| | - Franz Trautinger
- Department of Dermatology and Venereology, University Hospital of St. Pölten, Karl Landsteiner University of Health Sciences, St. Pölten, Austria
- Karl Landsteiner Institute of Dermatological Research, St. Pölten, Austria
| | - Knut Prillinger
- Department of Dermatology and Venereology, University Hospital of St. Pölten, Karl Landsteiner University of Health Sciences, St. Pölten, Austria
- Karl Landsteiner Institute of Dermatological Research, St. Pölten, Austria
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Latzka J, Trautinger F. Mycosis fungoides und Sézary-Syndrom - Überblick und Ausblick. J Dtsch Dermatol Ges 2023; 21:386-392. [PMID: 37070511 DOI: 10.1111/ddg.15051_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 02/10/2023] [Indexed: 04/19/2023]
Affiliation(s)
- Johanna Latzka
- Abteilung für Haut- und Geschlechtskrankheiten, Universitätsklinikum St. Pölten, Karl Landsteiner Privatuniversität für Gesundheitswissenschaften, St. Pölten, Österreich
- Karl Landsteiner Institut für Dermatologische Forschung, St. Pölten, Österreich
| | - Franz Trautinger
- Abteilung für Haut- und Geschlechtskrankheiten, Universitätsklinikum St. Pölten, Karl Landsteiner Privatuniversität für Gesundheitswissenschaften, St. Pölten, Österreich
- Karl Landsteiner Institut für Dermatologische Forschung, St. Pölten, Österreich
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Latzka J, Trautinger F. Mycosis fungoides and Sézary syndrome – Review and outlook. J Dtsch Dermatol Ges 2023; 21:386-391. [PMID: 36971307 DOI: 10.1111/ddg.15051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 02/10/2023] [Indexed: 03/29/2023]
Abstract
Mycosis fungoides and Sézary syndrome are the most important representatives of the heterogeneous group of cutaneous T-cell lymphomas. The diseases are rare and the diagnosis, which always requires a clinical-pathological correlation, is often delayed, especially in early forms of mycosis fungoides. The prognosis of mycosis fungoides depends on its stage and is usually favorable in the early stages. Clinically relevant prognostic parameters are missing and their development is the subject of current clinical research. Sézary syndrome, characterized by initial erythroderma and blood involvement, is a disease with a high mortality rate, in which good responses can now be achieved in many cases with new treatment options. The pathogenesis and immunology of the diseases is heterogeneous, with recent results pointing primarily to changes in specific signal transduction pathways that may be suitable as future treatment targets. Current therapy for mycosis fungoides and Sézary syndrome is primarily palliative with topical and systemic options either used alone or in combination. Only with allogeneic stem cell transplantation durable remissions can be achieved in selected patients. Similar to other areas of oncology, the development of new therapies for cutaneous lymphomas is currently changing from relatively untargeted empiricism to disease-specific, targeted pharmacotherapy based on knowledge from experimental research.
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Affiliation(s)
- Johanna Latzka
- Department of Dermatology and Venereology, University Hospital of St. Pölten, Karl Landsteiner University of Health Sciences, St. Pölten, Austria
- Karl Landsteiner Institute of Dermatological Research, St. Pölten, Austria
| | - Franz Trautinger
- Department of Dermatology and Venereology, University Hospital of St. Pölten, Karl Landsteiner University of Health Sciences, St. Pölten, Austria
- Karl Landsteiner Institute of Dermatological Research, St. Pölten, Austria
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Neudorfer C, Trautinger F, Prillinger K. Mutilierende digitale Ulzerationen an beiden Händen. J Dtsch Dermatol Ges 2022; 20:1657-1658. [PMID: 36508386 DOI: 10.1111/ddg.14862_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Carolina Neudorfer
- Klinische Abteilung für Dermatologie, Universitätsklinikum St. Pölten, St. Pölten, Österreich
| | - Franz Trautinger
- Klinische Abteilung für Dermatologie, Universitätsklinikum St. Pölten, St. Pölten, Österreich
| | - Knut Prillinger
- Klinische Abteilung für Dermatologie, Universitätsklinikum St. Pölten, St. Pölten, Österreich
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Neudorfer C, Trautinger F, Prillinger K. Mutilating digital ulcerations on both hands. J Dtsch Dermatol Ges 2022; 20:1657-1658. [PMID: 36121369 DOI: 10.1111/ddg.14862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Carolina Neudorfer
- Department of Dermatology, University Hospital St. Pölten, St. Pölten, Austria
| | - Franz Trautinger
- Department of Dermatology, University Hospital St. Pölten, St. Pölten, Austria
| | - Knut Prillinger
- Department of Dermatology, University Hospital St. Pölten, St. Pölten, Austria
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Stelzhammer P, Weber W, Binder H, Sagel U, Aspöck C, Trautinger F. The bacterial pathogen and resistance spectrum in a dermatological inpatient ward: a six-year, retrospective, epidemiological study. GMS Hyg Infect Control 2022; 17:Doc16. [PMID: 36157381 PMCID: PMC9487974 DOI: 10.3205/dgkh000419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Aim Treatment of bacterial soft tissue infections is an essential part of clinical dermatology, and the choice of antibiotic therapy is often empirical. The aim of this longitudinal retrospective study was to evaluate bacterial epidemiology, resistance patterns and antibiotic consumption in a dermatological inpatient ward. Method Bacterial isolates and antimicrobial susceptibility testing from a dermatological inpatient ward were recorded retrospectively from 2011 to 2016. The antibiotic consumption was evaluated and given as the assumed defined daily dose [DDD] per 100 days of covering per year. Results A total of 4,800 bacterial isolates were included (skin, mucous membrane and wounds 87%, urine 9.5%, blood 1.7%, tissue and tissue fluids 1.6%). The proportion of Gram-positive bacteria was 58% (Staphy loc occus aureus 37.8%, coagulase-negative staphylococci 21.5%, Enterococcus spp. 16.7%). Pseudomonas aeruginosa (27.2%), Escherichia coli (17.5%) and Proteus spp. (13.1%) were the most common Gram-negative bacteria. The proportion of multi-resistant pathogens was 5.8% for methicillin-resistant S. aureus, 0.9%, 0.8% and 1.8% for multi-resis tant P. aeruginosa, ESBL-producing E. coli and ESBL-producing Klebsiella pneumoniae of all isolates. Beta-lactam antibiotics were the most used drugs (14.4, 10.8, and 9.6 DDD/100 for aminopenicillins, cefalexin, and penicillin G), followed by clindamycin (9.0 DDD/100 patient days). Conclusion In view of the frequency of bacterial soft tissue infections and their need for inpatient treatment with mostly empirically chosen antibiotics, systematic microbiological surveillance should be recommended for dermatological inpatient wards.
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Affiliation(s)
- Philipp Stelzhammer
- Department of Dermatology and Venereology, University Hospital St. Poelten, St. Poelten, Austria,Karl Landsteiner Institute of Dermatological Research, St. Poelten, Austria,*To whom correspondence should be addressed: Philipp Stelzhammer, , E-mail:
| | - Wolfgang Weber
- Institute for Hygiene and Microbiology, University Hospital St. Poelten, Karl Landsteiner Private University of Health Sciences, St. Poelten, Austria
| | - Hermine Binder
- Hospital Pharmacy, University Hospital St. Poelten, St. Poelten, Austria
| | - Ulrich Sagel
- LADR MVZ Dres. Bachg, Haselhorst & colleagues, Recklinghausen, Germany
| | - Christoph Aspöck
- Institute for Hygiene and Microbiology, University Hospital St. Poelten, Karl Landsteiner Private University of Health Sciences, St. Poelten, Austria
| | - Franz Trautinger
- Department of Dermatology and Venereology, University Hospital St. Poelten, St. Poelten, Austria,Karl Landsteiner Institute of Dermatological Research, St. Poelten, Austria
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Assaf C, Booken N, Dippel E, Guenova E, Jonak C, Klemke CD, Nicolay JP, Schlaak M, Wobser M, Trautinger F. Chlormethin-Gel zur Behandlung der Mycosis fungoides: Ein Expertenkonsens aus Deutschland, Österreich und der Schweiz (DACH-Region) zum Therapiemanagement. J Dtsch Dermatol Ges 2022; 20:579-588. [PMID: 35578416 DOI: 10.1111/ddg.14688_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 11/11/2021] [Indexed: 11/26/2022]
Abstract
HINTERGRUND Chlormethin-Gel ist in Europa zur Therapie von Patienten mit Mycosis fungoides in allen Krankheitsstadien zugelassen. Die optimalen Behandlungsregime hinsichtlich Frequenz, Dosierung, Kombinations- oder Erhaltungstherapien sind noch nicht vollständig etabliert. METHODIK Zehn in der Erforschung und Behandlung kutaner T-Zell-Lymphome erfahrene Experten aus Deutschland, Österreich und der Schweiz (DACH-Region) wurden schriftlich zu Indikation, Anwendungsfrequenz, Beurteilung des Therapieerfolgs, Begleittherapie, Nebenwirkungen, Kombinationstherapien in späteren Krankheitsstadien, Erhaltungstherapie und Adhärenz im Rahmen der Therapie der Mycosis fungoides mit Chlormethin-Gel befragt. Die strukturiert aufbereiteten Ergebnisse der Umfrage wurden in einer Konsensuskonferenz diskutiert und Empfehlungen zum Management der Therapie mit Chlormethin-Gel entwickelt. ERGEBNISSE Wesentlich für die Therapie mit Chlormethin-Gel ist ein individuelles, symptomorientiertes Therapiemanagement. Systemische Nebenwirkungen des Wirkstoffs sind wegen der fehlenden systemischen Verfügbarkeit bei topischer Anwendung unwahrscheinlich. Die häufig auftretende allergische oder irritativ-toxische Kontaktdermatitis kann durch eine Anpassung des Therapieregimes, Therapiepausen sowie nebenwirkungsspezifische und unterstützende Maßnahmen häufig beherrscht werden. Ein einschleichender Therapiebeginn mit Anwendung von Chlormethin-Gel jeden zweiten Tag kann die Tolerabilität wesentlich verbessern, insbesondere wenn die Therapie alternierend mit topischen Kortikosteroiden erfolgt. SCHLUSSFOLGERUNGEN Die Anwendung von Chlormethin-Gel bei Mycosis fungoides wird durch die begleitende Kontaktdermatitis häufig eingeschränkt. Mit einem geeigneten Therapie- und Nebenwirkungsmanagement können vermeidbare Therapieabbrüche verhindert werden und mehr Patienten von der Therapie profitieren.
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Affiliation(s)
- Chalid Assaf
- Klinik für Dermatologie und Venerologie, HELIOS Klinikum Krefeld, Krefeld, Deutschland
| | - Nina Booken
- Klinik und Poliklinik für Dermatologie und Venerologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
| | - Edgar Dippel
- Hautklinik Ludwigshafen, Ludwigshafen, Deutschland
| | - Emmanuella Guenova
- Klinik für Dermatologie der Universitätsklinik Lausanne, Fakultät für Biologie und Medizin der Universität Lausanne, Lausanne, Schweiz
| | - Constanze Jonak
- Universitätsklinik für Dermatologie, Medizinische Universität Wien, Wien, Österreich
| | - Claus-Detlev Klemke
- Hautklinik und Hauttumorzentrum, Städtisches Klinikum Karlsruhe, Akademisches Lehrkrankenhaus der Universität Freiburg, Freiburg, Deutschland
| | - Jan P Nicolay
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Mannheim GmbH, Mannheim, Deutschland
| | - Max Schlaak
- Klinik für Dermatologie, Venerologie und Allergologie, Hauttumorcentrum, Charité - Universitätsmedizin Berlin corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Deutschland
| | - Marion Wobser
- Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Würzburg, Würzburg, Deutschland
| | - Franz Trautinger
- Abteilung für Haut- und Geschlechtskrankheiten, Universitätsklinikum St. Pölten, Karl Landsteiner Privatuniversität für Gesundheitswissenschaften, St. Pölten, Österreich
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Koller A, Trautinger F. Wichtige Differentialdiagnosen des Beinödems – ein kurzer Praxisleitfaden. Phlebologie 2022. [DOI: 10.1055/a-1781-6589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
ZusammenfassungDas differenzialdiagnostische Spektrum der Beinödeme ist vielfältig und umfasst sowohl phlebologische, entzündliche, traumatologische, medikamentöse und andere systemische und regionale Ursachen und Erkrankungen.Um die Ursachen für Beinödeme bestmöglich abzuklären, sind eine ausführliche Anamnese und klinische Untersuchung entscheidend. Die Lokalisation der Beinschwellung, Beginn und Dauer der Beschwerden, Schmerzsymptomatik, Allgemeinsymptome, Vorerkrankungen und bestehende Hautveränderungen können wichtige Hinweise auf mögliche zugrunde liegende Ursachen liefern. Nach Eingrenzung der möglichen Differenzialdiagnosen können gezielte apparative und laborchemische Untersuchungen ergänzend angeschlossen werden, um die Diagnose zu sichern und die richtige Therapie einzuleiten.
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Affiliation(s)
- Anna Koller
- Abteilung für Haut- und Geschlechtskrankheiten, Universitätsklinikum St. Pölten, St. Pölten, Österreich
- Karl Landsteiner Institut für Dermatologische Forschung, St. Pölten, Österreich
| | - Franz Trautinger
- Abteilung für Haut- und Geschlechtskrankheiten, Universitätsklinikum St. Pölten, St. Pölten, Österreich
- Karl Landsteiner Institut für Dermatologische Forschung, St. Pölten, Österreich
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Assaf C, Booken N, Dippel E, Guenova E, Jonak C, Klemke C, Nicolay JP, Schlaak M, Wobser M, Trautinger F. The optimal use of chlormethine gel for mycosis fungoides: An expert consensus from Germany, Austria and Switzerland (DACH region). J Dtsch Dermatol Ges 2022; 20:579-586. [DOI: 10.1111/ddg.14688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 11/11/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Chalid Assaf
- Department of Dermatology and Venereology HELIOS Klinikum Krefeld Krefeld Germany
| | - Nina Booken
- Department of Dermatology and Venereology University Hospital Hamburg‐ Eppendorf Hamburg Germany
| | - Edgar Dippel
- Department of Dermatology Ludwigshafen Medical Center Ludwigshafen Germany
| | - Emmanuella Guenova
- Department of Dermatology Lausanne University Hospital Faculty of Biology and Medicine University of Lausanne Lausanne Switzerland
| | - Constanze Jonak
- Department of Dermatology Medical University of Vienna Vienna Austria
| | - Claus‐Detlev Klemke
- Department of Dermatology and Skin Tumor Center Karlsruhe Medical Center Karlsruhe Germany Academic Teaching Hospital of the University of Freiburg Freiburg Germany
| | - Jan P. Nicolay
- Department of Dermatology Venereology and Allergology University Medical Center Mannheim Mannheim Germany
| | - Max Schlaak
- Department of Dermatology Venereology and Allergology Skin Tumor Center Charité – Universitätsmedizin Berlin corporate member of Freie Universität Berlin and Humboldt‐Universität zu Berlin Berlin Germany
| | - Marion Wobser
- Department of Dermatology Venereology and Allergology Würzburg University Hospital Würzburg Germany
| | - Franz Trautinger
- Department of Dermatology and Venereology University Hospital St. Pölten Karl Landsteiner University of Health Sciences St. Pölten Austria
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Weitzenböck HP, Gschwendtner A, Wiesner C, Depke M, Schmidt F, Trautinger F, Hengstschläger M, Hundsberger H, Mikula M. Proteome analysis of NRF2 inhibition in melanoma reveals CD44 up-regulation and increased apoptosis resistance upon vemurafenib treatment. Cancer Med 2021; 11:956-967. [PMID: 34951143 PMCID: PMC8855890 DOI: 10.1002/cam4.4506] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 11/30/2021] [Accepted: 12/04/2021] [Indexed: 12/27/2022] Open
Abstract
Malignant melanoma is the deadliest form of skin cancer and NRF2 has been proposed as a main regulator of tumor cell malignancy. Still the mechanisms how NRF2 is contributing to melanoma progression are incompletely understood. Here we analyzed the effects of either NRF2 induction or depletion, and we also quantified changes on the whole cell proteome level. Our results showed that inhibition of NRF2 leads to a loss of reactive oxygen species protection, but at the same time to an induction of an epithelial mesenchymal transition (EMT) phenotype and an up‐regulation of the stem cell marker CD44. Additionally, cells devoid of NRF2 showed increased cell viability after treatment with a MYC and a BRAF inhibitor. Importantly, survival upon vemurafenib treatment was dependent on CD44 expression. Finally, analysis of archival melanoma patient samples confirmed a vice versa relationship of NRF2 and CD44 expression. In summary, we recorded changes in the proteome after NRF2 modulation in melanoma cells. Surprisingly, we identified that NRF2 inhibition lead to induction of an EMT phenotype and an increase in survival of cells after apoptosis induction. Therefore, we propose that it is important for future therapies targeting NRF2 to consider blocking EMT promoting pathways in order to achieve efficient tumor therapy.
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Affiliation(s)
- Hans Peter Weitzenböck
- Medical and Pharmaceutical Biotechnology, IMC University of Applied Sciences, Krems, Austria
| | - Anna Gschwendtner
- Center for Pathobiochemistry and Genetics, Medical University of Vienna, Vienna, Austria
| | - Christoph Wiesner
- Medical and Pharmaceutical Biotechnology, IMC University of Applied Sciences, Krems, Austria
| | - Maren Depke
- Interfaculty Institute for Genetics and Functional Genomics, University Medicine Greifswald, Greifswald, Germany
| | - Frank Schmidt
- Proteomics Core, Weill Cornell Medicine-Qatar, Qatar Foundation-Education City, Doha, Qatar
| | - Franz Trautinger
- Department of Dermatology and Venereology, University Hospital of St. Pölten, Karl Landsteiner University of Health Sciences, St. Pölten, Austria.,Karl Landsteiner Institute of Dermatological Research, St. Pölten, Austria
| | - Markus Hengstschläger
- Center for Pathobiochemistry and Genetics, Medical University of Vienna, Vienna, Austria
| | - Harald Hundsberger
- Medical and Pharmaceutical Biotechnology, IMC University of Applied Sciences, Krems, Austria.,Department of Dermatology, University Hospital of the Paracelsus Medical University, Salzburg, Austria
| | - Mario Mikula
- Center for Pathobiochemistry and Genetics, Medical University of Vienna, Vienna, Austria
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15
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Jonak C, Alkon N, Rindler K, Rojahn TB, Shaw LE, Porkert S, Weninger W, Trautinger F, Stingl G, Tschandl P, Cerroni L, Farlik M, Brunner PM. Single-cell RNA sequencing profiling in a patient with discordant primary cutaneous B-cell and T-cell lymphoma reveals micromilieu-driven immune skewing. Br J Dermatol 2021; 185:1013-1025. [PMID: 34018188 DOI: 10.1111/bjd.20512] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Primary cutaneous lymphomas comprise a heterogeneous group of B-cell and T-cell malignancies which often show an indolent course, but can progress to aggressive disease in a subset of patients. Diagnosis is often delayed owing to clinical and histopathological similarities with benign inflammatory conditions. Especially during early disease, cancer cells are present at relatively low percentages compared with the inflammatory infiltrate, an interplay that is currently only insufficiently understood. OBJECTIVES To improve diagnostics and perform molecular characterization of a complex type of primary cutaneous lymphoma. METHODS Single-cell RNA sequencing (scRNA-seq) was performed and combined with T-cell and B-cell receptor sequencing. RESULTS We were able to diagnose a patient with concurrent mycosis fungoides (MF) and primary cutaneous follicle centre lymphoma (PCFCL), appearing in mutually exclusive skin lesions. Profiling of tumour cells and the tissue microenvironment revealed a type-2 immune skewing in MF, most likely guided by the expanded clone that also harboured upregulation of numerous pro-oncogenic genes. By contrast, PCFCL lesions exhibited a more type-1 immune phenotype, consistent with its indolent behaviour. CONCLUSIONS These data not only illustrate the diagnostic potential of scRNA-seq, but also allow the characterization of specific clonal populations that shape the unique tissue microenvironment in clinically distinct types of lymphoma skin lesions.
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Affiliation(s)
- C Jonak
- Department of Dermatology, Medical University of Vienna, Austria
| | - N Alkon
- Department of Dermatology, Medical University of Vienna, Austria
| | - K Rindler
- Department of Dermatology, Medical University of Vienna, Austria
| | - T B Rojahn
- Department of Dermatology, Medical University of Vienna, Austria
| | - L E Shaw
- Department of Dermatology, Medical University of Vienna, Austria
| | - S Porkert
- Department of Dermatology, Medical University of Vienna, Austria
| | - W Weninger
- Department of Dermatology, Medical University of Vienna, Austria
| | - F Trautinger
- Department of Dermatology and Venereology, Karl Landsteiner University of Health Sciences, St. Pölten, Austria.,Karl Landsteiner Institute of Dermatological Research, St. Pölten, Austria
| | - G Stingl
- Department of Dermatology, Medical University of Vienna, Austria
| | - P Tschandl
- Department of Dermatology, Medical University of Vienna, Austria
| | - L Cerroni
- Department of Dermatology, Medical University of Graz, Graz, Austria
| | - M Farlik
- Department of Dermatology, Medical University of Vienna, Austria
| | - P M Brunner
- Department of Dermatology, Medical University of Vienna, Austria
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16
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Gugerell A, Gouya-Lechner G, Hofbauer H, Laggner M, Trautinger F, Almer G, Peterbauer-Scherb A, Seibold M, Hoetzenecker W, Dreschl C, Mildner M, Ankersmit HJ. Safety and clinical efficacy of the secretome of stressed peripheral blood mononuclear cells in patients with diabetic foot ulcer-study protocol of the randomized, placebo-controlled, double-blind, multicenter, international phase II clinical trial MARSYAS II. Trials 2021; 22:10. [PMID: 33407796 PMCID: PMC7789696 DOI: 10.1186/s13063-020-04948-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 12/07/2020] [Indexed: 12/13/2022] Open
Abstract
Background Diabetes and its sequelae such as diabetic foot ulcer are rising health hazards not only in western countries but all over the world. Effective, yet safe treatments are desperately sought for by physicians, healthcare providers, and of course patients. Methods/design APOSEC, a novel, innovative drug, is tested in the phase I/II study MARSYAS II, where its efficacy to promote healing of diabetic foot ulcers will be determined. To this end, the cell-free secretome of peripheral blood mononuclear cells (APOSEC) blended with a hydrogel will be applied topically three times weekly for 4 weeks. APOSEC is predominantly effective in hypoxia-induced tissue damages by modulating the immune system and enhancing angiogenesis, whereby its anti-microbial ability and neuro-regenerative capacity will exert further positive effects. In total, 132 patients will be enrolled in the multicenter, randomized, double-blind, placebo-controlled, parallel group, dose-ranging phase I/II study and treated with APOSEC at three dose levels or placebo for 4 weeks, followed by an 8-week follow-up period to evaluate safety and efficacy of the drug. Wound area reduction after 4 weeks of treatment will serve as the primary endpoint. Conclusion We consider our study protocol to be suitable to test topically administered APOSEC in patients suffering from diabetic foot ulcers in a clinical phase I/II trial. Trial registration EudraCT 2018-001653-27. Registered on 30 July 2019. ClinicalTrials.gov NCT04277598. Registered on 20 February 2020. Title: “A randomized, placebo-controlled, double-blind study to evaluate safety and dose-dependent clinical efficacy of APO-2 at three different doses in patients with diabetic foot ulcer (MARSYAS II)” Supplementary Information The online version contains supplementary material available at 10.1186/s13063-020-04948-1.
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Affiliation(s)
- Alfred Gugerell
- Division of Thoracic Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.,Aposcience AG, Vienna, Austria
| | | | - Helmut Hofbauer
- Division of Thoracic Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.,Aposcience AG, Vienna, Austria
| | - Maria Laggner
- Division of Thoracic Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.,Aposcience AG, Vienna, Austria
| | - Franz Trautinger
- Clinical Department for Skin and Venereal Diseases, Universitaetsklinikum St.Poelten, St. Poelten, Austria
| | | | | | - Marcus Seibold
- Aposcience AG, Vienna, Austria.,Austrian Red Cross Blood Transfusion Service of Upper Austria, Linz, Austria
| | - Wolfram Hoetzenecker
- Department of Dermatology and Venerology, Kepler University Hospital, Linz, Austria
| | - Christiane Dreschl
- Department of Surgery, Krankenhaus der Elisabethinen Klagenfurt, Klagenfurt, Austria
| | - Michael Mildner
- Research Division of Biology and Pathobiology of the Skin, Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - Hendrik Jan Ankersmit
- Division of Thoracic Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria. .,Aposcience AG, Vienna, Austria.
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17
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Graier T, Salmhofer W, Jonak C, Weger W, Kölli C, Gruber B, Sator PG, Prillinger K, Mlynek A, Schütz-Bergmayr M, Richter L, Ratzinger G, Painsi C, Selhofer S, Häring N, Wippel-Slupetzky K, Skvara H, Trattner H, Tanew A, Inzinger M, Tatarski R, Bangert C, Ellersdorfer C, Lichem R, Gruber-Wackernagel A, Hofer A, Legat F, Schmiedberger E, Strohal R, Lange-Asschenfeldt B, Schmuth M, Vujic I, Hoetzenecker W, Trautinger F, Saxinger W, Müllegger R, Quehenberger F, Wolf P. Biologic drug survival rates in the era of anti-interleukin-17 antibodies: a time-period-adjusted registry analysis. Br J Dermatol 2020; 184:1094-1105. [PMID: 33289075 PMCID: PMC8248155 DOI: 10.1111/bjd.19701] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2020] [Indexed: 12/22/2022]
Abstract
Background Drug survival rates reflect efficacy and safety and may be influenced by the availability of alternative treatment options. Little is known about time‐dependent drug survival in psoriasis and the effect of increasing numbers of biologic treatment options. Objectives To determine whether drug survival is influenced by the availability of treatment options and by factors such as gender, psoriatic arthritis or previous biologic treatment. Methods This observational, retrospective, multicentre cohort study analysed data from patients registered in the Austrian Psoriasis Registry (PsoRA) who were treated with biologics between 1 January 2015 and 30 November 2019. Results A total of 1572 patients who received 1848 treatment cycles were included in this analysis. The highest long‐term Psoriasis Area and Severity Index improvement was observed after treatment with ixekizumab, followed by ustekinumab and secukinumab, adalimumab and etanercept. Overall, ustekinumab surpassed all other biologics in drug survival up to 48 months. However, when adjusted for biologic naïvety, its superiority vanished and drug survival rates were similar for ixekizumab (91·6%), secukinumab (90·2%) and ustekinumab (92·8%), all of them superior to adalimumab (76·5%) and etanercept (71·9%) at 12 months and beyond. Besides biologic non‐naïvety (2·10, P < 0·001), the introduction of a new drug such as secukinumab or ixekizumab (relative hazard ratio 1·6, P = 0·001) and female gender (1·50, P = 0·019) increased the risk of treatment discontinuation overall, whereas psoriatic arthritis did not (1·12, P = 0·21). Conclusions The time‐dependent availability of drugs should be considered when analysing and comparing drug survival. Previous biologic exposure significantly influences drug survival. Women are more likely to stop treatment.
What is already known about this topic?
Female gender and previous biologic exposure have been discussed as predictors for decreased drug survival in patients with psoriasis, but it remains unknown whether a time‐dependent increased availability of treatment options alters biologic drug survival.
What does this study add?
The increased availability of alternative biologic treatments over time leads to an elevated risk for treatment discontinuation overall; therefore, drug survival analysis has to be time adjusted. Moreover, the study reveals that the impact of previous biologic treatment on drug survival is tremendous and confirms worse drug survival in female patients.
Linked Comment: Gniadecki. Br J Dermatol 2021; 184:996–997.
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Affiliation(s)
- T Graier
- Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria
| | - W Salmhofer
- Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria
| | - C Jonak
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - W Weger
- Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria
| | - C Kölli
- Department of Dermatology and Venereology, State Hospital, Wiener Neustadt, Austria
| | - B Gruber
- Department of Dermatology and Venereology, Hospital of Wels-Grieskirchen, Wels-Grieskirchen, Austria
| | - P G Sator
- Department of Dermatology, Hietzing Hospital, Vienna, Austria
| | - K Prillinger
- Department of Dermatology and Venereology, University Hospital St Pölten, St Pölten, Austria
| | - A Mlynek
- Department of Dermatology, Hospital of Elisabethinen, Linz, Austria
| | - M Schütz-Bergmayr
- Department of Dermatology and Venereology, Kepler University Hospital, Linz, Austria
| | - L Richter
- Department of Dermatology and Venereology, State Hospital of Vienna Rudolfstiftung, Vienna, Austria
| | - G Ratzinger
- Department of Dermatology, Venereology and Allergology, Medical University of Innsbruck, Innsbruck, Austria
| | - C Painsi
- Department of Dermatology and Venereology, State Hospital, Klagenfurt, Austria
| | - S Selhofer
- Department of Dermatology and Allergology, Paracelsus Medical University, Salzburg, Austria
| | - N Häring
- Department of Dermatology and Venereology, Federal Academic Teaching Hospital, Feldkirch, Austria
| | | | - H Skvara
- Department of Dermatology and Venereology, State Hospital, Wiener Neustadt, Austria
| | - H Trattner
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - A Tanew
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - M Inzinger
- Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria
| | - R Tatarski
- Department of Dermatology and Allergology, Paracelsus Medical University, Salzburg, Austria
| | - C Bangert
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - C Ellersdorfer
- Department of Dermatology and Venereology, State Hospital of Vienna Rudolfstiftung, Vienna, Austria
| | - R Lichem
- Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria
| | - A Gruber-Wackernagel
- Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria
| | - A Hofer
- Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria
| | - F Legat
- Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria
| | - E Schmiedberger
- Institute for Medical Informatics, Statistics, and Documentation, Medical University of Graz, Graz, Austria
| | - R Strohal
- Department of Dermatology and Venereology, Federal Academic Teaching Hospital, Feldkirch, Austria
| | | | - M Schmuth
- Department of Dermatology, Venereology and Allergology, Medical University of Innsbruck, Innsbruck, Austria
| | - I Vujic
- Department of Dermatology and Venereology, State Hospital of Vienna Rudolfstiftung, Vienna, Austria
| | - W Hoetzenecker
- Department of Dermatology and Venereology, Kepler University Hospital, Linz, Austria
| | - F Trautinger
- Department of Dermatology and Venereology, University Hospital St Pölten, St Pölten, Austria
| | - W Saxinger
- Department of Dermatology and Venereology, Hospital of Wels-Grieskirchen, Wels-Grieskirchen, Austria
| | - R Müllegger
- Department of Dermatology and Venereology, State Hospital, Wiener Neustadt, Austria
| | - F Quehenberger
- Institute for Medical Informatics, Statistics, and Documentation, Medical University of Graz, Graz, Austria
| | - P Wolf
- Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria
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18
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Smiljkovic D, Kiss R, Lupinek C, Hoermann G, Greiner G, Witzeneder N, Krajnik G, Trautinger F, Vrtala S, Mittermann I, Kundi M, Jilma B, Valenta R, Sperr WR, Valent P. Microarray-Based Detection of Allergen-Reactive IgE in Patients with Mastocytosis. J Allergy Clin Immunol Pract 2020; 8:2761-2768.e16. [PMID: 32348913 DOI: 10.1016/j.jaip.2020.04.030] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 04/03/2020] [Accepted: 04/11/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND Because of a high risk to develop fatal anaphylaxis, early detection of immunoglobulin E (IgE)-dependent allergy is of particular importance in patients with mastocytosis. OBJECTIVE We examined whether microarray-based screening for allergen-reactive IgE (allergen-chip) is a sensitive and robust approach to detect specific IgE in patients with mastocytosis. METHODS Sera for 42 patients were analyzed, including 4 with cutaneous mastocytosis, 2 with mastocytosis in the skin, and 36 with systemic mastocytosis. In addition, sera from an age- and sex-matched control cohort (n = 42) were analyzed. RESULTS In 15 of 42 patients with mastocytosis (35.7%), specific IgE was detected by allergen-chip profiling. Ves v 5 and Bet v 1 were the most frequently detected allergens (Ves v 5: 16.7% of patients; Bet v 1: 11.9% of patients). Allergen reactivity was confirmed by demonstrating upregulation of CD203c on blood basophils upon exposure to the respective allergen(s) in these patients. Specific IgE was identified by chip studies in 11 of 26 patients with mastocytosis with mediator-related symptoms (42.3%) and in 4 of 14 patients with mastocytosis without symptoms (28.6%). In the cohort with known allergy, 9 of 9 patients (100%) had a positive allergen-chip result. In patients with mastocytosis without a known allergy (n = 31), the chip identified 6 positive cases (19.5%). The prevalence of chip-positive patients was slightly lower in the mastocytosis group (35.7%) compared with age- and sex-matched controls (40.5%). CONCLUSIONS Although specific IgE may not be detectable in all sensitized patients with mastocytosis, allergy chip-profiling is a reliable screening approach for the identification of patients with mastocytosis suffering from IgE-dependent allergies.
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Affiliation(s)
- Dubravka Smiljkovic
- Department of Internal Medicine I, Division of Hematology & Hemostaseology, Medical University of Vienna, Vienna, Austria
| | - Renata Kiss
- Department of Pathophysiology and Allergy Research, Division of Immunopathology, Center for Pathophysiology, Immunology and Infectiology, Medical University of Vienna, Vienna, Austria
| | - Christian Lupinek
- Department of Pathophysiology and Allergy Research, Division of Immunopathology, Center for Pathophysiology, Immunology and Infectiology, Medical University of Vienna, Vienna, Austria
| | - Gregor Hoermann
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria; Ludwig Boltzmann Institute for Hematology and Oncology, Medical University of Vienna, Vienna, Austria; Central Institute of Medical and Chemical Laboratory Diagnostics, University Hospital Innsbruck, Innsbruck, Austria
| | - Georg Greiner
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria; Ludwig Boltzmann Institute for Hematology and Oncology, Medical University of Vienna, Vienna, Austria
| | - Nadine Witzeneder
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Gerhard Krajnik
- Department of Internal Medicine I, University Hospital St. Poelten, St. Poelten, Austria
| | - Franz Trautinger
- Department of Dermatology, University Hospital St. Poelten, St. Poelten, Austria
| | - Susanne Vrtala
- Department of Pathophysiology and Allergy Research, Division of Immunopathology, Center for Pathophysiology, Immunology and Infectiology, Medical University of Vienna, Vienna, Austria
| | - Irene Mittermann
- Department of Pathophysiology and Allergy Research, Division of Immunopathology, Center for Pathophysiology, Immunology and Infectiology, Medical University of Vienna, Vienna, Austria
| | - Michael Kundi
- Institute of Environmental Health of the Medical University of Vienna, Vienna, Austria
| | - Bernd Jilma
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
| | - Rudolf Valenta
- Department of Pathophysiology and Allergy Research, Division of Immunopathology, Center for Pathophysiology, Immunology and Infectiology, Medical University of Vienna, Vienna, Austria; NRC Institute of Immunology FMBA of Russia, Moscow, Russia; Laboratory for Immunopathology, Department of Clinical Immunology and Allergy, Sechenov First Moscow State Medical University, Moscow, Russia; Karl Landsteiner University of Health Sciences, Krems, Austria
| | - Wolfgang R Sperr
- Department of Internal Medicine I, Division of Hematology & Hemostaseology, Medical University of Vienna, Vienna, Austria; Ludwig Boltzmann Institute for Hematology and Oncology, Medical University of Vienna, Vienna, Austria.
| | - Peter Valent
- Department of Internal Medicine I, Division of Hematology & Hemostaseology, Medical University of Vienna, Vienna, Austria; Ludwig Boltzmann Institute for Hematology and Oncology, Medical University of Vienna, Vienna, Austria.
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19
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Antoni A, Trautinger F, Heinz T, Hajdu S. Hemiarthroplasty in a patient with femoral neck fracture and pyoderma gangrenosum: a case report and review of the literature. J Med Case Rep 2020; 14:8. [PMID: 31931877 PMCID: PMC6958711 DOI: 10.1186/s13256-019-2329-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Accepted: 12/02/2019] [Indexed: 11/10/2022] Open
Abstract
Background Pyoderma gangrenosum is a rare ulcerating skin disease of unknown etiology, making its coincidence with orthopedic trauma a rare challenge. Patients are at risk of progression of the existing lesions and development of new lesions upon skin injury when surgical procedures are performed. To our knowledge, this is the first report in the literature of disease unrelated surgery during active pyoderma gangrenosum. Case presentation We present a case of femoral neck fracture in a Caucasian patient with concurrent pyoderma gangrenosum localized in the axilla. Hemiarthroplasty was safely performed after disease activity was reduced with systemic corticosteroids. Tissue-protective wound closure was used together with perioperative corticosteroids and antibiotics. No signs of pyoderma gangrenosum developed at the surgical wound site, and the axillary lesions showed constant improvement until healing with scar tissue. Conclusions In our patient, the preoperative steroid treatment, perioperative antibiotics, and soft tissue protective surgical technique led to successful management of this rare coincidence.
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Affiliation(s)
- Anna Antoni
- Department of Trauma Surgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
| | - Franz Trautinger
- Karl Landsteiner Institute of Dermatological Research, Karl Landsteiner Society, Franziskanergasse 4a, 3100, St. Pölten, Austria
| | - Thomas Heinz
- Department of Trauma Surgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Stefan Hajdu
- Department of Trauma Surgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
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20
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21
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Scarisbrick JJ, Quaglino P, Prince HM, Papadavid E, Hodak E, Bagot M, Servitje O, Berti E, Ortiz-Romero P, Stadler R, Patsatsi A, Knobler R, Guenova E, Child F, Whittaker S, Nikolaou V, Tomasini C, Amitay I, Prag Naveh H, Ram-Wolff C, Battistella M, Alberti-Violetti S, Stranzenbach R, Gargallo V, Muniesa C, Koletsa T, Jonak C, Porkert S, Mitteldorf C, Estrach T, Combalia A, Marschalko M, Csomor J, Szepesi A, Cozzio A, Dummer R, Pimpinelli N, Grandi V, Beylot-Barry M, Pham-Ledard A, Wobser M, Geissinger E, Wehkamp U, Weichenthal M, Cowan R, Parry E, Harris J, Wachsmuth R, Turner D, Bates A, Healy E, Trautinger F, Latzka J, Yoo J, Vydianath B, Amel-Kashipaz R, Marinos L, Oikonomidi A, Stratigos A, Vignon-Pennamen MD, Battistella M, Climent F, Gonzalez-Barca E, Georgiou E, Senetta R, Zinzani P, Vakeva L, Ranki A, Busschots AM, Hauben E, Bervoets A, Woei-A-Jin FJSH, Matin R, Collins G, Weatherhead S, Frew J, Bayne M, Dunnill G, McKay P, Arumainathan A, Azurdia R, Benstead K, Twigger R, Rieger K, Brown R, Sanches JA, Miyashiro D, Akilov O, McCann S, Sahi H, Damasco FM, Querfeld C, Folkes A, Bur C, Klemke CD, Enz P, Pujol R, Quint K, Geskin L, Hong E, Evison F, Vermeer M, Cerroni L, Kempf W, Kim Y, Willemze R. The PROCLIPI international registry of early-stage mycosis fungoides identifies substantial diagnostic delay in most patients. Br J Dermatol 2019; 181:350-357. [PMID: 30267549 DOI: 10.1111/bjd.17258] [Citation(s) in RCA: 112] [Impact Index Per Article: 22.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/25/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND Survival in mycosis fungoides (MF) is varied and may be poor. The PROCLIPI (PROspective Cutaneous Lymphoma International Prognostic Index) study is a web-based data collection system for early-stage MF with legal data-sharing agreements permitting international collaboration in a rare cancer with complex pathology. Clinicopathological data must be 100% complete and in-built intelligence in the database system ensures accurate staging. OBJECTIVES To develop a prognostic index for MF. METHODS Predefined datasets for clinical, haematological, radiological, immunohistochemical, genotypic, treatment and quality of life are collected at first diagnosis of MF and annually to test against survival. Biobanked tissue samples are recorded within a Federated Biobank for translational studies. RESULTS In total, 430 patients were enrolled from 29 centres in 15 countries spanning five continents. Altogether, 348 were confirmed as having early-stage MF at central review. The majority had classical MF (81·6%) with a CD4 phenotype (88·2%). Folliculotropic MF was diagnosed in 17·8%. Most presented with stage I (IA: 49·4%; IB: 42·8%), but 7·8% presented with enlarged lymph nodes (stage IIA). A diagnostic delay between first symptom development and initial diagnosis was frequent [85·6%; median delay 36 months (interquartile range 12-90)]. This highlights the difficulties in accurate diagnosis, which includes lack of a singular diagnostic test for MF. CONCLUSIONS This confirmed early-stage MF cohort is being followed-up to identify prognostic factors, which may allow better management and improve survival by identifying patients at risk of disease progression. This study design is a useful model for collaboration in other rare diseases, especially where pathological diagnosis can be complex.
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Affiliation(s)
- J J Scarisbrick
- European Co-ordinating PROCLIPI Centre for PROCLIPI, University Hospitals Birmingham, Birmingham, U.K
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
- Member of the UK Cutaneous Lymphoma Group
| | - P Quaglino
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - H M Prince
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - E Papadavid
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - E Hodak
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - M Bagot
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - O Servitje
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - E Berti
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - P Ortiz-Romero
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - R Stadler
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - A Patsatsi
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - R Knobler
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - E Guenova
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - F Child
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the UK Cutaneous Lymphoma Group
| | - S Whittaker
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
- Member of the UK Cutaneous Lymphoma Group
| | - V Nikolaou
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - C Tomasini
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - I Amitay
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - H Prag Naveh
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - C Ram-Wolff
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - M Battistella
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - S Alberti-Violetti
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - R Stranzenbach
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - V Gargallo
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - C Muniesa
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - T Koletsa
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - C Jonak
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - S Porkert
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - C Mitteldorf
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - T Estrach
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - A Combalia
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - M Marschalko
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - J Csomor
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - A Szepesi
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - A Cozzio
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - R Dummer
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - N Pimpinelli
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - V Grandi
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - M Beylot-Barry
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - A Pham-Ledard
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - M Wobser
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - E Geissinger
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - U Wehkamp
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - M Weichenthal
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - R Cowan
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the UK Cutaneous Lymphoma Group
| | - E Parry
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the UK Cutaneous Lymphoma Group
| | - J Harris
- Member of the UK Cutaneous Lymphoma Group
| | - R Wachsmuth
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the UK Cutaneous Lymphoma Group
| | - D Turner
- Member of the UK Cutaneous Lymphoma Group
| | - A Bates
- Member of the UK Cutaneous Lymphoma Group
| | - E Healy
- Member of the UK Cutaneous Lymphoma Group
| | - F Trautinger
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - J Latzka
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - J Yoo
- European Co-ordinating PROCLIPI Centre for PROCLIPI, University Hospitals Birmingham, Birmingham, U.K
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - B Vydianath
- European Co-ordinating PROCLIPI Centre for PROCLIPI, University Hospitals Birmingham, Birmingham, U.K
| | - R Amel-Kashipaz
- European Co-ordinating PROCLIPI Centre for PROCLIPI, University Hospitals Birmingham, Birmingham, U.K
| | - L Marinos
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - A Oikonomidi
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - A Stratigos
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - M-D Vignon-Pennamen
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - M Battistella
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - F Climent
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - E Gonzalez-Barca
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - E Georgiou
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - R Senetta
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - P Zinzani
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - L Vakeva
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - A Ranki
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - A-M Busschots
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - E Hauben
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - A Bervoets
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - F J S H Woei-A-Jin
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - R Matin
- Member of the UK Cutaneous Lymphoma Group
| | - G Collins
- Member of the UK Cutaneous Lymphoma Group
| | | | - J Frew
- Member of the UK Cutaneous Lymphoma Group
| | - M Bayne
- Member of the UK Cutaneous Lymphoma Group
| | - G Dunnill
- Member of the UK Cutaneous Lymphoma Group
| | - P McKay
- Member of the UK Cutaneous Lymphoma Group
| | | | - R Azurdia
- Member of the UK Cutaneous Lymphoma Group
| | - K Benstead
- Member of the UK Cutaneous Lymphoma Group
| | - R Twigger
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - K Rieger
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - R Brown
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - J A Sanches
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - D Miyashiro
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - O Akilov
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - S McCann
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - H Sahi
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - F M Damasco
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - C Querfeld
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - A Folkes
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - C Bur
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - C-D Klemke
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - P Enz
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - R Pujol
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - K Quint
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - L Geskin
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - E Hong
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - F Evison
- European Co-ordinating PROCLIPI Centre for PROCLIPI, University Hospitals Birmingham, Birmingham, U.K
| | - M Vermeer
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - L Cerroni
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - W Kempf
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - Y Kim
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - R Willemze
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
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22
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Trautinger F. Lasers in medicine. Photochem Photobiol Sci 2019; 18:1619-1620. [PMID: 33856668 DOI: 10.1039/c9pp90031d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Welcome to this special web collection of Photochem. & Photobiol. Sci. entitled ‘Lasers in medicine’.
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Affiliation(s)
- Franz Trautinger
- Department of Dermatology and Venereology, Karl Landsteiner University of Health Sciences, and Karl Landsteiner Institute of Dermatological Research, St Pölten, Dunant-Platz 1, St Pölten, 3100, Austria.
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23
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Abstract
Chronic ulcers of the lower extremities are one of the most common medical problems encountered in western societies. The prevalence of leg ulcers is estimated to be 0.5-1.0% of the German population and is clearly associated with age. Therefore, in an aging society chronic leg ulcers are an important health issue with respect to increased morbidity and healthcare costs. The most frequent causes of leg ulcers are chronic venous insufficiency, peripheral arterial occlusive disease and diabetes mellitus. Efficient treatment necessitates an exact diagnosis and a close interdisciplinary collaboration. Affected patients often require instructions regarding self-help and support for competent nursing and prophylaxis. Therapeutic strategies, especially in the geriatric setting, aim to maintain the quality of life through preservation of patient mobility and autonomy.
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Affiliation(s)
- N Duschek
- Klinische Abteilung für Haut- und Geschlechtskrankheiten, Universitätsklinikum St. Pölten, Karl Landsteiner Privatuniversität für Gesundheitswissenschaften, Dunant-Platz 1, 3100, St. Pölten, Österreich.
| | - F Trautinger
- Klinische Abteilung für Haut- und Geschlechtskrankheiten, Universitätsklinikum St. Pölten, Karl Landsteiner Privatuniversität für Gesundheitswissenschaften, Dunant-Platz 1, 3100, St. Pölten, Österreich
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24
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Porkert S, Wehkamp U, Brunner P, Tsolakidis K, Trautinger F, Schlaepfer T, Guenova E, Jonak C. Retrospective validation of prognostic markers and models in a cohort of 60 patients with lethal mycosis fungoides. Eur J Cancer 2019. [DOI: 10.1016/s0959-8049(19)30586-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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25
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Abstract
Cutaneous T-cell lymphomas (CTCL) are a heterogenous group of non-Hodgkin lymphomas arising in the skin. Mycosis fungoides (MF), the most common variant, is characterised by clonal proliferation of skin residing malignant T-cells. Initially appearing with erythematous patches and plaques it follows a chronic course with progression to cutaneous tumours and extracutaneous involvement in some patients. Phototherapy with ultraviolet A radiation combined with 8-methoxypsoralen (PUVA) and with narrow-band ultraviolet B radiation (NB-UVB) are among the first line options for the treatment of MF and can induce remission in most patients. Sézary syndrome (SS) is a rare and more aggressive CTCL variant with generalized skin involvement. Patients with SS and with erythroderma from MF can benefit from treatment with extracorporeal photochemotherapy (ECP) where peripheral blood is exposed to PUVA. Phototherapy can be safely combined with systemic agents, most notably interferon-alpha and retinoids. Another photoresponsive CTCL variant is lymphomatoid papulosis (LP), a CD30+ lymphoproliferative disease characterised by chronically recurring papules. The disease responds favourably to PUVA but low dose methotrexate might be preferred for long term disease control. Recently updated treatment guidelines have been published to provide evidence-based algorithms for the stage-oriented treatment of MF, SS and LP. Areas of uncertainty are treatment schedules that are currently not optimised for CTCL, the use of phototherapy for maintenance, and the value of ultraviolet A1 radiation, excimer lasers, and photodynamic therapy.
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Affiliation(s)
- Franz Trautinger
- Department of Dermatology and Venereology, Karl Landsteiner University of Health Sciences, University Hospital of St. Pölten, Austria.
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26
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Wolf P, Weger W, Legat F, Painsi C, Saxinger W, Müllegger R, Sator P, Ratzinger G, Selhofer S, Richter L, Salmhofer W, Lange-Asschenfeldt B, Trautinger F, Mlynek A, Strohal R, Augustin M, Quehenberger F. Quality of life and treatment goals in psoriasis from the patient perspective: results of an Austrian cross-sectional survey. J Dtsch Dermatol Ges 2018; 16:981-990. [PMID: 30117711 DOI: 10.1111/ddg.13613] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Accepted: 02/06/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND Patients with psoriasis experience impairment in quality of life. Thus, high-quality dermatological care is of particular importance. PATIENTS AND METHODS We performed a nationwide cross-sectional survey in Austria (BQSAustria Psoriasis 2014/2015) with a special focus on quality of life and satisfaction with treatment among psoriasis patients predominantly treated at tertiary care centers. RESULTS Overall, 70.2 % of 1,184 patients reported impaired quality of life (DLQI 2-5: 29.4 %; 6-10: 19.3 %; 11-15: 11.5 %; 16-20: 5.2 % and > 20: 4.9 %) despite treatment over the preceding four weeks (topical treatment in 88.2 % of cases and/or systemic treatment in 38.7 %). On average, none of the 25 defined subjective treatment goals was achieved to a sufficient degree. In particular, 82.2 % of patients continued to have pruritus despite treatment, which was highly significantly associated with a poor general health status over the preceding week (Spearman's rank correlation; p = 1.1e-45), the extent of body surface area (p = 3.2e-11) and scalp area (p = 3.2e-11) affected, as well as pain (p = 2.3e-22). Treatment with a biologic was significantly correlated with higher patient satisfaction (Wilcoxon-Test, p = 2.0e-16). CONCLUSIONS Despite dermatological care, the majority of Austrian psoriasis patients continues to experience impaired quality of life; there is potential for improvement in the achievement of treatment goals.
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Affiliation(s)
- Peter Wolf
- Department of Dermatology and Venereology, Graz Medical University, Graz, Austria
| | - Wolfgang Weger
- Department of Dermatology and Venereology, Graz Medical University, Graz, Austria
| | - Franz Legat
- Department of Dermatology and Venereology, Graz Medical University, Graz, Austria.,Kurhaus Bad Gleichenberg, Bad Gleichenberg, Austria
| | - Clemens Painsi
- Department of Dermatology and Venereology, Graz Medical University, Graz, Austria.,Department of Dermatology and Venereology, Klagenfurt Medical Center, Klagenfurt, Austria
| | - Werner Saxinger
- Department of Dermatology and Venereology, Wels-Grieskirchen Medical Center, Wels, Austria
| | - Robert Müllegger
- Department of Dermatology and Venereology, State Medical Center, Wiener Neustadt, Austria
| | - Paul Sator
- Department of Dermatology, Hietzing Hospital, Vienna, Austria
| | - Gudrun Ratzinger
- Department of Dermatology, Venereology and Allergology, Medical University of Innsbruck, Austria
| | - Sylvia Selhofer
- Department of Dermatology, Paracelsus Private Medical University, Salzburg, Austria
| | - Leo Richter
- Department of Dermatology and Venereology, The Rudolfstiftung Hospital, Vienna, Austria
| | - Wolfgang Salmhofer
- Department of Dermatology and Venereology, Graz Medical University, Graz, Austria
| | | | - Franz Trautinger
- Department of Dermatology and Venereology, University Medical Center St. Pölten, Karl Landsteiner University of Health Sciences, Krems, Austria
| | - Alexander Mlynek
- Department of Dermatology, Elisabethinen Medical Center, Linz, Austria
| | - Robert Strohal
- Department of Dermatology and Venereology, State Hospital and Academic Teaching Hospital Feldkirch, Feldkirch, Austria
| | - Matthias Augustin
- Institute for Health Services Research in Dermatology and Nursing, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Franz Quehenberger
- Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria
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27
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Wolf P, Weger W, Legat F, Painsi C, Saxinger W, Müllegger R, Sator P, Ratzinger G, Selhofer S, Richter L, Salmhofer W, Lange‐Asschenfeldt B, Trautinger F, Mlynek A, Strohal R, Augustin M, Quehenberger F. Lebensqualität und Behandlungsziele bei Psoriasis aus Patientensicht: Ergebnisse eines österreichweiten Querschnitt‐Survey. J Dtsch Dermatol Ges 2018; 16:981-991. [DOI: 10.1111/ddg.13613_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Accepted: 02/06/2018] [Indexed: 11/26/2022]
Affiliation(s)
- Peter Wolf
- Universitätsklinik für Dermatologie und VenerologieMedizinische Universität Graz Graz Österreich
| | - Wolfgang Weger
- Universitätsklinik für Dermatologie und VenerologieMedizinische Universität Graz Graz Österreich
| | - Franz Legat
- Universitätsklinik für Dermatologie und VenerologieMedizinische Universität Graz Graz Österreich
- Das Kurhaus Bad GleichenbergBad Gleichenberg Österreich
| | - Clemens Painsi
- Universitätsklinik für Dermatologie und VenerologieMedizinische Universität Graz Graz Österreich
- Abteilung für Dermatologie und VenerologieKlinikum Klagenfurt am Wörthersee Klagenfurt Österreich
| | - Werner Saxinger
- Abteilung für Haut‐ und GeschlechtskrankheitenKlinikum Wels‐Grieskirchen Wels Österreich
| | - Robert Müllegger
- Abteilung für Dermatologie und VenerologieLandesklinikum Wiener Neustadt Wiener Neustadt Österreich
| | - Paul Sator
- Dermatologische AbteilungKrankenhaus Hietzing Wien Österreich
| | - Gudrun Ratzinger
- Universitätsklinik für DermatologieVenerologie und AllergologieMedizinische Universität Innsbruck Innsbruck Österreich
| | - Sylvia Selhofer
- Universitätsklinik für DermatologieParacelsus Medizinische Privatuniversität Salzburg Salzburg Österreich
| | - Leo Richter
- Abteilung für Dermatologie und VenerologieKrankenanstalt Wien‐Rudolfstiftung Wien Österreich
| | - Wolfgang Salmhofer
- Universitätsklinik für Dermatologie und VenerologieMedizinische Universität Graz Graz Österreich
| | | | - Franz Trautinger
- Abteilung für Haut‐ und GeschlechtskrankheitenUniversitätsklinikum St. Pölten, Karl Landsteiner Privatuniversität für Gesundheitswissenschaften Krems Österreich
| | - Alexander Mlynek
- Abteilung für DermatologieOrdensklinikum Linz – Elisabethinen Linz Österreich
| | - Robert Strohal
- Abteilung für Dermatologie und VenerologieLandeskrankenhaus Feldkirch – Akademisches Lehrspital Feldkirch Österreich
| | - Matthias Augustin
- Institut für Versorgungsforschung in der Dermatologie und bei PflegeberufenUniversitätsklinikum Hamburg‐Eppendorf Hamburg Deutschland
| | - Franz Quehenberger
- Institut für Medizinische InformatikStatistik und DokumentationMedizinische Universität Graz, Graz Österreich
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28
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Zettinig G, Wrba F, Trautinger F, Peloschek P, Luger A. Necrobiotic panniculitis due to repeated insulin injection: a rare cause of a false positive somatostatin receptor scintigraphy. Nuklearmedizin 2018. [DOI: 10.1055/s-0038-1625107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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29
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Trautinger F. Controversy on the Use of Povidone-Iodine in Chronic Wounds. Skin Pharmacol Physiol 2018; 31:261. [DOI: 10.1159/000491641] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Accepted: 06/29/2018] [Indexed: 11/19/2022]
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30
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Abstract
Mycosis fungoides (MF), the most common variant among cutaneous T cell lymphomas (CTCL), is characterized in its early stages by clonal proliferation of malignant T-cells in the skin manifesting as erythematous patches and plaques with a chronic course and progression to cutaneous tumors and extracutaneous organs in some patients. Skin directed therapies (SDT) are primarily used for effective palliation in early stage disease. Phototherapy with ultraviolet A radiation combined with 8-methoxypsoralen (PUVA) and with ultraviolet B radiation (UVB) has a longstanding history in the treatment of MF and are highly effective in inducing remissions. Patients with erythroderma and blood involvement benefit from treatment with extracorporeal photochemotherapy (ECP) where peripheral blood is exposed to PUVA. Phototherapy can be safely combined with systemic agents, most notably interferon-alpha and retinoids. Recently updated treatment guidelines have been published to provide evidence based algorithms for the stage-oriented treatment of MF. PUVA and narrow-band UVB (NB-UVB) are recommended as first line treatment for early stages with combination modalities reserved for refractory and more advanced cases and ECP is among the standard treatments for MF erythroderma. Areas of uncertainty relate to optimized treatment dose and schedules, the use of phototherapy for maintenance, and the role of newer phototherapeutic modalities (e.g. ultraviolet A1 radiation, excimer sources, photodynamic therapy) in the treatment of MF.
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Affiliation(s)
- Franz Trautinger
- Department of Dermatology and Venereology, University Hospital of St. Pölten, Karl Landsteiner University of Health Sciences, Krems an der Donau, Austria - .,Karl Landsteiner Institute of Dermatological Research, St. Pölten, Austria -
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31
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Kiefer FW, Winhofer Y, Iacovazzo D, Korbonits M, Wolfsberger S, Knosp E, Trautinger F, Höftberger R, Krebs M, Luger A, Gessl A. PRKAR1A mutation causing pituitary-dependent Cushing disease in a patient with Carney complex. Eur J Endocrinol 2017; 177:K7-K12. [PMID: 28522647 DOI: 10.1530/eje-17-0227] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2017] [Accepted: 05/18/2017] [Indexed: 02/02/2023]
Abstract
CONTEXT Carney complex (CNC) is an autosomal dominant condition caused, in most cases, by an inactivating mutation of the PRKAR1A gene, which encodes for the type 1 alpha regulatory subunit of protein kinase A. CNC is characterized by the occurrence of endocrine overactivity, myxomas and typical skin manifestations. Cushing syndrome due to primary pigmented nodular adrenocortical disease (PPNAD) is the most frequent endocrine disease observed in CNC. CASE DESCRIPTION Here, we describe the first case of a patient with CNC and adrenocorticotropic hormone (ACTH)-dependent Cushing disease due to a pituitary corticotroph adenoma. Loss-of-heterozygosity analysis of the pituitary tumour revealed loss of the wild-type copy of PRKAR1A, suggesting a role of this gene in the pituitary adenoma development. CONCLUSION PRKAR1A loss-of-function mutations can rarely lead to ACTH-secreting pituitary adenomas in CNC patients. Pituitary-dependent disease should be considered in the differential diagnosis of Cushing syndrome in CNC patients.
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Affiliation(s)
- Florian W Kiefer
- Clinical Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria
| | - Yvonne Winhofer
- Clinical Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria
| | - Donato Iacovazzo
- Centre for Endocrinology, Barts and The London School of Medicine, Queen Mary University of London, London, UK
| | - Márta Korbonits
- Centre for Endocrinology, Barts and The London School of Medicine, Queen Mary University of London, London, UK
| | - Stefan Wolfsberger
- Department of Neurosurgery, Medical University of Vienna, Vienna, Austria
| | - Engelbert Knosp
- Department of Neurosurgery, Medical University of Vienna, Vienna, Austria
| | - Franz Trautinger
- Department of Dermatology and Venereology, Karl Landsteiner University of Health Sciences, St Pölten, Austria
| | - Romana Höftberger
- Institute of Neurology, Medical University of Vienna, Vienna, Austria
| | - Michael Krebs
- Clinical Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria
| | - Anton Luger
- Clinical Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria
| | - Alois Gessl
- Clinical Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria
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Prillinger KE, Trautinger F, Kitzwögerer M, Eder J. Two faces of gamma-delta mycosis fungoides: before and after renal transplantation. BMJ Case Rep 2017; 2017:bcr-2016-216990. [PMID: 28228429 DOI: 10.1136/bcr-2016-216990] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
We describe a patient with a 30-year history of mycosis fungoides (MF) and renal transplantation performed 3 years before he presented with an ulcerated tumour in the lumbosacral area. Biopsy revealed a lymphatic infiltrate of medium-sized, pleomorphic T cells expressing the gamma-delta T-cell receptor. Radiological staging and bone marrow biopsy revealed no extracutaneous involvement. Despite reduction in systemic immunosuppressants, total skin electron beam radiotherapy and systemic chemotherapy, the disease followed a highly aggressive course and the patient died 31 years after initial diagnosis of MF. Pre-existing MF is not listed as a contraindication for solid organ transplantation. With an ever-increasing number of organ recipients, the number of MF patients undergoing solid organ transplantation will be likely to increase. Systematic collection and analysis of such cases is thus warranted to lead to a better understanding to what kind MF gets influenced by solid organ transplantation and ongoing immunosuppression.
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Affiliation(s)
- Knut Erich Prillinger
- Department of Dermatology and Venereology, Karl Landsteiner University of Health Sciences, Sankt Pölten, Austria
| | - Franz Trautinger
- Department of Dermatology and Venereology, Karl Landsteiner University of Health Sciences, Sankt Pölten, Austria
| | - Melitta Kitzwögerer
- Department of Clinical Pathology, University Hospital St Pölten, Karl Landsteiner University, St Pölten, Austria
| | - Johanna Eder
- Department of Dermatology and Venereology, Karl Landsteiner University of Health Sciences, Sankt Pölten, Austria
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Trautinger F, Gebhart W. In memoriam Prim. i.R. OMR Dr. Heinrich Jünger. J Dtsch Dermatol Ges 2017; 15:246-247. [DOI: 10.1111/ddg.13179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Affiliation(s)
- Kerstin Fischer
- Department of Dermatology and Venereology, University Medical Center St. Pölten, Karl Landsteiner University for Health Sciences, St. Pölten, Austria
| | - Franz Trautinger
- Department of Dermatology and Venereology, University Medical Center St. Pölten, Karl Landsteiner University for Health Sciences, St. Pölten, Austria
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Eder J, Kammerstätter M, Erhart F, Mairhofer-Muri D, Trautinger F. Illness Perception in Primary Cutaneous T-cell Lymphomas: What Patients Believe About Their Disease. Acta Derm Venereol 2016; 96:381-5. [PMID: 26392387 DOI: 10.2340/00015555-2245] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
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.
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Affiliation(s)
- Johanna Eder
- Department of Dermatology and Venereology, Karl Landsteiner University of Health Sciences, 3100 St. Poelten, Austria.
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Inzinger M, Wippel-Slupetzky K, Weger W, Richter L, Mlynek A, Fleischander B, Scheurecker C, Sandor N, Mairhofer D, Sator PG, Moser-Oberthaler S, Häring N, Viznerova P, Painsi C, Tanew A, Ponholzer P, Tatarski R, Brenner W, Stingl G, Salmhofer W, Rappersberger K, Klein G, Saxinger W, Auböck J, Kölli C, Trautinger F, Steiner A, Ratzinger G, Strohal R, Riedl E, Lange-Asschenfeldt B, Pehamberger H, Volc-Platzer B, Selhofer S, Legat FJ, Müllegger R, Reider N, Schmuth M, Hintner H, Hofer A, Gruber-Wackernagel A, Aberer W, Quehenberger F, Wolf P. Survival and Effectiveness of Tumour Necrosis Factor-alpha Inhibitors in the Treatment of Plaque Psoriasis under Daily Life Conditions: Report from the Psoriasis Registry Austria. Acta Derm Venereol 2016; 96:207-12. [PMID: 26271044 DOI: 10.2340/00015555-2214] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This retrospective multicentre analysis from the Psoriasis Registry Austria (PsoRA) was conducted to determine drug effectiveness and survival of anti-tumour necrosis factor alpha (anti-TNF-α) agents in patients with moderate-to-severe chronic plaque psoriasis over a 9-year period. Data on 1,019 treatment cycles with adalimumab (n = 460), etanercept (n = 501), and/or infliximab (n = 58) administered to 827 patients (272 women, 555 men) were available for analysis. Compared with etanercept, adalimumab and infliximab showed superior short-term effectiveness. Intention-to-treat-calculated median drug survivals for adalimumab (1,264 days) and etanercept (1,438 days) were similar to each other (p = 0.74), but significantly superior to that of infliximab (477 days) (p = 7.0e-07 vs. adalimumab and p=2.2e-07 vs. etanercept, respectively). Their drug survival rates at 36 months were 51.6%, 56.0%, and 22.6%, respectively. Survival rates correlated significantly with effectiveness for adalimumab and etanercept, but not for infliximab.
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Affiliation(s)
- Martin Inzinger
- Department of Dermatology, Medical University of Graz, Auenbruggerplatz 8, AT-8036 Graz, Austria
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Stadler J, Eder J, Pratscher B, Brandt S, Schneller D, Müllegger R, Vogl C, Trautinger F, Brem G, Burgstaller JP. SNPase-ARMS qPCR: Ultrasensitive Mutation-Based Detection of Cell-Free Tumor DNA in Melanoma Patients. PLoS One 2015; 10:e0142273. [PMID: 26562020 PMCID: PMC4642939 DOI: 10.1371/journal.pone.0142273] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Accepted: 10/20/2015] [Indexed: 12/18/2022] Open
Abstract
Cell-free circulating tumor DNA in the plasma of cancer patients has become a common point of interest as indicator of therapy options and treatment response in clinical cancer research. Especially patient- and tumor-specific single nucleotide variants that accurately distinguish tumor DNA from wild type DNA are promising targets. The reliable detection and quantification of these single-base DNA variants is technically challenging. Currently, a variety of techniques is applied, with no apparent “gold standard”. Here we present a novel qPCR protocol that meets the conditions of extreme sensitivity and specificity that are required for detection and quantification of tumor DNA. By consecutive application of two polymerases, one of them designed for extreme base-specificity, the method reaches unprecedented sensitivity and specificity. Three qPCR assays were tested with spike-in experiments, specific for point mutations BRAF V600E, PTEN T167A and NRAS Q61L of melanoma cell lines. It was possible to detect down to one copy of tumor DNA per reaction (Poisson distribution), at a background of up to 200 000 wild type DNAs. To prove its clinical applicability, the method was successfully tested on a small cohort of BRAF V600E positive melanoma patients.
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Affiliation(s)
- Julia Stadler
- Biotechnology in Animal Production, Department for Agrobiotechnology, IFA Tulln, Tulln, Lower Austria, Austria
- Institute of Animal Breeding and Genetics, University of Veterinary Medicine Vienna, Vienna, Austria
| | - Johanna Eder
- Department of Dermatology and Venereology, Karl Landsteiner University of Health Sciences, St. Poelten, Lower Austria, Austria
- Karl Landsteiner Institute of Dermatological Research, St. Poelten, Lower Austria, Austria
| | - Barbara Pratscher
- Research Group Oncology of the Equine Clinic, Department for Companion Animal and Horses, University of Veterinary Medicine Vienna, Vienna, Austria
| | - Sabine Brandt
- Research Group Oncology of the Equine Clinic, Department for Companion Animal and Horses, University of Veterinary Medicine Vienna, Vienna, Austria
| | - Doris Schneller
- Biotechnology in Animal Production, Department for Agrobiotechnology, IFA Tulln, Tulln, Lower Austria, Austria
- Institute of Animal Breeding and Genetics, University of Veterinary Medicine Vienna, Vienna, Austria
| | - Robert Müllegger
- Department of Dermatology and Venereology, Landesklinikum Wiener Neustadt, Wiener Neustadt, Lower Austria, Austria
| | - Claus Vogl
- Institute of Animal Breeding and Genetics, University of Veterinary Medicine Vienna, Vienna, Austria
| | - Franz Trautinger
- Department of Dermatology and Venereology, Karl Landsteiner University of Health Sciences, St. Poelten, Lower Austria, Austria
- Karl Landsteiner Institute of Dermatological Research, St. Poelten, Lower Austria, Austria
| | - Gottfried Brem
- Biotechnology in Animal Production, Department for Agrobiotechnology, IFA Tulln, Tulln, Lower Austria, Austria
- Institute of Animal Breeding and Genetics, University of Veterinary Medicine Vienna, Vienna, Austria
| | - Joerg P. Burgstaller
- Biotechnology in Animal Production, Department for Agrobiotechnology, IFA Tulln, Tulln, Lower Austria, Austria
- Institute of Animal Breeding and Genetics, University of Veterinary Medicine Vienna, Vienna, Austria
- * E-mail:
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Fischer K, Trautinger F. Phacomatosis pigmentovascularis. J Dtsch Dermatol Ges 2015. [DOI: 10.1111/ddg.100_12834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Kerstin Fischer
- Abteilung für Haut- und Geschlechtskrankheiten; Universitätsklinikum St. Pölten, Karl Landsteiner Universität für Gesundheitswissenschaften; St. Pölten Österreich
| | - Franz Trautinger
- Abteilung für Haut- und Geschlechtskrankheiten; Universitätsklinikum St. Pölten, Karl Landsteiner Universität für Gesundheitswissenschaften; St. Pölten Österreich
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Moser J, Moshammer R, Koglbauer G, Kitzwögerer M, Bachner M, Trautinger F. Sentinel node biopsy in melanoma: a single-centre experience with 216 consecutive patients. Br J Dermatol 2015; 174:889-91. [PMID: 26402518 DOI: 10.1111/bjd.14189] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- J Moser
- Karl Landsteiner Institute of Dermatological Research, St. Pölten, Austria. .,Department of Dermatology and Venereology, Karl Landsteiner University of Health Sciences, St. Pölten, Austria.
| | - R Moshammer
- Karl Landsteiner Institute of Dermatological Research, St. Pölten, Austria.,Department of Dermatology and Venereology, Karl Landsteiner University of Health Sciences, St. Pölten, Austria
| | - G Koglbauer
- Karl Landsteiner Institute of Dermatological Research, St. Pölten, Austria.,Department of Dermatology and Venereology, Karl Landsteiner University of Health Sciences, St. Pölten, Austria
| | - M Kitzwögerer
- Department of Pathology, Karl Landsteiner University of Health Sciences, St. Pölten, Austria
| | - M Bachner
- Department of Surgery, Karl Landsteiner University of Health Sciences, St. Pölten, Austria
| | - F Trautinger
- Karl Landsteiner Institute of Dermatological Research, St. Pölten, Austria.,Department of Dermatology and Venereology, Karl Landsteiner University of Health Sciences, St. Pölten, Austria
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Rogojanu R, Eder J, Jerey W, Klosner G, Paulitschke V, Ellinger I, Thalhammer T, Kolmer D, Trautinger F. Abstract 1091: A new image processing approach for functional context-based analysis of tryptase positive mast cells in cutaneous T-cell lymphomas. Cancer Res 2015. [DOI: 10.1158/1538-7445.am2015-1091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Quantification data on mast cells is scarce in primary cutaneous T-cell lymphomas (CTCL), a heterogeneous group of non-Hodgkin lymphomas with initial presentation in the skin. The aim of the study was to develop a new whole-slide in-silico analysis method for immunohistochemistry stained skin sections. The design of the analysis method was focused on results about structural context of the cell location distribution and cell morphometry linked to mast cell activation states.
Immunohistochemistry staining with a monoclonal anti-mast cell tryptase antibody was performed on paraffin embedded biopsies from patients with different CTCL subtypes and controls (normal skin, inflammatory skin diseases),while hematoxylin was used for counter staining. Slides were scanned with a TissueFAXS 200 Cytometer (TissueGnostics GmbH, Vienna). Whole-slide digital images were analyzed using StrataQuest 5.0 Advanced (TissueGnostics, Vienna).
Hematoxylin+ cell nuclei and tryptase+ cells (TRYP+) objects were automatically detected using the available analysis modules with adaptive segmentation of color-deconvoluted images. Mast cells were first selected as brown-positive cells in a peri-nuclear compartment, then further stratified depending on the spatial distribution of brown-positive dots inside the cellular compartment. In an additional analysis layer, an algorithm pipeline for the identification of the epidermis / dermis area was assembled. Density-based CTCL areas were segmented in a third independent pipeline. Inside dermis, two additional CTCL-proximity masks were defined at 0-30μm away from CTCL (P1 mask), as well as in the 30-60μm interval (P2 mask).
Typically, there were more mast cells inside CTCL areas than in P1, which in turn had less than the P2 mask. This distribution was especially noticed in Mycosis fungoides(MF) IIB, where CTCL had 2-3 times more mast cells than P1 mask had. However, this trend was not consistent in all types of lymphoma. Interestingly, MF IIA had a different distribution showing more mast cells in P1 than in CTCL areas.
The new algorithms provided a rich data insight on functional context-based characteristics and propose new surrogate markers for further characterization of CTCL. The analysis time needed for statistically relevant large whole-slide tissue sections was drastically reduced when using the computer-aided approach when compared against full manual annotation and counting. Moreover, distance assessment and morphometry parameter quantification for each cell are only feasible in in-silico approaches.
Note: This abstract was not presented at the meeting.
Citation Format: Radu Rogojanu, Johanna Eder, Waltraud Jerey, Gabriele Klosner, Verene Paulitschke, Isabella Ellinger, Theresia Thalhammer, Dan Kolmer, Franz Trautinger. A new image processing approach for functional context-based analysis of tryptase positive mast cells in cutaneous T-cell lymphomas. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 1091. doi:10.1158/1538-7445.AM2015-1091
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Affiliation(s)
| | - Johanna Eder
- 2Karl Landsteiner Institute of Dermatological Research, St. Poelten, Austria
| | | | | | | | | | | | | | - Franz Trautinger
- 2Karl Landsteiner Institute of Dermatological Research, St. Poelten, Austria
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Eder J, Kern A, Moser J, Kitzwögerer M, Sedivy R, Trautinger F. Frequency of primary cutaneous lymphoma variants in Austria: retrospective data from a dermatology referral centre between 2006 and 2013. J Eur Acad Dermatol Venereol 2015; 29:1517-23. [PMID: 25600184 DOI: 10.1111/jdv.12907] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Accepted: 11/04/2014] [Indexed: 11/29/2022]
Abstract
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.
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Affiliation(s)
- J Eder
- Karl Landsteiner Institute of Dermatological Research, St. Pölten, Austria.,Department of Dermatology and Venereology, Karl Landsteiner University of Health Sciences, St. Pölten, Austria
| | - A Kern
- Karl Landsteiner Institute of Dermatological Research, St. Pölten, Austria.,Department of Dermatology and Venereology, Karl Landsteiner University of Health Sciences, St. Pölten, Austria
| | - J Moser
- Karl Landsteiner Institute of Dermatological Research, St. Pölten, Austria.,Department of Dermatology and Venereology, Karl Landsteiner University of Health Sciences, St. Pölten, Austria
| | - M Kitzwögerer
- Institute of Clinical Pathology, Karl Landsteiner University of Health Sciences, St. Pölten, Austria
| | - R Sedivy
- Institute of Clinical Pathology, Karl Landsteiner University of Health Sciences, St. Pölten, Austria
| | - F Trautinger
- Karl Landsteiner Institute of Dermatological Research, St. Pölten, Austria.,Department of Dermatology and Venereology, Karl Landsteiner University of Health Sciences, St. Pölten, Austria
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Eder J, Prillinger K, Korn A, Geroldinger A, Trautinger F. Prevalence of actinic keratosis among dermatology outpatients in Austria. Br J Dermatol 2014; 171:1415-21. [PMID: 24864059 DOI: 10.1111/bjd.13132] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/15/2014] [Indexed: 11/30/2022]
Abstract
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.
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Affiliation(s)
- J Eder
- Department of Dermatology and Venereology, Karl Landsteiner University of Health Sciences, St. Pölten, Austria; Karl Landsteiner Institute of Dermatological Research, St. Pölten, Austria
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Moser W, Thier K, Hafner C, Trautinger F, Ungersbock K, Sedivy R, Oberndorfer S. P08.19 * PRIMARY INTRATHECAL MELANOMA ARISING FROM MENINGEAL MELANOCYTOSIS: A CASE REPORT. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou174.207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Jung P, Trautinger F. Kapillarmikroskopie der Zehen. J Dtsch Dermatol Ges 2013. [DOI: 10.1111/ddg.12117_suppl] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Jung P, Trautinger F. Kapillarmikroskopie. J Dtsch Dermatol Ges 2013. [DOI: 10.1111/ddg.12137_suppl] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
Microscopy of the nailfold capillaries has found increasing use in dermatology, rheumatology and angiology particularly as an important tool to distinguish between primary and secondary Raynaud disease. The best evidence is available in systemic sclerosis where specific capillaroscopic patterns have a high positive predictive value for the development of the disease. Conversely, a regular capillary pattern rules out systemic sclerosis with high degree of probability. PRINCE (prognostic index for nailfold capillaroscopic examination) was developed to identify patients at high risk of developing systemic sclerosis. CSURI (capillaroscopic skin ulcer risk index) should predict the risk of developing digital ulcers in patients with systemic sclerosis with high specificity and sensitivity. As a consequence of recent results a pathologic capillary pattern was integrated by the EULAR Scleroderma Trials and Research Group (EUSTAR) in the diagnostic algorithm of the VEDOSS-Project (very early diagnosis of systemic sclerosis). Capillary patterns may correlate with visceral involvement and capillaroscopy thus has the potential as a screening tool to enable early diagnosis of organ involvement in systemic sclerosis.
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Affiliation(s)
- Peter Jung
- Department of Dermatology, State Hospital St. Pölten, Austria.
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Eder J, Laccone F, Rohrbach M, Giunta C, Aumayr K, Reichel C, Trautinger F. A newCOL3A1mutation in Ehlers-Danlos syndrome type IV. Exp Dermatol 2013; 22:231-4. [DOI: 10.1111/exd.12105] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/28/2013] [Indexed: 12/01/2022]
Affiliation(s)
- Johanna Eder
- Department of Dermatology and Venereology; Landesklinikum St. Poelten; St. Poelten; Austria
| | - Franco Laccone
- Institute of Medical Genetics; Medical University of Vienna; Vienna; Austria
| | - Marianne Rohrbach
- Connective Tissue Unit; Division of Metabolism; University Children's Hospital Zurich; Zurich; Switzerland
| | - Cecilia Giunta
- Connective Tissue Unit; Division of Metabolism; University Children's Hospital Zurich; Zurich; Switzerland
| | - Klaus Aumayr
- Clinical Institute of Pathology; Medical University of Vienna; Vienna; Austria
| | - Christofer Reichel
- Department of Dermatology and Venereology; Landesklinikum St. Poelten; St. Poelten; Austria
| | - Franz Trautinger
- Department of Dermatology and Venereology; Landesklinikum St. Poelten; St. Poelten; Austria
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Anstey A, Trautinger F. The art and science of photodermatology--beyond the surface of the skin. Photochem Photobiol Sci 2012. [PMID: 23192159 DOI: 10.1039/c2pp90048c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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