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Kaiser S, Verboket RD, Frank J, Marzi I, Janko M. Effectiveness of combined local therapy with antibiotics and fibrin vs. vacuum-assisted wound therapy in soft tissue infections: a retrospective study. Eur J Trauma Emerg Surg 2024:10.1007/s00068-024-02483-1. [PMID: 38466400 DOI: 10.1007/s00068-024-02483-1] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Accepted: 02/20/2024] [Indexed: 03/13/2024]
Abstract
PURPOSE Soft tissue infections can be severe and life-threatening. Their treatment consists currently in radical surgical wound debridement and combined systemic antimicrobial therapy. Different side effects are possible. Local antibiotic therapy represents a new approach to reduce side effects and improve healing. The aim of this study is to assess the effectiveness of the local sprayed use of antibiotics with fibrin sealing compared with negative pressure wound therapy as an established treatment of soft-tissue infections. METHODS In this retrospective study, patients with soft tissue infections who underwent surgical treatment were analysed. One group consists of patients, who received local fibrin-antibiotic spray (FAS) (n = 62). Patients treated by vacuum-assisted wound therapy (VAWT) as the established treatment were the control group (n = 57). Main outcomes were differences in the success of healing, the duration until healing and the number of needed operations. RESULTS Clinical healing could be achieved for 55 patients (98.21%) in the FAS group vs. 47 patients (92.16%) in the VAWT group (p = 0.19). Time to require this was 10.65 ± 10.38 days in the FAS group and 22.85 ± 14.02 days in the VAWT group (p < 0.001). In the FAS group, patients underwent an average of 1.44 ± 0.72 vs.3.46 ± 1.66 operations in the VAWT group (p < 0.001). CONCLUSION Compared to vacuum-assisted wound therapy in soft tissue infections, local fibrin-antibiotic spray shows faster clinical healing and less needed operations. Leading to shorter hospital stays and more satisfied patients. The combination of sprayed fibrin and antibiotics can be seen as a promising and effective method.
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Affiliation(s)
- S Kaiser
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital, Goethe University Frankfurt, Theodor‑Stern‑Kai 7, 60590, Frankfurt am Main, Germany
| | - R D Verboket
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital, Goethe University Frankfurt, Theodor‑Stern‑Kai 7, 60590, Frankfurt am Main, Germany.
| | - J Frank
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital, Goethe University Frankfurt, Theodor‑Stern‑Kai 7, 60590, Frankfurt am Main, Germany
| | - I Marzi
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital, Goethe University Frankfurt, Theodor‑Stern‑Kai 7, 60590, Frankfurt am Main, Germany
| | - M Janko
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital, Goethe University Frankfurt, Theodor‑Stern‑Kai 7, 60590, Frankfurt am Main, Germany
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Michels S, Massutí B, Vasyliv I, Stratmann J, Frank J, Adams A, Felip E, Grohé C, Rodriguez-Abreu D, Bischoff H, Carcereny I Costa E, Corral J, Pereira E, Fassunke J, Fischer RN, Insa A, Koleczko S, Nogova L, Reck M, Reutter T, Riedel R, Schaufler D, Scheffler M, Weisthoff M, Provencio M, Merkelbach-Bruse S, Hellmich M, Sebastian M, Büttner R, Persigehl T, Rosell R, Wolf J. Overall survival and central nervous system activity of crizotinib in ROS1-rearranged lung cancer-final results of the EUCROSS trial. ESMO Open 2024; 9:102237. [PMID: 38350336 PMCID: PMC10937203 DOI: 10.1016/j.esmoop.2024.102237] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 12/12/2023] [Accepted: 01/07/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND In 2019, we reported the first efficacy and safety analysis of EUCROSS, a phase II trial investigating crizotinib in ROS1 fusion-positive lung cancer. At that time, overall survival (OS) was immature and the effect of crizotinib on intracranial disease control remained unclear. Here, we present the final analysis of OS, systemic and intracranial activity, and the impact of co-occurring aberrations. MATERIALS AND METHODS EUCROSS was a prospective, single-arm, phase II trial. The primary endpoint was best overall response rate (ORR) using RECIST 1.1. Secondary and exploratory endpoints were progression-free survival (PFS), OS, and efficacy in pre-defined subgroups. RESULTS Median OS of the intention-to-treat population (N = 34) was 54.8 months [95% confidence interval (CI) 20.3 months-not reached (NR); median follow-up 81.4 months] and median all-cause PFS of the response-evaluable population (N = 30) was 19.4 months (95% CI 10.1-32.2 months). Time on treatment was significantly correlated with OS (R = 0.82; P < 0.0001). Patients with co-occurring TP53 aberrations (28%) had a significantly shorter OS [hazard ratio (HR) 11; 95% CI 2.0-56.0; P = 0.006] and all-cause PFS (HR 4.2; 95% CI 1.2-15; P = 0.025). Patients with central nervous system (CNS) involvement at baseline (N = 6; 20%) had a numerically shorter median OS and all-cause PFS. Median intracranial PFS was 32.2 months (95% CI 23.7 months-NR) and the rate of isolated CNS progression was 24%. CONCLUSIONS Our final analysis proves the efficacy of crizotinib in ROS1-positive lung cancer, but also highlights the devastating impact of TP53 mutations on survival and treatment efficacy. Additionally, our data show that CNS disease control is durable and the risk of CNS progression while on crizotinib treatment is low.
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Affiliation(s)
- S Michels
- Department I for Internal Medicine and Center for Integrated Oncology Aachen Bonn Cologne Dusseldorf, University of Cologne, Faculty of Medicine and University Hospital of Cologne, Lung Cancer Group Cologne, Cologne, Germany.
| | - B Massutí
- Department for Oncology, Alicante University Hospital-ISABIAL, Alicante, Spain
| | - I Vasyliv
- University of Cologne, Faculty of Medicine and University Hospital of Colone, Department of Radiology and Center for Integrated Oncology Aachen Bonn Cologne Dusseldorf, Cologne, Germany
| | - J Stratmann
- Department of Hematology and Oncology, University Hospital of Frankfurt, Frankfurt am Main
| | - J Frank
- Faculty of Medicine and University Hospital of Cologne, Institute of Medical Statistics and Computational Biology, University of Cologne, Cologne, Germany
| | - A Adams
- Faculty of Medicine and University Hospital of Cologne, Institute of Medical Statistics and Computational Biology, University of Cologne, Cologne, Germany
| | - E Felip
- Vall d'Hebron Institute of Oncology, Vall d'Hebron University Hospital, Barcelona, Spain
| | - C Grohé
- Department of Respiratory Medicine, ELK Berlin, Berlin, Germany
| | - D Rodriguez-Abreu
- Universidad de Las Palmas de Gran Canaria, Complejo Hospitalario Universitario Insular Materno-Infantil de Gran Canaria, Gran Canaria, Spain
| | - H Bischoff
- Thoraxonkologie, Thoraxklinik, Heidelberg, Germany
| | - E Carcereny I Costa
- Medical Oncology Department, Catalan Institute of Oncology (ICO)-Badalona and Badalona-Applied Research Group in Oncology (B-ARGO), Badalona
| | - J Corral
- Department for Medical Oncology, Clínica Universidad de Navarra, Madrid
| | - E Pereira
- Spanish Lung Cancer Group, Barcelona, Spain
| | - J Fassunke
- University of Cologne, Faculty of Medicine and University Hospital of Cologne, Lung Cancer Group Cologne, Institute of Pathology and Center for Integrated Oncology Aachen Bonn Cologne Dusseldorf, Cologne, Germany
| | - R N Fischer
- Department I for Internal Medicine and Center for Integrated Oncology Aachen Bonn Cologne Dusseldorf, University of Cologne, Faculty of Medicine and University Hospital of Cologne, Lung Cancer Group Cologne, Cologne, Germany
| | - A Insa
- Hospital Clínico Universitario de Valencia, València, Spain
| | - S Koleczko
- Department I for Internal Medicine and Center for Integrated Oncology Aachen Bonn Cologne Dusseldorf, University of Cologne, Faculty of Medicine and University Hospital of Cologne, Lung Cancer Group Cologne, Cologne, Germany
| | - L Nogova
- Department I for Internal Medicine and Center for Integrated Oncology Aachen Bonn Cologne Dusseldorf, University of Cologne, Faculty of Medicine and University Hospital of Cologne, Lung Cancer Group Cologne, Cologne, Germany
| | - M Reck
- Department for Thoracic Oncology, LungenClinic Grosshansdorf, Airway Research Center North (ARCN), German Center for Lung Research, Großhansdorf
| | - T Reutter
- Department I for Internal Medicine and Center for Integrated Oncology Aachen Bonn Cologne Dusseldorf, University of Cologne, Faculty of Medicine and University Hospital of Cologne, Lung Cancer Group Cologne, Cologne, Germany; Department of Oncology, Asklepios Clinic Altona, Hematology, Palliative Care and Rheumatology, Asklepios Tumorzentrum Hamburg, Hamburg, Germany
| | - R Riedel
- Department I for Internal Medicine and Center for Integrated Oncology Aachen Bonn Cologne Dusseldorf, University of Cologne, Faculty of Medicine and University Hospital of Cologne, Lung Cancer Group Cologne, Cologne, Germany
| | - D Schaufler
- Department I for Internal Medicine and Center for Integrated Oncology Aachen Bonn Cologne Dusseldorf, University of Cologne, Faculty of Medicine and University Hospital of Cologne, Lung Cancer Group Cologne, Cologne, Germany
| | - M Scheffler
- Department I for Internal Medicine and Center for Integrated Oncology Aachen Bonn Cologne Dusseldorf, University of Cologne, Faculty of Medicine and University Hospital of Cologne, Lung Cancer Group Cologne, Cologne, Germany
| | - M Weisthoff
- University of Cologne, Faculty of Medicine and University Hospital of Colone, Department of Radiology and Center for Integrated Oncology Aachen Bonn Cologne Dusseldorf, Cologne, Germany
| | - M Provencio
- Department of Medical Oncology, Hospital Universitario Puerta de Hierro de Majadahonda, Madrid
| | - S Merkelbach-Bruse
- University of Cologne, Faculty of Medicine and University Hospital of Cologne, Lung Cancer Group Cologne, Institute of Pathology and Center for Integrated Oncology Aachen Bonn Cologne Dusseldorf, Cologne, Germany
| | - M Hellmich
- Faculty of Medicine and University Hospital of Cologne, Institute of Medical Statistics and Computational Biology, University of Cologne, Cologne, Germany
| | - M Sebastian
- Department of Hematology and Oncology, University Hospital of Frankfurt, Frankfurt am Main
| | - R Büttner
- University of Cologne, Faculty of Medicine and University Hospital of Cologne, Lung Cancer Group Cologne, Institute of Pathology and Center for Integrated Oncology Aachen Bonn Cologne Dusseldorf, Cologne, Germany
| | - T Persigehl
- University of Cologne, Faculty of Medicine and University Hospital of Colone, Department of Radiology and Center for Integrated Oncology Aachen Bonn Cologne Dusseldorf, Cologne, Germany
| | - R Rosell
- Germans Trias i Pujol Research Institute (IGTP), Badalona; Quiron Dexeus University Hospital, Institute of Oncology Rosell (IOR), Barcelona, Spain
| | - J Wolf
- Department I for Internal Medicine and Center for Integrated Oncology Aachen Bonn Cologne Dusseldorf, University of Cologne, Faculty of Medicine and University Hospital of Cologne, Lung Cancer Group Cologne, Cologne, Germany
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Gerischer L, Mainert M, Wohmann N, Kubisch I, Stölzel U, Stauch T, von Wegerer S, Braun F, Weiler-Normann C, Blaschke S, Frank J, Somasundaram R, Diehl-Wiesenecker E. German Porphyria Registry (PoReGer)-Background and Setup. Healthcare (Basel) 2024; 12:111. [PMID: 38201016 PMCID: PMC10779132 DOI: 10.3390/healthcare12010111] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 12/29/2023] [Accepted: 01/01/2024] [Indexed: 01/12/2024] Open
Abstract
Porphyrias, as most rare diseases, are characterized by complexity and scarcity of knowledge. A national registry in one of the largest European populations that prospectively collects longitudinal clinical and laboratory data are an important and effective tool to close this gap. The German Porphyria Registry (PoReGer) was founded by four centers with longstanding expertise in the field of porphyrias and rare diseases (Charité-Universitätsmedizin Berlin, Porphyria Center Saxony Chemnitz, University Medical Center Hamburg-Eppendorf, University Medical Center Göttingen) and the German reference laboratory for porphyria, and is supported by the largest German porphyria patient organization. A specified data matrix for three subgroups (acute, chronic blistering cutaneous, acute non-blistering cutaneous) includes data on demographics, specific porphyria-related symptoms, clinical course, general medical history, necessary follow-up assessments (including laboratory and imaging results), symptomatic and disease-modifying therapies, and side-effects. Additionally, the registry includes patient-reported outcome measures on quality of life, depression, and fatigue. PoReGer aims to broaden and deepen the understanding on all porphyria-related subjects. We expect these data to significantly improve the management and care of porphyria patients. Additionally, the data can be used for educational purposes to increase awareness, for the planning of healthcare services, and for machine learning algorithms for early detection of porphyrias.
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Affiliation(s)
- Lea Gerischer
- Department of Neurology, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
- Neuroscience Clinical Research Center, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
| | - Mona Mainert
- Department of Emergency Medicine and Porphyria Clinic, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 12203 Berlin, Germany
| | - Nils Wohmann
- Department of Internal Medicine II, Saxony Porphyria Center, Klinikum Chemnitz, gGmbH, 09116 Chemnitz, Germany
| | - Ilja Kubisch
- Department of Internal Medicine II, Saxony Porphyria Center, Klinikum Chemnitz, gGmbH, 09116 Chemnitz, Germany
| | - Ulrich Stölzel
- Department of Internal Medicine II, Saxony Porphyria Center, Klinikum Chemnitz, gGmbH, 09116 Chemnitz, Germany
| | - Thomas Stauch
- Porphyria Laboratory IPNET, MVZ Labor PD Dr. Med. Volkmann GbR, 76131 Karlsruhe, Germany
| | | | - Fabian Braun
- Martin Zeitz Center for Rare Diseases, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
- III. Department of Medicine, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Christina Weiler-Normann
- Martin Zeitz Center for Rare Diseases, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Sabine Blaschke
- Emergency Department, University Medical Center Göttingen, 37075 Göttingen, Germany
| | - Jorge Frank
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, 37075 Göttingen, Germany
| | - Rajan Somasundaram
- Department of Emergency Medicine and Porphyria Clinic, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 12203 Berlin, Germany
| | - Eva Diehl-Wiesenecker
- Department of Emergency Medicine and Porphyria Clinic, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 12203 Berlin, Germany
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4
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Kumar S, Borisov O, Maj C, Ralser DJ, Humbatova A, Hanneken S, Schmieder A, Groß J, Maintz L, Heineke A, Knuever J, Fagerberg C, Parmentier L, Anemüller W, Oji V, Tantcheva-Poór I, Fölster-Holst R, Wenzel J, Krawitz PM, Frank J, Betz RC. Founder Variants in KRT5 and POGLUT1 Are Implicated in Dowling-Degos Disease. J Invest Dermatol 2024; 144:181-184. [PMID: 37468035 DOI: 10.1016/j.jid.2023.04.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 04/14/2023] [Indexed: 07/21/2023]
Affiliation(s)
- Sheetal Kumar
- Institute of Human Genetics, University of Bonn, Medical Faculty & University Hospital Bonn, Bonn, Germany
| | - Oleg Borisov
- Institute for Genomic Statistics and Bioinformatics, University of Bonn, Medical Faculty & University Hospital Bonn, Bonn, Germany
| | - Carlo Maj
- Institute for Genomic Statistics and Bioinformatics, University of Bonn, Medical Faculty & University Hospital Bonn, Bonn, Germany; Center for Human Genetics, University Hospital of Marburg, Marburg, Germany
| | - Damian J Ralser
- Institute of Human Genetics, University of Bonn, Medical Faculty & University Hospital Bonn, Bonn, Germany
| | - Aytaj Humbatova
- Institute of Human Genetics, University of Bonn, Medical Faculty & University Hospital Bonn, Bonn, Germany
| | | | - Astrid Schmieder
- Department of Dermatology, Venereology and Allergology, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Janina Groß
- Department of Dermatology and Allergy, University Hospital Bonn, Bonn, Germany
| | - Laura Maintz
- Department of Dermatology and Allergy, University Hospital Bonn, Bonn, Germany; Christine Kuehne - Center for Allergy Research and Education Davos (CK-CARE), Davos, Switzerland
| | - Andre Heineke
- Dermatologist practice, Dr. Karches/Dr. Thielert, Hannover, Germany
| | - Jana Knuever
- Department of Dermatology, University of Cologne, Cologne, Germany
| | - Christina Fagerberg
- Department of Clinical Genetics, Odense University Hospital, Odense, Denmark
| | | | - Waltraud Anemüller
- Department of Dermatology, Allergology and Venereology, University of Luebeck, Luebeck, Germany
| | - Vinzenz Oji
- Department of Dermatology, University of Muenster, Muenster, Germany
| | | | - Regina Fölster-Holst
- Department of Dermatology, Allergology and Venereology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Joerg Wenzel
- Department of Dermatology, Venereology and Allergology, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Peter M Krawitz
- Institute for Genomic Statistics and Bioinformatics, University of Bonn, Medical Faculty & University Hospital Bonn, Bonn, Germany
| | - Jorge Frank
- Department of Dermatology, Venereology and Allergology, University Medical Center Goettingen, Goettingen, Germany
| | - Regina C Betz
- Institute of Human Genetics, University of Bonn, Medical Faculty & University Hospital Bonn, Bonn, Germany.
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Cesarato N, Schwieger-Briel A, Gossmann Y, Henne SK, Hillmann K, Frommherz LH, Wehner M, Xiong X, Thiele H, Oji V, Milani D, Tantcheva-Poor I, Giehl K, Fölster-Holst R, Teichler A, Braeckmans D, Hoeger PH, Jones G, Frank J, Weibel L, Blume-Peytavi U, Hamm H, Nöthen MM, Geyer M, Heilmann-Heimbach S, Basmanav FB, Betz RC. Short anagen hair syndrome: association with mono- and biallelic variants in WNT10A and a genetic overlap with male pattern hair loss. Br J Dermatol 2023; 189:741-749. [PMID: 37671665 DOI: 10.1093/bjd/ljad314] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 08/08/2023] [Accepted: 08/23/2023] [Indexed: 09/07/2023]
Abstract
BACKGROUND Short anagen hair (SAH) is a rare paediatric hair disorder characterized by a short anagen phase, an inability to grow long scalp hair and a negative psychological impact. The genetic basis of SAH is currently unknown. OBJECTIVES To perform molecular genetic investigations in 48 individuals with a clinical phenotype suggestive of SAH to identify, if any, the genetic basis of this condition. METHODS Exome sequencing was performed in 27 patients diagnosed with SAH or with a complaint of short, nongrowing hair. The cohort was screened for variants with a minor allele frequency (MAF) < 5% in the general population and a Combined Annotation Dependent Depletion (CADD) score > 15, to identify genes whose variants were enriched in this cohort. Sanger sequencing was used for variant validation and screening of 21 additional individuals with the same clinical diagnosis and their relatives. Genetic association testing of SAH-related variants for male pattern hair loss (MPHL) was performed using UK Biobank data. RESULTS Analyses revealed that 20 individuals (42%) carried mono- or biallelic pathogenic variants in WNT10A. Rare WNT10A variants are associated with a phenotypic spectrum ranging from no clinical signs to severe ectodermal dysplasia. A significant association was found between WNT10A and SAH, and this was mostly observed in individuals with light-coloured hair and regression of the frontoparietal hairline. Notably, the most frequent variant in the cohort [c.682T>A;p.(Phe228Ile)] was in linkage disequilibrium with four common WNT10A variants, all of which have a known association with MPHL. Using UK Biobank data, our analyses showed that c.682T>A;p.(Phe228Ile) and one other variant identified in the SAH cohort are also associated with MPHL, and partially explain the known associations between WNT10A and MPHL. CONCLUSIONS Our results suggest that WNT10A is associated with SAH and that SAH has a genetic overlap with the common phenotype MPHL. The presumed shared biologic effect of WNT10A variants in SAH and MPHL is a shortening of the anagen phase. Other factors, such as modifier genes and sex, may also play a role in the clinical manifestation of hair phenotypes associated with the WNT10A locus.
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Affiliation(s)
| | - Agnes Schwieger-Briel
- Department of Pediatric Dermatology, University Children's Hospital Zurich, Zurich, Switzerland
- Department of Dermatology, Medical Center - University of Freiburg, Freiburg, Germany
| | | | | | - Kathrin Hillmann
- Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Leonie H Frommherz
- Department of Dermatology and Allergy, Ludwig-Maximilian-University of Munich, Munich, Germany
| | | | | | - Holger Thiele
- Cologne Center for Genomics, University of Cologne, Cologne, Germany
| | - Vinzenz Oji
- Department of Dermatology, University Hospital of Muenster, Muenster, Germany
| | - Donatella Milani
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Iliana Tantcheva-Poor
- Department of Dermatology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Kathrin Giehl
- Department of Dermatology and Allergy, Ludwig-Maximilian-University of Munich, Munich, Germany
| | - Regina Fölster-Holst
- Department of Dermatology, Venereology and Allergology, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Anne Teichler
- Department of Paediatric Dermatology, Catholic Children's Hospital Wilhelmstift, Hamburg, Germany
| | - Delphine Braeckmans
- Department of Paediatric Dermatology, Catholic Children's Hospital Wilhelmstift, Hamburg, Germany
| | - Peter H Hoeger
- Department of Paediatric Dermatology, Catholic Children's Hospital Wilhelmstift, Hamburg, Germany
| | - Gabriela Jones
- Clinical Genetics Department, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Jorge Frank
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany
| | - Lisa Weibel
- Department of Pediatric Dermatology, University Children's Hospital Zurich, Zurich, Switzerland
| | - Ulrike Blume-Peytavi
- Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Henning Hamm
- Department of Dermatology, Venereology, and Allergology, University Hospital Würzburg, Würzburg, Germany
| | | | - Matthias Geyer
- Institute of Structural Biology, University of Bonn, Medical Faculty and University Hospital Bonn, Bonn, Germany
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6
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Kumar S, Hausen J, Sivalingam S, Humbatova A, Buness A, Frank J, Ralser DJ, Betz RC. Altered Notch signalling in Dowling-Degos disease: a transcriptomic insight into disease pathogenesis. Br J Dermatol 2023; 189:772-774. [PMID: 37625796 DOI: 10.1093/bjd/ljad306] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 08/14/2023] [Accepted: 08/25/2023] [Indexed: 08/27/2023]
Abstract
Dowling-Degos disease (DDD) is a rare autosomal-dominant hyperpigmentation disorder caused by mutations in KRT5, POFUT1, POGLUT1 and PSENEN. Our results suggest that dysfunctional Notch signalling in melanocytes plays a key role in DDD pathogenesis, and that altered biogenesis and intracellular trafficking of melanosomes, receptor tyrosine kinase signalling and oestrogen signalling receptor-mediated signalling may represent downstream molecular mechanisms through which decreased Notch signalling leads to hyperpigmentation in DDD. Furthermore, a common downstream pathomechanism for both POGLUT1 and PSENEN mutation carriers can be assumed.
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Affiliation(s)
- Sheetal Kumar
- Institute of Human Genetics, University of Bonn, Medical Faculty and University Hospital Bonn, Bonn, Germany
| | - Jonas Hausen
- Institute for Genomic Statistics and Bioinformatics, University of Bonn, Medical Faculty and University Hospital Bonn, Bonn, Germany
| | - Sugirthan Sivalingam
- Institute for Genomic Statistics and Bioinformatics, University of Bonn, Medical Faculty and University Hospital Bonn, Bonn, Germany
| | - Aytaj Humbatova
- Institute of Human Genetics, University of Bonn, Medical Faculty and University Hospital Bonn, Bonn, Germany
| | - Andreas Buness
- Institute for Genomic Statistics and Bioinformatics, University of Bonn, Medical Faculty and University Hospital Bonn, Bonn, Germany
- Institute for Medical Biometry, Informatics and Epidemiology, Medical Faculty, University of Bonn, Bonn Germany
| | - Jorge Frank
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany
| | - Damian J Ralser
- Institute of Human Genetics, University of Bonn, Medical Faculty and University Hospital Bonn, Bonn, Germany
| | - Regina C Betz
- Institute of Human Genetics, University of Bonn, Medical Faculty and University Hospital Bonn, Bonn, Germany
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7
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Diehl-Wiesenecker E, Blaschke S, Wohmann N, Kubisch I, Stauch T, Mainert M, Helm F, von Wegerer S, Pittrow D, Frank J, Stölzel U, Somasundaram R. Detect Acute Porphyrias in Emergency Departments (DePorED) - a pilot study. Orphanet J Rare Dis 2023; 18:146. [PMID: 37308920 DOI: 10.1186/s13023-023-02768-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 06/04/2023] [Indexed: 06/14/2023] Open
Abstract
BACKGROUND Acute porphyrias (APs) are a group of rare metabolic diseases related to a disturbed heme biosynthesis. Symptoms may first occur as life threatening attacks, comprising abdominal pain and/or variable neuro-psychiatric symptoms, thus leading to presentation in emergency departments (ED) first. Due to the low prevalence, diagnosis of AP is often missed, even after readmission to the ED. Therefore, strategies are needed to consider APs in ED patients with unexplained abdominal pain, especially since early and adequate treatment will avoid an unfavorable clinical course. Aim of this prospective study was to investigate the prevalence of APs in ED patients and thus, addressing feasibility of screening for rare diseases, such as APs in the real life setting. METHODS From September 2019 to March 2021, patients presenting to the ED of three German tertiary care hospitals with moderate to severe prolonged abdominal pain (Visual Analog Scale, VAS > 4 out of 10 points) not otherwise explained were screened and prospectively enrolled. In addition to standard of care (SOC) diagnostics a blood and urine sample for plasma fluorescence scan and biochemical porphyrin analysis were sent to a certified German porphyria laboratory. RESULTS Overall, of 653 screened patients, 68 patients (36 females; mean age 36 years) were included for biochemical porphyrin analysis. No patient with AP was detected. The most frequent discharge diagnoses included "abdominal and digestive symptoms" (n = 22, 32%), "gastrooesophageal diseases" (n = 18, 27%), "infectious bowel disease" (n = 6, 9%) and "biliopancreatic diseases" (n = 6, 9%). Although not primarily addressed, we observed an increase in knowledge of the ED staffs at all study sites regarding our screening algorithm and thus, awareness for APs. CONCLUSIONS To the best of our knowledge, we performed the first prospective screening project for APs in the ED. Although we detected no patient with AP in this study, we demonstrated the feasibility of a multicenter screening process for APs by building up a well-working infrastructure comprising laboratory testing as well as data management. This enables the set-up of a larger scale revised follow-up study with a central focus on structured education, thus, possibly acting as blueprint for other rare diseases.
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Affiliation(s)
- Eva Diehl-Wiesenecker
- Department of Emergency Medicine and Porphyria Clinic, Charité University Medicine Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Hindenburgdamm 30, 12203, Berlin, Germany.
| | - Sabine Blaschke
- Emergency Department, University Medical Center Göttingen, Göttingen, Germany
| | - Nils Wohmann
- Department of Internal Medicine II and Saxony Porphyria Center, Klinikum Chemnitz, Chemnitz, Germany
| | - Ilja Kubisch
- Department of Internal Medicine II and Saxony Porphyria Center, Klinikum Chemnitz, Chemnitz, Germany
| | | | - Mona Mainert
- Department of Emergency Medicine and Porphyria Clinic, Charité University Medicine Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Hindenburgdamm 30, 12203, Berlin, Germany
| | - Franziska Helm
- Department of Internal Medicine II and Saxony Porphyria Center, Klinikum Chemnitz, Chemnitz, Germany
| | - Sabine von Wegerer
- Department of Emergency Medicine and Porphyria Clinic, Charité University Medicine Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Hindenburgdamm 30, 12203, Berlin, Germany
- Berliner Leberring e.V, Berlin, Germany
| | - David Pittrow
- Institute for Clinical Pharmacology, Technical University of Dresden (TUD), Dresden, Germany
- Innovation Center Real World Evidence, GWT-TUD, Dresden, Germany
| | - Jorge Frank
- Department of Dermatology, Venerology and Allergology, University Medical Center, Göttingen, Germany
| | - Ulrich Stölzel
- Department of Internal Medicine II and Saxony Porphyria Center, Klinikum Chemnitz, Chemnitz, Germany
| | - Rajan Somasundaram
- Department of Emergency Medicine and Porphyria Clinic, Charité University Medicine Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Hindenburgdamm 30, 12203, Berlin, Germany
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8
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Kumar S, Wenzel J, Schön MP, Betz RC, Frank J. POGLUT1-Varianten bei Morbus Dowling-Degos - Assoziation mit spezifischen klinischen und histopathologischen Merkmalen? J Dtsch Dermatol Ges 2023; 21:540-541. [PMID: 37183756 DOI: 10.1111/ddg.15111_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: 03/29/2023] [Accepted: 03/29/2023] [Indexed: 05/16/2023]
Affiliation(s)
| | - Jörg Wenzel
- Klinik und Poliklinik für Dermatologie und Allergologie, Universität Bonn, Medizinische Fakultät und Universitätsklinikum Bonn
| | - Michael P Schön
- Klinik für Dermatologie, Venerologie und Allergologie und
- Niedersächsisches Institut für Berufsdermatologie, Universitätsmedizin Göttingen
| | | | - Jorge Frank
- Klinik für Dermatologie, Venerologie und Allergologie und
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9
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Hertl M, Welzel J, Schön M, Buhl T, Frank J. Zwanzig Jahre und kein bisschen leise! J Dtsch Dermatol Ges 2023; 21:327-329. [PMID: 37070502 DOI: 10.1111/ddg.15083_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
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10
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Frank J, Has C, Betz RC. Ausgewählte Genodermatosen - Stand der Dinge und Zukunftsaussichten. J Dtsch Dermatol Ges 2023; 21:337-342. [PMID: 37070517 DOI: 10.1111/ddg.15054_g] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 02/10/2023] [Indexed: 04/19/2023]
Affiliation(s)
- Jorge Frank
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsmedizin Göttingen
| | - Cristina Has
- Klinik für Dermatologie und Venerologie, Universitätsklinikum Freiburg
| | - Regina C Betz
- Institut für Humangenetik, Universität Bonn, Medizinische Fakultät und Universitätsklinikum Bonn
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11
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Frank J, Has C, Betz RC. Selected genodermatoses - Status quo and future prospects. J Dtsch Dermatol Ges 2023; 21:337-341. [PMID: 36976174 DOI: 10.1111/ddg.15054] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 02/10/2023] [Indexed: 03/29/2023]
Abstract
Genodermatoses are monogenetic disorders, which may manifest with symptoms either exclusively on the skin or also involve other organs in the context of an associated syndrome. Over the past 30 years, numerous hereditary hair, tumor, blistering, and keratinization diseases have been characterized both clinically and genetically. This has resulted in the continuous development of disease-specific classifications as well as diagnostic algorithms and examination techniques, and has also led to new pathogenesis-based therapeutic approaches. While the deciphering of the underlying genetic defects of these diseases is already well advanced, there is still much room for the development of new translationally motivated treatment strategies.
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Affiliation(s)
- Jorge Frank
- Department of Dermatology, Venereology and Allergology, Göttingen University Medical Center, Göttingen, Germany
| | - Cristina Has
- Department of Dermatology and Venereology, Medical Center University of Freiburg, Freiburg, Germany
| | - Regina C Betz
- Institute of Human Genetic, University of Bonn, Medical Faculty and University Hospital Bonn, Bonn, Germany
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12
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Lindemann H, Bonetzki T, Frank J. Diagnostic spectrum and therapeutic efficiency in teledermatology-Results of the largest cohort study to date. J Dermatol 2023. [PMID: 36890665 DOI: 10.1111/1346-8138.16769] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 01/30/2023] [Accepted: 02/17/2023] [Indexed: 03/10/2023]
Abstract
Timely and comprehensive dermatological care is a major challenge. Digitized medical consultation offers a possibility to overcome this problem. Here, we studied the diagnostic spectrum and treatment success in teledermatology in the largest cohort to date. Over 12 months, 21 725 individuals received a diagnosis and therapeutic advice using the asynchronous image-text method. In the context of quality management, 1802 individuals (~10%) of both sexes with a mean age of 33.7 years (SD 15.36) received a follow-up 3 months after the initial consultation to assess the treatment outcome. Of these, 81.2% did not require a face-to-face consultation. Therapeutic efficiency could be ascertained in 83.3% of the patients, whereas 10.9% did not improve, and 5.8% did not provide an information on the course of therapy. Teledermatology is a useful tool in digitalized medicine and complements the classical in-person dermatological examination, as shown by the high degree of treatment efficacy in this study. Although face-to-face consultations can not and should not be completely substituted by teledermatology it reflects a significant contribution to patient care and justifies the further expansion of digital structures in dermatological care.
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Affiliation(s)
- Hanna Lindemann
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany
| | - Tim Bonetzki
- Ruhr West University of Applied Sciences, Müheim, Germany
| | - Jorge Frank
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany
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13
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Has C, Hess M, Anemüller W, Blume-Peytavi U, Emmert S, Fölster-Holst R, Frank J, Giehl K, Günther C, Hammersen J, Hillmann K, Höflein B, Hoeger PH, Hotz A, Mai TA, Oji V, Schneider H, Süßmuth K, Tantcheva-Póor I, Thielking F, Zirn B, Fischer J, Reimer-Taschenbrecker A. Epidemiology of inherited epidermolysis bullosa in Germany. J Eur Acad Dermatol Venereol 2023; 37:402-410. [PMID: 36196047 DOI: 10.1111/jdv.18637] [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: 04/13/2022] [Accepted: 08/17/2022] [Indexed: 01/18/2023]
Abstract
BACKGROUND Epidermolysis bullosa (EB) is a rare genetic disorder manifesting with skin and mucosal membrane blistering in different degrees of severity. OBJECTIVE Epidemiological data from different countries have been published, but none are available from Germany. METHODS In this population-based cross-sectional study, people living with EB in Germany were identified using the following sources: academic hospitals, diagnostic laboratories and patient organization. RESULTS Our study indicates an overall EB incidence of 45 per million live births in Germany. With 14.23 per million live births for junctional EB, the incidence is higher than in other countries, possibly reflecting the availability of early molecular genetic diagnostics in severely affected neonates. Dystrophic EB was assessed at 15.58 cases per million live births. The relatively low incidence found for EB simplex, 14.93 per million live births, could be explained by late or missed diagnosis, but also by 33% of cases remaining not otherwise specified. Using log-linear models, we estimated a prevalence of 54 per million for all EB types, 2.44 for junctional EB, 12.16 for dystrophic EB and 28.44 per million for EB simplex. These figures are comparable to previously reported data from other countries. CONCLUSIONS Altogether, there are at least 2000 patients with EB in the German population. These results should support national policies and pharmaceutical companies in decision-making, allow more precise planning of drug development and clinical trials, and aid patient advocacy groups in their effort to improve quality of life of people with this orphan disease.
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Affiliation(s)
- Cristina Has
- Department of Dermatology, Medical Faculty and Medical Center, University of Freiburg, Freiburg, Germany
| | - Moritz Hess
- Medical Faculty and Medical Center, Institute of Medical Biometry and Statistics, University of Freiburg, Freiburg, Germany
| | | | - Ulrike Blume-Peytavi
- Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Steffen Emmert
- Clinic and Policlinic for Dermatology and Venereology, University Medical Center Rostock, Rostock, Germany
| | - Regina Fölster-Holst
- Department of Dermatology, Venereology and Allergology, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Jorge Frank
- Department of Dermatology, Venereology and Allergology, University Hospital Göttingen, Göttingen, Germany
| | - Kathrin Giehl
- Department of Dermatology and Allergy, University of Munich LMU, Munich, Germany
| | - Claudia Günther
- Department of Dermatology, University Hospital, Technical University Dresden, Dresden, Germany
| | - Johanna Hammersen
- Department of Pediatrics, University of Erlangen-Nürnberg, Erlangen, Germany
| | - Kathrin Hillmann
- Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Bettina Höflein
- "Interessengemeinschaft Epidermolysis bullosa (IEB) e.V. Debra Deutschland", Biedenkopf, Germany
| | - Peter H Hoeger
- Fachbereich Pädiatrie und Pädiatrische Dermatologie/Allergologie, Katholisches Kinderkrankenhaus Wilhelmstift, Hamburg, Germany
| | - Alrun Hotz
- Medical Faculty and Medical Center, Institute of Human Genetics, University of Freiburg, Freiburg, Germany
| | - Thuy Anh Mai
- Fachbereich Pädiatrie und Pädiatrische Dermatologie/Allergologie, Katholisches Kinderkrankenhaus Wilhelmstift, Hamburg, Germany
| | - Vinzenz Oji
- Department of Dermatology, University Hospital Münster, Münster, Germany
| | - Holm Schneider
- Department of Pediatrics, University of Erlangen-Nürnberg, Erlangen, Germany
| | - Kira Süßmuth
- Department of Dermatology, University Hospital Münster, Münster, Germany
| | | | - Frederieke Thielking
- Department of Dermatology, Venereology and Allergology, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Birgit Zirn
- Genetikum® Stuttgart, Genetic Counselling and Diagnostics, Stuttgart, Germany
| | - Judith Fischer
- Medical Faculty and Medical Center, Institute of Human Genetics, University of Freiburg, Freiburg, Germany
| | - Antonia Reimer-Taschenbrecker
- Department of Dermatology, Medical Faculty and Medical Center, University of Freiburg, Freiburg, Germany.,Department of Dermatology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA
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14
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Foo JC, Redler S, Forstner AJ, Basmanav FB, Pethukova L, Guo J, Streit F, Witt SH, Sirignano L, Zillich L, Avasthi S, Ripke S, Christiano AM, Tesch F, Schmitt J, Nöthen MM, Betz RC, Rietschel M, Frank J. Exploring the overlap between alopecia areata and major depressive disorder: Epidemiological and genetic perspectives. J Eur Acad Dermatol Venereol 2023. [PMID: 36695075 DOI: 10.1111/jdv.18921] [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: 08/12/2022] [Accepted: 01/05/2023] [Indexed: 01/26/2023]
Abstract
BACKGROUND Research suggests that Alopecia areata (AA) and Major Depressive Disorder (MDD) show substantial comorbidity. To date, no study has investigated the hypothesis that this is attributable to shared genetic aetiology. OBJECTIVES To investigate AA-MDD comorbidity on the epidemiological and molecular genetic levels. METHODS First, epidemiological analyses were performed using data from a cohort of adult German health insurance beneficiaries (n = 1.855 million) to determine the population-based prevalence of AA-MDD comorbidity. Second, analyses were performed to determine the prevalence of MDD in a clinical AA case-control sample with data on psychiatric phenotypes, stratifying for demographic factors to identify possible contributing factors to AA-MDD comorbidity. Third, the genetic overlap between AA and MDD was investigated using a polygenic risk score (PRS) approach and linkage disequilibrium score (LDSC) regression. For PRS, summary statistics from a large MDD GWAS meta-analysis (PGC-MD2) were used as the training sample, while a Central European AA cohort, including the above-mentioned AA patients, and an independent replication US-AA cohort were used as target samples. LDSC was performed using summary statistics of PGC-MD2 and the largest AA meta-analysis to date. RESULTS High levels of AA-MDD comorbidity were reported in the population-based (MDD in 24% of AA patients), and clinical samples (MDD in 44% of AA patients). MDD-PRS explained a modest proportion of variance in AA case-control status (R2 = 1%). This signal was limited to the major histocompatibility complex (MHC) region on chromosome 6. LDSC regression (excluding MHC) revealed no significant genetic correlation between AA and MDD. CONCLUSIONS As in previous research, AA patients showed an increased prevalence of MDD. The present analyses suggest that genetic overlap may be confined to the MHC region, which is implicated in immune function. More detailed investigation is required to refine understanding of how the MHC is involved in the development of AA and MDD comorbidity.
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Affiliation(s)
- J C Foo
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - S Redler
- Institute of Human Genetics, Medical Faculty & University Hospital Bonn, University of Bonn, Bonn, Germany.,Institute of Human Genetics, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - A J Forstner
- Institute of Human Genetics, Medical Faculty & University Hospital Bonn, University of Bonn, Bonn, Germany.,Institute of Neuroscience and Medicine (INM-1), Research Center Jülich, Jülich, Germany
| | - F B Basmanav
- Institute of Human Genetics, Medical Faculty & University Hospital Bonn, University of Bonn, Bonn, Germany
| | - L Pethukova
- Department of Dermatology, Columbia University, New York City, New York, USA.,Department of Epidemiology, Columbia University, New York City, New York, USA
| | - J Guo
- Department of Biostatistics, Columbia University, New York City, New York, USA
| | - F Streit
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - S H Witt
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - L Sirignano
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - L Zillich
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - S Avasthi
- Laboratory for Statistical Genetics, Charité University Hospital Berlin, Berlin, Germany
| | - S Ripke
- Laboratory for Statistical Genetics, Charité University Hospital Berlin, Berlin, Germany
| | - A M Christiano
- Department of Genetics and Development, Columbia University, New York City, New York, USA
| | - F Tesch
- Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - J Schmitt
- Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - M M Nöthen
- Institute of Human Genetics, Medical Faculty & University Hospital Bonn, University of Bonn, Bonn, Germany
| | - R C Betz
- Institute of Human Genetics, Medical Faculty & University Hospital Bonn, University of Bonn, Bonn, Germany
| | - M Rietschel
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - J Frank
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
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15
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16
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Stanisz H, Mitteldorf C, Janning H, Bennemann A, Schön MP, Frank J. Subzelluläre Kompartimentierung von STIM1 zur Unterscheidung des Morbus Darier vom Morbus Hailey-Hailey. J Dtsch Dermatol Ges 2022; 20:1613-1620. [PMID: 36508364 DOI: 10.1111/ddg.14912_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: 11/23/2021] [Accepted: 08/14/2022] [Indexed: 12/14/2022]
Affiliation(s)
- Hedwig Stanisz
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsmedizin Göttingen
| | - Christina Mitteldorf
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsmedizin Göttingen
| | - Helena Janning
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsmedizin Göttingen
| | - Anette Bennemann
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsmedizin Göttingen
| | - Michael P Schön
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsmedizin Göttingen.,Niedersächsisches Institut für Berufsdermatologie, Universitätsmedizin Göttingen
| | - Jorge Frank
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsmedizin Göttingen
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17
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Stanisz H, Mitteldorf C, Janning H, Bennemann A, Schön MP, Frank J. Subcellular compartmentalization of STIM1 for the distinction of Darier disease from Hailey-Hailey disease. J Dtsch Dermatol Ges 2022; 20:1613-1619. [PMID: 36442136 DOI: 10.1111/ddg.14912] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 08/14/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND OBJECTIVES Darier disease (DD) and Hailey-Hailey disease (HHD) are rare disorders caused by mutations in the ATPase, Sarcoplasmic/Endoplasmic Reticulum Ca2+ Transporting 2 (ATP2A2) and ATPase Ca2+ Transporting Type 2C, Member 1 (ATP2C1) gene, respectively, which lead to a disturbance of calcium metabolism in keratinocytes. Clinically, this is reflected by an impairment of keratinization. Histologically, acantholysis with variable degrees of dyskeratosis and parakeratosis is observed. Both diseases can usually be differentiated clinically, histopathologically and genetically. However, their routine distinction might be challenging since some patients do not harbor ATP2A2 or ATP2C1 mutations. To solve this diagnostic challenge, we studied the differential expression of two proteins of store-operated calcium entry (SOCE), stromal interaction molecule 1 (STIM1) and calcium release-activated calcium modulator 1 (ORAI1), by immunohistochemistry. PATIENTS AND METHODS Five individuals with ambiguous diagnostic findings and eight controls with an unambiguous diagnosis were studied clinically, histologically, genetically, and by immunohistochemistry for STIM1 and ORAI1. RESULTS DD patients consistently showed a cytoplasmic STIM1 expression while patients with HHD revealed a membrane-associated staining pattern. In contrast, ORAI1 did not show a differential expression pattern. CONCLUSIONS Our data suggest subcellular compartmentalization of STIM1 as novel biomarker for the distinction of the two disorders.
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Affiliation(s)
- Hedwig Stanisz
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany
| | - Christina Mitteldorf
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany
| | - Helena Janning
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany
| | - Anette Bennemann
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany
| | - Michael P Schön
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany.,Lower Saxony Institute of Occupational Dermatology, University Medical Center Göttingen, Göttingen, Germany
| | - Jorge Frank
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany
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Liu Y, Banka S, Huang Y, Hardman-Smart J, Pye D, Torrelo A, Beaman GM, Kazanietz MG, Baker MJ, Ferrazzano C, Shi C, Orozco G, Eyre S, van Geel M, Bygum A, Fischer J, Miedzybrodzka Z, Abuzahra F, Rübben A, Cuvertino S, Ellingford JM, Smith MJ, Evans DG, Weppner-Parren LJMT, van Steensel MAM, Chaudhary IH, Mangham DC, Lear JT, Paus R, Frank J, Newman WG, Zhang X. Germline intergenic duplications at Xq26.1 underlie Bazex-Dupré-Christol basal cell carcinoma susceptibility syndrome. Br J Dermatol 2022; 187:948-961. [PMID: 35986704 DOI: 10.1111/bjd.21842] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 07/27/2022] [Accepted: 08/18/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Bazex-Dupré-Christol syndrome (BDCS; MIM301845) is a rare X-linked dominant genodermatosis characterized by follicular atrophoderma, congenital hypotrichosis and multiple basal cell carcinomas (BCCs). Previous studies have linked BDCS to an 11·4-Mb interval on chromosome Xq25-q27.1. However, the genetic mechanism of BDCS remains an open question. OBJECTIVES To investigate the genetic aetiology and molecular mechanisms underlying BDCS. METHODS We ascertained multiple individuals from eight unrelated families affected with BDCS (F1-F8). Whole-exome (F1 and F2) and genome sequencing (F3) were performed to identify putative disease-causing variants within the linkage region. Array comparative genomic hybridization and quantitative polymerase chain reaction (PCR) were used to explore copy number variations, followed by long-range gap PCR and Sanger sequencing to amplify the duplication junctions and to define the head-tail junctions. Hi-C was performed on dermal fibroblasts from two affected individuals with BDCS and one control. Public datasets and tools were used to identify regulatory elements and transcription factor binding sites within the minimal duplicated region. Immunofluorescence was performed in hair follicles, BCCs and trichoepitheliomas from patients with BDCS and sporadic BCCs. The ACTRT1 variant c.547dup (p.Met183Asnfs*17), previously proposed to cause BDCS, was evaluated with t allele frequency calculator. RESULTS In eight families with BDCS, we identified overlapping 18-135-kb duplications (six inherited and two de novo) at Xq26.1, flanked by ARHGAP36 and IGSF1. Hi-C showed that the duplications did not affect the topologically associated domain, but may alter the interactions between flanking genes and putative enhancers located in the minimal duplicated region. We detected ARHGAP36 expression near the control hair follicular stem cell compartment, and found increased ARHGAP36 levels in hair follicles in telogen, in BCCs and in trichoepitheliomas from patients with BDCS. ARHGAP36 was also detected in sporadic BCCs from individuals without BDCS. Our modelling showed the predicted maximum tolerated minor allele frequency of ACTRT1 variants in control populations to be orders of magnitude higher than expected for a high-penetrant ultra-rare disorder, suggesting loss of function of ACTRT1 variants to be an unlikely cause for BDCS. CONCLUSIONS Noncoding Xq26.1 duplications cause BDCS. The BDCS duplications most likely lead to dysregulation of ARHGAP36. ARHGAP36 is a potential therapeutic target for both inherited and sporadic BCCs. What is already known about this topic? Bazex-Dupré-Christol syndrome (BDCS) is a rare X-linked basal cell carcinoma susceptibility syndrome linked to an 11·4-Mb interval on chromosome Xq25-q27.1. Loss-of-function variants in ACTRT1 and its regulatory elements were suggested to cause BDCS. What does this study add? BDCS is caused by small tandem noncoding intergenic duplications at chromosome Xq26.1. The Xq26.1 BDCS duplications likely dysregulate ARHGAP36, the flanking centromeric gene. ACTRT1 loss-of-function variants are unlikely to cause BDCS. What is the translational message? This study provides the basis for accurate genetic testing for BDCS, which will aid precise diagnosis and appropriate surveillance and clinical management. ARHGAP36 may be a novel therapeutic target for all forms of sporadic basal cell carcinomas.
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Affiliation(s)
- Yanshan Liu
- McKusick-Zhang Center for Genetic Medicine, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100005, China
| | - Siddharth Banka
- Division of Evolution, Infection and Genomics, Faculty of Biology, Medicine and Human Sciences, University of Manchester, Manchester, M13 9PL, UK
- Manchester Centre for Genomic Medicine, Manchester University NHS Foundation Trust, Manchester, M13 9WL, UK
| | - Yingzhi Huang
- McKusick-Zhang Center for Genetic Medicine, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100005, China
| | - Jonathan Hardman-Smart
- The Centre for Dermatology Research, University of Manchester, MAHSC, and National Institutes of Health Biomedical Research Center, Manchester, M13 9PL, UK
- St John's Institute of Dermatology, Kings College London, London, WC2R 2LS, UK
| | - Derek Pye
- The Centre for Dermatology Research, University of Manchester, MAHSC, and National Institutes of Health Biomedical Research Center, Manchester, M13 9PL, UK
| | - Antonio Torrelo
- Department of Dermatology, Hospital Infantil Universitario Niño Jesús, 28009, Madrid, Spain
| | - Glenda M Beaman
- Division of Evolution, Infection and Genomics, Faculty of Biology, Medicine and Human Sciences, University of Manchester, Manchester, M13 9PL, UK
- Manchester Centre for Genomic Medicine, Manchester University NHS Foundation Trust, Manchester, M13 9WL, UK
| | - Marcelo G Kazanietz
- Department of Systems Pharmacology and Translational Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Martin J Baker
- Department of Systems Pharmacology and Translational Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Carlo Ferrazzano
- Centre for Genetics and Genomics Versus Arthritis Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, M13 9PL, UK
| | - Chenfu Shi
- Centre for Genetics and Genomics Versus Arthritis Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, M13 9PL, UK
| | - Gisela Orozco
- Centre for Genetics and Genomics Versus Arthritis Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, M13 9PL, UK
| | - Stephen Eyre
- Centre for Genetics and Genomics Versus Arthritis Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, M13 9PL, UK
| | - Michel van Geel
- Department of Dermatology, University Hospital Maastricht, 6229, Maastricht, the Netherlands
- GROW School for Oncology and Developmental Biology, Maastricht University Medical Center+, 6229, Maastricht, the Netherlands
| | - Anette Bygum
- Department of Clinical Genetics, Odense University Hospital, 5230, Odense, Denmark
- Hospital Clinical Institute, University of Southern Denmark, 5230, Odense, Denmark
| | - Judith Fischer
- Institute of Human Genetics, Medical Center, University of Freiburg, 79106, Freiburg, Germany
| | - Zosia Miedzybrodzka
- School of Medicine, Medical Sciences, Nutrition and Dentistry, University of Aberdeen, Aberdeen, AB25 2ZD, UK
- Medical Genetics Department, NHS Grampian, Foresterhill, Aberdeen, AB25 2ZD, UK
| | - Faris Abuzahra
- Department of Dermatology, Zaandam Medical Center, 1502, Zaandam, the Netherlands
| | - Albert Rübben
- Department of Dermatology and Allergology, University Hospital of RWTH Aachen, 52062, Aachen, Germany
| | - Sara Cuvertino
- Division of Evolution, Infection and Genomics, Faculty of Biology, Medicine and Human Sciences, University of Manchester, Manchester, M13 9PL, UK
| | - Jamie M Ellingford
- Division of Evolution, Infection and Genomics, Faculty of Biology, Medicine and Human Sciences, University of Manchester, Manchester, M13 9PL, UK
- Manchester Centre for Genomic Medicine, Manchester University NHS Foundation Trust, Manchester, M13 9WL, UK
| | - Miriam J Smith
- Division of Evolution, Infection and Genomics, Faculty of Biology, Medicine and Human Sciences, University of Manchester, Manchester, M13 9PL, UK
- Manchester Centre for Genomic Medicine, Manchester University NHS Foundation Trust, Manchester, M13 9WL, UK
| | - D Gareth Evans
- Division of Evolution, Infection and Genomics, Faculty of Biology, Medicine and Human Sciences, University of Manchester, Manchester, M13 9PL, UK
- Manchester Centre for Genomic Medicine, Manchester University NHS Foundation Trust, Manchester, M13 9WL, UK
| | | | - Maurice A M van Steensel
- Skin Research Institute of Singapore, Agency for Science, Technology and Research (A*STAR), Singapore, 138543, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University (NTU), Singapore, 636921, Singapore
| | - Iskander H Chaudhary
- Department of Pathology, Royal Liverpool University Hospital, Liverpool, L7 8XP, UK
| | - D Chas Mangham
- Adult Histopathology, Laboratory Medicine, Manchester University NHS Foundation Trust, Health Innovation Manchester, Manchester, M13 9WL, UK
| | - John T Lear
- The Centre for Dermatology Research, University of Manchester, MAHSC, and National Institutes of Health Biomedical Research Center, Manchester, M13 9PL, UK
- Department of Dermatology, Salford Royal NHS Foundation Trust, Manchester, M6 8AD, UK
| | - Ralf Paus
- The Centre for Dermatology Research, University of Manchester, MAHSC, and National Institutes of Health Biomedical Research Center, Manchester, M13 9PL, UK
- Dr Phillip Frost Department of Dermatology & Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, 33125, USA
- Monasterium Laboratory, Nano-Bioanalytik Zentrum, D-48149, Münster, Germany
| | - Jorge Frank
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, 37075, Göttingen, Germany
| | - William G Newman
- Division of Evolution, Infection and Genomics, Faculty of Biology, Medicine and Human Sciences, University of Manchester, Manchester, M13 9PL, UK
- Manchester Centre for Genomic Medicine, Manchester University NHS Foundation Trust, Manchester, M13 9WL, UK
| | - Xue Zhang
- McKusick-Zhang Center for Genetic Medicine, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100005, China
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Knott E, Zlevor A, Hinshaw L, Laeseke P, Longhurst C, Frank J, Bradley C, Couillard A, Xu Z, Lee F, Ziemlewicz T. Abstract No. 170 Histotripsy vs. microwave ablation in the liver: a comparison study in a porcine model. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.251] [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: 11/28/2022] Open
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Schmetz A, Xiong X, Cesarato N, Basmanav FB, Gierthmuehlen P, Schaper J, Schlieper D, Wehner M, Thiele H, Frank J, Betz RC, Redler S. Phänotypische Vielfalt bei Varianten im TP63-Gen. J Dtsch Dermatol Ges 2022; 20:871-875. [PMID: 35711055 DOI: 10.1111/ddg.14770_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: 11/28/2022]
Affiliation(s)
- Ariane Schmetz
- Institut für Humangenetik, Medizinische Fakultät und Universitätsklinikum Düsseldorf, Heinrich-Heine-Universität Düsseldorf
| | - Xing Xiong
- Institut für Humangenetik, Universität Bonn, Medizinische Fakultät und Universitätsklinikum Bonn
| | - Nicole Cesarato
- Institut für Humangenetik, Universität Bonn, Medizinische Fakultät und Universitätsklinikum Bonn
| | - Fitnat Buket Basmanav
- Institut für Humangenetik, Universität Bonn, Medizinische Fakultät und Universitätsklinikum Bonn
| | - Petra Gierthmuehlen
- Klinik für Zahnärztliche Prothetik, Fakultät und Universitätsklinikum Düsseldorf, Heinrich-Heine-Universität Düsseldorf
| | - Jörg Schaper
- Zentrum für seltene Erkrankungen, Medizinische Fakultät und Universitätsklinikum Düsseldorf, Heinrich-Heine-Universität Düsseldorf
| | - Daniel Schlieper
- Interdisziplinäres Zentrum für Palliativmedizin, Medizinische Fakultät und Universitätsklinikum Düsseldorf, Heinrich-Heine-Universität Düsseldorf
| | - Maria Wehner
- Institut für Humangenetik, Universität Bonn, Medizinische Fakultät und Universitätsklinikum Bonn
| | - Holger Thiele
- Cologne Center for Genomics (CCG), Universität zu Köln, Medizinische Fakultät und Universitätsklinikum Köln
| | - Jorge Frank
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsmedizin Göttingen, Göttingen
| | - Regina C Betz
- Institut für Humangenetik, Universität Bonn, Medizinische Fakultät und Universitätsklinikum Bonn
| | - Silke Redler
- Institut für Humangenetik, Medizinische Fakultät und Universitätsklinikum Düsseldorf, Heinrich-Heine-Universität Düsseldorf.,Zentrum für seltene Erkrankungen, Medizinische Fakultät und Universitätsklinikum Düsseldorf, Heinrich-Heine-Universität Düsseldorf
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Schmetz A, Xiong X, Cesarato N, Basmanav FB, Gierthmuehlen P, Schaper J, Schlieper D, Wehner M, Thiele H, Frank J, Betz RC, Redler S. Phenotype diversity associated with TP63 mutations. J Dtsch Dermatol Ges 2022; 20:872-875. [PMID: 35593033 DOI: 10.1111/ddg.14770] [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: 11/30/2022]
Affiliation(s)
- Ariane Schmetz
- Institute of Human Genetics, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University, Düsseldorf, Germany
| | - Xing Xiong
- Institute of Human Genetics, University of Bonn, Medical Faculty and University Hospital Bonn, Bonn, Germany
| | - Nicole Cesarato
- Institute of Human Genetics, University of Bonn, Medical Faculty and University Hospital Bonn, Bonn, Germany
| | - Fitnat Buket Basmanav
- Institute of Human Genetics, University of Bonn, Medical Faculty and University Hospital Bonn, Bonn, Germany
| | - Petra Gierthmuehlen
- Department of Prosthodontics, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University, Düsseldorf, Germany
| | - Jörg Schaper
- Center of Rare Disorders, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University, Düsseldorf, Germany
| | - Daniel Schlieper
- Interdisciplinary Centre for Palliative Medicine, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University, Düsseldorf, Germany
| | - Maria Wehner
- Institute of Human Genetics, University of Bonn, Medical Faculty and University Hospital Bonn, Bonn, Germany
| | - Holger Thiele
- Cologne Center for Genomics (CCG), University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Jorge Frank
- Department of Dermatology, Venereology and Allergology, Göttingen University Medical Center, Göttingen, Germany
| | - Regina C Betz
- Institute of Human Genetics, University of Bonn, Medical Faculty and University Hospital Bonn, Bonn, Germany
| | - Silke Redler
- Institute of Human Genetics, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University, Düsseldorf, Germany.,Center of Rare Disorders, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University, Düsseldorf, Germany
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Abstract
The porphyrias are clinically variable and genetically heterogeneous, predominantly hereditary metabolic diseases, which are caused by a dysfunction of specific enzymes in heme biosynthesis. Here, we provide an overview of the etiopathogenesis, clinic, differential diagnosis, laboratory diagnostics and therapy of these complex metabolic disorders and cover in detail the most common form of porphyria worldwide (porphyria cutanea tarda), the most frequent childhood porphyria (erythropoietic protoporphyria), and the most common neurocutaneous porphyria (variegate porphyria).
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Affiliation(s)
- Wiebke Muschalek
- Department of Dermatology, Venereology and Allergology, University Hospital Göttingen, Göttingen, Germany
| | - Matthias A Hermasch
- Department of Dermatology, Venereology and Allergology, University Hospital Göttingen, Göttingen, Germany
| | | | - Jorge Frank
- Department of Dermatology, Venereology and Allergology, University Hospital Göttingen, Göttingen, Germany
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Muschalek W, Hermasch MA, Schön MP, Frank J. Eine Frau mit Blasenbildung und Photosensitivität. J Dtsch Dermatol Ges 2022; 20:358-361. [PMID: 35304944 DOI: 10.1111/ddg.14645_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: 11/30/2022]
Affiliation(s)
- Wiebke Muschalek
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsmedizin Göttingen, Göttingen, Deutschland
| | - Matthias A Hermasch
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsmedizin Göttingen, Göttingen, Deutschland
| | - Michael P Schön
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsmedizin Göttingen, Göttingen, Deutschland
| | - Jorge Frank
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsmedizin Göttingen, Göttingen, Deutschland
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Muschalek W, Hermasch MA, Poblete-Gutiérrez P, Frank J. Die Porphyrien. J Dtsch Dermatol Ges 2022; 20:316-333. [PMID: 35304948 DOI: 10.1111/ddg.14743_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: 06/17/2021] [Accepted: 01/16/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Wiebke Muschalek
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsmedizin Göttingen, Göttingen, Deutschland
| | - Matthias A Hermasch
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsmedizin Göttingen, Göttingen, Deutschland
| | | | - Jorge Frank
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsmedizin Göttingen, Göttingen, Deutschland
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Keller M, Kreuzer M, Reidy B, Scheurer A, Guggenbühl B, Luder M, Frank J, Giller K. Effects on performance, carcass and meat quality of replacing maize silage and concentrate by grass silage and corn-cob mix in the diet of growing bulls. Meat Sci 2022; 188:108795. [DOI: 10.1016/j.meatsci.2022.108795] [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] [Received: 01/08/2022] [Revised: 02/18/2022] [Accepted: 03/02/2022] [Indexed: 10/18/2022]
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Muschalek W, Hermasch MA, Schön MP, Frank J. A woman with blistering and photosensitivity. J Dtsch Dermatol Ges 2022; 20:358-360. [PMID: 35099121 DOI: 10.1111/ddg.14645] [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: 11/29/2022]
Affiliation(s)
- Wiebke Muschalek
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany
| | - Matthias A Hermasch
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany
| | - Michael P Schön
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany
| | - Jorge Frank
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany
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Herzig C, Frank J, Nenning A, Gerstl M, Bumberger A, Fleig J, Opitz AK, Limbeck A. Combining electrochemical and quantitative elemental analysis to investigate the sulfur poisoning process of ceria thin film fuel electrodes. J Mater Chem A Mater 2022; 10:1840-1851. [PMID: 35178245 PMCID: PMC8788136 DOI: 10.1039/d1ta06873c] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 12/17/2021] [Indexed: 06/14/2023]
Abstract
This work deals with the effect of sulfur incorporation into model-type GDC thin films on their in-plane ionic conductivity. By means of impedance measurements, a strongly deteriorating effect on the grain boundary conductivity was confirmed, which additionally depends on the applied electrochemical polarisation. To quantify the total amount of sulfur incorporated into GDC thin films, online-laser ablation of solids in liquid (online-LASIL) was used as a novel solid sampling strategy. Online-LASIL combines several advantages of conventional sample introduction systems and enables the detection of S as a minor component in a very limited sample system (in the present case 35 μg total sample mass). To reach the requested sensitivity for S detection using an inductively coupled plasma-mass spectrometer (ICP-MS), the reaction cell of the quadrupole instrument was used and the parameters for the mass shift reaction with O2 were optimised. The combination of electrical and quantitative analytical results allows the identification of a potential sulfur incorporation pathway, which very likely proceeds along GDC grain boundaries with oxysulfide formation as the main driver of ion transport degradation. Depending on the applied cathodic bias, the measured amount of sulfur would be equivalent to 1-4 lattice constants of GDC transformed into an oxysulfide phase at the material's grain boundaries.
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Affiliation(s)
- C Herzig
- TU Wien, Institute of Chemical Technologies and Analytics Getreidemarkt 9/164 I2AC 1060 Vienna Austria
| | - J Frank
- TU Wien, Joint Workshop, Technical Chemistry Vienna Austria
| | - A Nenning
- TU Wien, Institute of Chemical Technologies and Analytics Getreidemarkt 9/164 I2AC 1060 Vienna Austria
| | - M Gerstl
- TU Wien, Institute of Chemical Technologies and Analytics Getreidemarkt 9/164 I2AC 1060 Vienna Austria
| | - A Bumberger
- TU Wien, Institute of Chemical Technologies and Analytics Getreidemarkt 9/164 I2AC 1060 Vienna Austria
| | - J Fleig
- TU Wien, Institute of Chemical Technologies and Analytics Getreidemarkt 9/164 I2AC 1060 Vienna Austria
| | - A K Opitz
- TU Wien, Institute of Chemical Technologies and Analytics Getreidemarkt 9/164 I2AC 1060 Vienna Austria
| | - A Limbeck
- TU Wien, Institute of Chemical Technologies and Analytics Getreidemarkt 9/164 I2AC 1060 Vienna Austria
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Hermasch MA, Janning H, Perera RP, Schnabel V, Rostam N, Ramos-Gomes F, Muschalek W, Bennemann A, Alves F, Ralser DJ, Betz RC, Schön MP, Dosch R, Frank J. Evolutionary distinct roles of γ-secretase subunit nicastrin in zebrafish and humans. J Dermatol Sci 2022; 105:80-87. [PMID: 35016821 DOI: 10.1016/j.jdermsci.2022.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 12/20/2021] [Accepted: 01/03/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Mutations in the genes that encode the human γ-secretase subunits Presenilin-1, Presenilin Enhancer Protein 2, and Nicastrin (NCSTN) are associated with familial hidradenitis suppurativa (HS); and, regarding Presenilin Enhancer Protein 2, also with comorbidity for the hereditary pigmentation disorder Dowling-Degos disease. OBJECTIVE Here, the consequences of targeted inactivation of ncstn, the zebrafish homologue of human NCSTN, were studied. METHODS After morpholino (MO)-mediated ncstn-knockdown, the possibilities of phenotype rescue through co-injection of ncstn-MO with wildtype zebrafish ncstn or human NCSTN mRNA were investigated. Further, the effects of the co-injection of a human missense, nonsense, splice-site, and frameshift mutation were studied. RESULTS MO-mediated ncstn-knockdown resulted in a significant reduction in melanophore morphology, size and number; and alterations in their patterns of migration and distribution. This phenotype was rescued by co-injection of zebrafish ncstn RNA, human NCSTN RNA, or a construct encoding the human NCSTN missense mutation p.P211R. CONCLUSION Human NCSTN mutations encoding null alleles confer loss-of-function regarding pigmentation homeostasis in zebrafisch. In contrast, the human missense mutation p.P211R was less harmful, asserting sufficient residual ncstn activity to maintain pigmentation in zebrafish. Since fish lack the anatomical structures affected by HS, our data suggest that the zebrafish ncstn gene and the human NCSTN gene have probably acquired different functions during evolution. In fish, one major role of ncstn is the maintenance of pigmentation homeostasis. In contrast, one of the roles of NCSTN in humans is the prevention of inflammatory processes in the adnexal structures of the skin, as seen in familial HS.
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Affiliation(s)
- Matthias Andreas Hermasch
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany
| | - Helena Janning
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany
| | | | - Viktor Schnabel
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany
| | - Nadia Rostam
- Department of Developmental Biochemistry, University Medical Center Göttingen, Göttingen, Germany
| | - Fernanda Ramos-Gomes
- Max Planck Institute for Experimental Medicine, Translational Molecular Imaging, Göttingen, Germany
| | - Wiebke Muschalek
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany
| | - Anette Bennemann
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany
| | - Frauke Alves
- Max Planck Institute for Experimental Medicine, Translational Molecular Imaging, Göttingen, Germany; Clinic of Hematology and Oncology, University Medical Center Göttingen, Germany; Institute of Interventional and Diagnostic Radiology, University Medical Center Göttingen, Germany
| | | | - Regina Christine Betz
- Institute of Human Genetics, University of Bonn, Medical Faculty and University Hospital Bonn, Bonn, Germany
| | - Michael Peter Schön
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany; Lower Saxony Institute of Occupational Dermatology, University Medical Center Göttingen, Göttingen, Germany
| | - Roland Dosch
- Department of Developmental Biochemistry, University Medical Center Göttingen, Göttingen, Germany
| | - Jorge Frank
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany.
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Schnabel V, Hermasch MA, Wolf S, Schön MP, Betz RC, Frank J. Eine Frau mit hyperpigmentierten Maculae und Papeln. J Dtsch Dermatol Ges 2021; 19:1655-1659. [PMID: 34811908 DOI: 10.1111/ddg.14487_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: 11/29/2022]
Affiliation(s)
- Viktor Schnabel
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsmedizin Göttingen
| | - Matthias A Hermasch
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsmedizin Göttingen
| | - Sabrina Wolf
- Institut für Humangenetik, Medizinische Fakultät und Universitätsklinikum Bonn
| | - Michael P Schön
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsmedizin Göttingen
| | - Regina C Betz
- Institut für Humangenetik, Medizinische Fakultät und Universitätsklinikum Bonn
| | - Jorge Frank
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsmedizin Göttingen
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Affiliation(s)
- Viktor Schnabel
- Department of Dermatology, Venereology und Allergology, University Medical Center Göttingen, Göttingen, Germany
| | - Matthias A Hermasch
- Department of Dermatology, Venereology und Allergology, University Medical Center Göttingen, Göttingen, Germany
| | - Sabrina Wolf
- Institute of Human Genetics, University of Bonn, School of Medicine and University Hospital Bonn, Bonn, Germany
| | - Michael P Schön
- Department of Dermatology, Venereology und Allergology, University Medical Center Göttingen, Göttingen, Germany
| | - Regina C Betz
- Institute of Human Genetics, University of Bonn, School of Medicine and University Hospital Bonn, Bonn, Germany
| | - Jorge Frank
- Department of Dermatology, Venereology und Allergology, University Medical Center Göttingen, Göttingen, Germany
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Voth M, Sommer K, Schindler C, Frank J, Marzi I. Rise of extremity fractures and sport accidents in children at 8-12 years and increase of admittance via the resuscitation room over a decade. Eur J Trauma Emerg Surg 2021; 48:3439-3448. [PMID: 34519864 PMCID: PMC9532303 DOI: 10.1007/s00068-021-01785-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 06/14/2021] [Accepted: 09/01/2021] [Indexed: 11/26/2022]
Abstract
Introduction In an emergency department, the majority of pediatric trauma patients present because of minor injuries. The aim of this study was to evaluate temporal changes in age-related injury pattern, trauma mechanism, and surgeries in pediatric patients. Methods This retrospective study included patients < 18 years of age following trauma from 01/2009 to 12/2018 at a level I trauma center. They were divided into two groups: group A (A: 01/2009 to 12/2013) and group B (B: 01/2014 to 12/2018). Injury mechanism, injury pattern, and surgeries were analyzed. As major injuries fractures, dislocations, and organ injuries and as minor injuries contusions and superficial wounds were defined. Results 23,582 patients were included (58% male, median age 8.2 years). There was a slight increase in patients comparing A (n = 11,557) and B (n = 12,025) with no difference concerning demographic characteristics. Significant more patients (A: 1.9%; B: 2.4%) were admitted to resuscitation room, though the number of multiple injured patients was not significantly different. In A (25.5%), major injuries occurred significantly less frequently than in B (27.0%), minor injuries occurred equally. Extremity fractures were significantly more frequent in B (21.5%) than in A (20.2%), peaking at 8–12 years. Most trauma mechanisms of both groups were constant, with a rising of sport injuries at 8–12 years. Conclusion Although number of patients increases only slightly over a decade, there was a clear increase in major injuries, particularly extremity fractures, peaking at 8–12 years. At this age also sport accidents significantly increased. At least, admittance to resuscitation room rose but without an increase of multiple injured patients.
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Affiliation(s)
- M Voth
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany.
| | - K Sommer
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany
| | - C Schindler
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany
| | - J Frank
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany
| | - I Marzi
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany
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Kondo RN, Basmanav FB, Wolf S, Minelli L, Frank J, Betz RC. Hair loss, facial dysmorphology, and skeletal alterations - a diagnostic challenge. Int J Dermatol 2021; 60:e419-e421. [PMID: 34152005 DOI: 10.1111/ijd.15718] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 04/26/2021] [Accepted: 05/24/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Rogério Nabor Kondo
- Dermatology Service, Hospital Universitário Regional do Norte do Paraná, State University of Londrina, Paraná, Brazil
| | - Fitnat Buket Basmanav
- Institute of Human Genetics, University of Bonn, Medical Faculty & University Hospital Bonn, Bonn, Germany
| | - Sabrina Wolf
- Institute of Human Genetics, University of Bonn, Medical Faculty & University Hospital Bonn, Bonn, Germany
| | - Lorivaldo Minelli
- Dermatology Service, Hospital Universitário Regional do Norte do Paraná, State University of Londrina, Paraná, Brazil
| | - Jorge Frank
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany
| | - Regina C Betz
- Institute of Human Genetics, University of Bonn, Medical Faculty & University Hospital Bonn, Bonn, Germany
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Berger S, Shaw DR, Berben T, Ouboter HT, In 't Zandt MH, Frank J, Reimann J, Jetten MSM, Welte CU. Current production by non-methanotrophic bacteria enriched from an anaerobic methane-oxidizing microbial community. Biofilm 2021; 3:100054. [PMID: 34308332 PMCID: PMC8258643 DOI: 10.1016/j.bioflm.2021.100054] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 01/29/2021] [Revised: 04/12/2021] [Accepted: 05/19/2021] [Indexed: 12/21/2022] Open
Abstract
In recent years, the externalization of electrons as part of respiratory metabolic processes has been discovered in many different bacteria and some archaea. Microbial extracellular electron transfer (EET) plays an important role in many anoxic natural or engineered ecosystems. In this study, an anaerobic methane-converting microbial community was investigated with regard to its potential to perform EET. At this point, it is not well-known if or how EET confers a competitive advantage to certain species in methane-converting communities. EET was investigated in a two-chamber electrochemical system, sparged with methane and with an applied potential of +400 mV versus standard hydrogen electrode. A biofilm developed on the working electrode and stable low-density current was produced, confirming that EET indeed did occur. The appearance and presence of redox centers at −140 to −160 mV and at −230 mV in the biofilm was confirmed by cyclic voltammetry scans. Metagenomic analysis and fluorescence in situ hybridization of the biofilm showed that the anaerobic methanotroph ‘Candidatus Methanoperedens BLZ2’ was a significant member of the biofilm community, but its relative abundance did not increase compared to the inoculum. On the contrary, the relative abundance of other members of the microbial community significantly increased (up to 720-fold, 7.2% of mapped reads), placing these microorganisms among the dominant species in the bioanode community. This group included Zoogloea sp., Dechloromonas sp., two members of the Bacteroidetes phylum, and the spirochete Leptonema sp. Genes encoding proteins putatively involved in EET were identified in Zoogloea sp., Dechloromonas sp. and one member of the Bacteroidetes phylum. We suggest that instead of methane, alternative carbon sources such as acetate were the substrate for EET. Hence, EET in a methane-driven chemolithoautotrophic microbial community seems a complex process in which interactions within the microbial community are driving extracellular electron transfer to the electrode.
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Affiliation(s)
- S Berger
- Institute for Water and Wetland Research, Department of Microbiology, Radboud University, Nijmegen, the Netherlands
| | - D R Shaw
- Biological and Environmental Science and Engineering Division, Water Desalination and Reuse Research Center, King Abdullah University of Science and Technology, Thuwal, Saudi Arabia.,Soehngen Institute of Anaerobic Microbiology, Radboud University, Nijmegen, the Netherlands
| | - T Berben
- Institute for Water and Wetland Research, Department of Microbiology, Radboud University, Nijmegen, the Netherlands
| | - H T Ouboter
- Institute for Water and Wetland Research, Department of Microbiology, Radboud University, Nijmegen, the Netherlands.,Soehngen Institute of Anaerobic Microbiology, Radboud University, Nijmegen, the Netherlands
| | - M H In 't Zandt
- Institute for Water and Wetland Research, Department of Microbiology, Radboud University, Nijmegen, the Netherlands.,Netherlands Earth System Science Center, Utrecht University, Utrecht, the Netherlands
| | - J Frank
- Institute for Water and Wetland Research, Department of Microbiology, Radboud University, Nijmegen, the Netherlands.,Soehngen Institute of Anaerobic Microbiology, Radboud University, Nijmegen, the Netherlands
| | - J Reimann
- Institute for Water and Wetland Research, Department of Microbiology, Radboud University, Nijmegen, the Netherlands
| | - M S M Jetten
- Institute for Water and Wetland Research, Department of Microbiology, Radboud University, Nijmegen, the Netherlands.,Netherlands Earth System Science Center, Utrecht University, Utrecht, the Netherlands.,Soehngen Institute of Anaerobic Microbiology, Radboud University, Nijmegen, the Netherlands
| | - C U Welte
- Institute for Water and Wetland Research, Department of Microbiology, Radboud University, Nijmegen, the Netherlands.,Soehngen Institute of Anaerobic Microbiology, Radboud University, Nijmegen, the Netherlands
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Frank J. Frühzeitige Diagnose der Neurofibromatose Typ 1 – Eine Herausforderung. J Dtsch Dermatol Ges 2021; 19:1-2. [PMID: 33491886 DOI: 10.1111/ddg.14229_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: 11/30/2022]
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35
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Bröcker EB, Buhl T, Frank J, Fritsch P, Goerdt S, Gollnick HPM, Schön MP. Wolfram Sterry und das Journal der Deutschen Dermatologischen Gesellschaft – Erinnerung an eine Erfolgsgeschichte in mehreren Akten. J Dtsch Dermatol Ges 2020; 18:1531-1532. [PMID: 33373140 DOI: 10.1111/ddg.14345_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: 11/26/2022]
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Hermasch MA, Schön MP, Frank J. Comorbid acne inversa and Dowling-Degos disease due to a single NCSTN mutation: is there enough evidence? Br J Dermatol 2020; 184:374. [PMID: 32894577 DOI: 10.1111/bjd.19539] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 08/31/2020] [Indexed: 12/19/2022]
Affiliation(s)
- M A Hermasch
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Robert Koch Straße 40, 37075, Göttingen, Germany
| | - M P Schön
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Robert Koch Straße 40, 37075, Göttingen, Germany.,Lower Saxony Institute of Occupational Dermatology, University Medical Center Göttingen, Göttingen, Germany
| | - J Frank
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Robert Koch Straße 40, 37075, Göttingen, Germany
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Martin A, Lang E, Ramsauer B, Gröning T, Bedin GL, Frank J. Kontinuierliche medizinische Fortbildung in der Dermatologie für Ärzte und Studierende während der Coronavirus‐Pandemie – eine große Herausforderung. J Dtsch Dermatol Ges 2020; 18:835-840. [PMID: 32881293 PMCID: PMC7461411 DOI: 10.1111/ddg.14190_g] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 06/20/2020] [Indexed: 11/29/2022]
Abstract
Kontinuierliche medizinische Fortbildung (Continuing Medical Education, CME) ist die wesentliche Grundlage der studentischen Lehre sowie der Aus- und Weiterbildung von Ärzten. Eine moderne und adäquate Patientenversorgung ist ohne sie nicht denkbar. Vor kurzem zwang die durch das schwere akute respiratorische Syndrom-Coronavirus 2 (SARS-CoV-2) verursachte Pandemie die gesamte medizinische Gemeinschaft, ihre Gewohnheiten bezüglich der medizinischen Fortbildung und Lehre sowie des Lernens in der Medizin zu ändern. Infolgedessen rückten über soziale Medien (Social Media) verbreitete digitale Aus-, Fortbildungs- und Lehrformate, medizinische Online-Enzyklopädien, webbasierte medizinische Lernportale und medizinische Podcasts in den Vordergrund. In diesem Beitrag geben wir einen Überblick zu aktuelle Konzepten in der medizinischen Online-Fortbildung, unter besonderer Berücksichtigung der Dermatologie.
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Affiliation(s)
- Alice Martin
- Klinik für DermatologieAllergologie und DermatochirurgieHELIOS Universitätsklinikum WuppertalUniversität Witten‐ HerdeckeWuppertalDeutschland
| | - Estefanía Lang
- Dermanostic Online‐Praxis für DermatologieDüsseldorfDeutschland
| | - Babett Ramsauer
- Klinik für GeburtsmedizinVivantes Klinikum NeuköllnBerlinDeutschland
| | - Thilo Gröning
- Gemeinschaftspraxis für FrauenheilkundeMönchengladbachDeutschland
| | | | - Jorge Frank
- Klinik für DermatologieVenerologie und AllergologieUniversitätsmedizin GöttingenGöttingenDeutschland
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Martin A, Lang E, Ramsauer B, Gröning T, Bedin GL, Frank J. Continuing medical and student education in dermatology during the coronavirus pandemic – a major challenge. J Dtsch Dermatol Ges 2020; 18:835-840. [DOI: 10.1111/ddg.14190] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 06/20/2020] [Indexed: 01/22/2023]
Affiliation(s)
- Alice Martin
- Department of Dermatology Allergology and Dermatosurgery HELIOS University Hospital Wuppertal University Witten/Herdecke Wuppertal Germany
| | - Estefanía Lang
- Dermanostic online Practice for Dermatology Düsseldorf Germany
| | - Babett Ramsauer
- Department of Obstetrics Vivantes Neukölln Hospital Berlin Germany
| | - Thilo Gröning
- Joint Practice for Gynecology Mönchengladbach Germany
| | | | - Jorge Frank
- Department of Dermatology Venereology and Allergology University Medical Center Göttingen Göttingen Germany
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Hermasch MA, Schnabel V, Schön MP, Fischer J, Frank J. Schmerzhafte Hautschwellung nach Wasserkontakt. J Dtsch Dermatol Ges 2020; 18:764-768. [DOI: 10.1111/ddg.14098_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: 11/28/2022]
Affiliation(s)
- Matthias A. Hermasch
- Klinik für Dermatologie Venerologie und Allergologie Universitätsmedizin Göttingen
| | - Viktor Schnabel
- Klinik für Dermatologie Venerologie und Allergologie Universitätsmedizin Göttingen
| | - Michael P. Schön
- Klinik für Dermatologie Venerologie und Allergologie Universitätsmedizin Göttingen
| | - Judith Fischer
- Institut für Humangenetik Universitätsklinikum Freiburg Medizinische Fakultät Albert‐Ludwigs‐Universität Freiburg
| | - Jorge Frank
- Klinik für Dermatologie Venerologie und Allergologie Universitätsmedizin Göttingen
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Frank J, Thoms K. Reinduktion immunologischer Systemtherapien beim metastasierten Melanom – Möglichkeiten und Grenzen. J Dtsch Dermatol Ges 2020; 18:421-422. [DOI: 10.1111/ddg.14100_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: 11/28/2022]
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41
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Hermasch MA, Schnabel V, Schön MP, Fischer J, Frank J. Painful skin swelling after water contact. J Dtsch Dermatol Ges 2020; 18:764-768. [PMID: 32352216 DOI: 10.1111/ddg.14098] [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: 11/29/2022]
Affiliation(s)
- Matthias A Hermasch
- Department of Dermatology, Venereology und Allergology, University Medical Center Göttingen, Göttingen, Germany
| | - Viktor Schnabel
- Department of Dermatology, Venereology und Allergology, University Medical Center Göttingen, Göttingen, Germany
| | - Michael P Schön
- Department of Dermatology, Venereology und Allergology, University Medical Center Göttingen, Göttingen, Germany
| | - Judith Fischer
- Institute of Human Genetics, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Jorge Frank
- Department of Dermatology, Venereology und Allergology, University Medical Center Göttingen, Göttingen, Germany
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Lang M, Leménager T, Streit F, Fauth-Bühler M, Frank J, Juraeva D, Witt S, Degenhardt F, Hofmann A, Heilmann-Heimbach S, Kiefer F, Brors B, Grabe HJ, John U, Bischof A, Bischof G, Völker U, Homuth G, Beutel M, Lind P, Medland S, Slutske W, Martin N, Völzke H, Nöthen M, Meyer C, Rumpf HJ, Wurst F, Rietschel M, Mann K. Genome-wide association study of pathological gambling. Eur Psychiatry 2020; 36:38-46. [DOI: 10.1016/j.eurpsy.2016.04.001] [Citation(s) in RCA: 74] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Revised: 03/09/2016] [Accepted: 04/01/2016] [Indexed: 12/18/2022] Open
Abstract
AbstractBackgroundPathological gambling is a behavioural addiction with negative economic, social, and psychological consequences. Identification of contributing genes and pathways may improve understanding of aetiology and facilitate therapy and prevention. Here, we report the first genome-wide association study of pathological gambling. Our aims were to identify pathways involved in pathological gambling, and examine whether there is a genetic overlap between pathological gambling and alcohol dependence.MethodsFour hundred and forty-five individuals with a diagnosis of pathological gambling according to the Diagnostic and Statistical Manual of Mental Disorders were recruited in Germany, and 986 controls were drawn from a German general population sample. A genome-wide association study of pathological gambling comprising single marker, gene-based, and pathway analyses, was performed. Polygenic risk scores were generated using data from a German genome-wide association study of alcohol dependence.ResultsNo genome-wide significant association with pathological gambling was found for single markers or genes. Pathways for Huntington's disease (P-value = 6.63 × 10−3); 5′-adenosine monophosphate-activated protein kinase signalling (P-value = 9.57 × 10−3); and apoptosis (P-value = 1.75 × 10−2) were significant. Polygenic risk score analysis of the alcohol dependence dataset yielded a one-sided nominal significant P-value in subjects with pathological gambling, irrespective of comorbid alcohol dependence status.ConclusionsThe present results accord with previous quantitative formal genetic studies which showed genetic overlap between non-substance- and substance-related addictions. Furthermore, pathway analysis suggests shared pathology between Huntington's disease and pathological gambling. This finding is consistent with previous imaging studies.
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Lang BM, Balermpas P, Bauer A, Blum A, Brölsch GF, Dirschka T, Follmann M, Frank J, Frerich B, Fritz K, Hauschild A, Heindl LM, Howaldt HP, Ihrler S, Kakkassery V, Klumpp B, Krause-Bergmann A, Löser C, Meissner M, Sachse MM, Schlaak M, Schön MP, Tischendorf L, Tronnier M, Vordermark D, Welzel J, Weichenthal M, Wiegand S, Kaufmann R, Grabbe S. S2k Guidelines for Cutaneous Basal Cell Carcinoma - Part 2: Treatment, Prevention and Follow-up. J Dtsch Dermatol Ges 2020; 17:214-230. [PMID: 30762963 DOI: 10.1111/ddg.13755] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Basal cell carcinoma (BCC) is the most common malignant tumor among fair-skinned individuals, and its incidence had been steadily rising in the past decades. In order to maintain the highest quality of patient care possible, the German S2k guidelines were updated following a systematic literature search and with the participation of all professional societies and associations involved in the management of the disease. Part 2 addresses issues such as proper risk stratification, the various therapeutic approaches, and prevention as well as follow-up of patients with basal cell carcinoma.
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Affiliation(s)
- Berenice M Lang
- Department of Dermatology, Mainz University Medical Center, Mainz, Germany
| | - Panagiotis Balermpas
- Department of Radiation Oncology, Frankfurt University Medical Center, Frankfurt, Germany
| | - Andrea Bauer
- Department of Dermatology, Carl Gustav Carus University Medical Center, Dresden, Germany
| | - Andreas Blum
- Dermatology and Teaching Practice, Konstanz, Germany
| | - G Felix Brölsch
- Department of Plastic, Aesthetic, Hand and Reconstructive Surgery, Hanover Medical School, Hanover, Germany
| | - Thomas Dirschka
- CentroDerm Clinic, Wuppertal, Germany.,Faculty of Health, Witten-Herdecke University, Witten, Germany
| | | | - Jorge Frank
- Department of Dermatology, Venereology and Allergology, Göttingen University Medical Center, Göttingen, Germany
| | - Bernhard Frerich
- Department of Oral and Maxillofacial Plastic Surgery, Rostock University Medical Center, Rostock, Germany
| | - Klaus Fritz
- Dermatology and Laser Center, Landau, Germany
| | - Axel Hauschild
- Department of Dermatology, Venereology and Allergology, Schleswig-Holstein University Medical Center, Kiel, Germany
| | - Ludwig M Heindl
- Department of Ophthalmology, Cologne University Medical Center, Cologne, Germany
| | - Hans-Peter Howaldt
- Department of Oral and Maxillofacial Surgery, Gießen University Medical Center, Gießen, Germany
| | - Stephan Ihrler
- Laboratory for Dermatohistology and Oral Pathology, Munich, Germany
| | - Vinodh Kakkassery
- Department of Ophthalmology, Schleswig-Holstein University Medical Center, Lübeck, Germany.,Department of Ophthalmology, Rostock University Medical Center, Rostock, Germany
| | - Bernhard Klumpp
- Department of Diagnostic and Interventional Radiology, Tübingen University Medical Center, Tübingen, Germany.,Department of Radiology, Rems-Murr Medical Center, Winnenden, Germany
| | | | - Christoph Löser
- Department of Dermatology, Ludwigshafen Medical Center, Ludwigshafen, Germany
| | - Markus Meissner
- Department of Dermatology, Venereology and Allergology, Frankfurt University Medical Center, Frankfurt, Germany
| | - Michael M Sachse
- Department of Dermatology, Allergology and Phlebology, Bremerhaven Medical Center, Bremerhaven, Germany
| | - Max Schlaak
- Department of Dermatology and Allergology, Munich University Medical Center, Munich, Germany
| | - Michael P Schön
- Department of Dermatology, Venereology and Allergology, Göttingen University Medical Center, Göttingen, Germany
| | | | - Michael Tronnier
- Department of Dermatology, Venereology and Allergology, Helios Medical Center, Hildesheim, Germany
| | - Dirk Vordermark
- Department of Radiation Oncology, Halle University Medical Center, Martin Luther University, Halle, Germany
| | - Julia Welzel
- Department of Dermatology and Allergology, Augsburg Medical Center, Augsburg, Germany
| | - Michael Weichenthal
- Department of Dermatology, Venereology and Allergology, Schleswig-Holstein University Medical Center, Kiel, Germany
| | - Susanne Wiegand
- Department of Otolaryngology, Leipzig University Medical Center, Leipzig, Germany
| | - Roland Kaufmann
- Department of Dermatology, Venereology and Allergology, Frankfurt University Medical Center, Frankfurt, Germany
| | - Stephan Grabbe
- Department of Dermatology, Mainz University Medical Center, Mainz, Germany
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Lang E, Martin A, Frank J. Digitalisierung in der Medizin während der COVID-19-Pandemie – Möglichkeiten und Grenzen der Teledermatologie. Kompass Dermatol 2020. [PMCID: PMC7705936 DOI: 10.1159/000512398] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Bei Hautkrankheiten handelt es sich initial oft um Blickdiagnosen. Daher bieten sich dermatologische Fragestellungen für telemedizinische Konsultationen an. Die Ergebnisse zahlreicher internationaler Studien weisen darauf hin, dass die Teledermatologie sowohl von den Patienten als auch den Ärzten in zunehmendem Maße angenommen wird. Nach der Lockerung des Verbots der ausschließlichen Fernbehandlung durch den Ärztetag im Jahr 2018 können Ärzte ihre Patienten auch ohne vorherigen persönlichen Erstkontakt ausschließlich telefonisch oder per Internet behandeln. Durch die Zulassung und den Ausbau der telemedizinischen Tätigkeit in verschiedenen deutschen Bundesländern wurde und wird die Teledermatologie insbesondere während der COVID-19-Pandemie erfolgreich eingesetzt.
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Affiliation(s)
- Estefania Lang
- Dermanostic Online-Praxis für Dermatologie, Düsseldorf, Deutschland
| | - Alice Martin
- Klinik für Dermatologie, Allergologie und Dermatochirurgie, HELIOS Universitätsklinikum Wuppertal, Universität Witten/Herdecke, Witten, Deutschland
| | - Jorge Frank
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsmedizin Göttingen, Göttingen, Deutschland
- *Univ.-Prof. Dr. med. Jorge Frank, Klinik für Dermatologie, Venerologie und Allergologie, Universitätsmedizin Göttingen, Robert Koch Str. 40, Göttingen, Deutschland,
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Maffia M, Vergara D, Romano A, Corricciati C, Damato M, Frank J, Fournier I, Salzet M, Quattrini A. Spatio-temporal analysis of rat peripheral nerve regeneration. J Biotechnol 2019. [DOI: 10.1016/j.jbiotec.2019.05.025] [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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Lang BM, Balermpas P, Bauer A, Blum A, Brölsch GF, Dirschka T, Follmann M, Frank J, Frerich B, Fritz K, Hauschild A, Heindl LM, Howaldt HP, Ihrler S, Kakkassery V, Klumpp B, Krause-Bergmann A, Löser C, Meissner M, Sachse MM, Schlaak M, Schön MP, Tischendorf L, Tronnier M, Vordermark D, Welzel J, Weichenthal M, Wiegand S, Kaufmann R, Grabbe S. S2k-Leitlinie Basalzellkarzinom der Haut - Teil 1: Epidemiologie, Genetik und Diagnostik. J Dtsch Dermatol Ges 2019; 17:94-104. [PMID: 30615280 DOI: 10.1111/ddg.13733_g] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
| | | | - Andrea Bauer
- Klinik und Poliklinik für Dermatologie, Universitätsklinikum Carl Gustav Carus Dresden
| | | | - G Felix Brölsch
- Klinik für Plastische, Ästhetische, Hand- und Wiederherstellungschirurgie, Medizinische Hochschule Hannover
| | - Thomas Dirschka
- CentroDerm, Wuppertal.,Fakultät für Gesundheit, Universität Witten-Herdecke
| | | | - Jorge Frank
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsmedizin Göttingen
| | - Bernhard Frerich
- Klinik und Poliklinik für Mund-, Kiefer- und plastische Gesichtschirurgie, Universitätsmedizin Rostock
| | | | - Axel Hauschild
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel
| | | | - Hans-Peter Howaldt
- Klinik und Poliklinik für Mund-, Kiefer- und Gesichtschirurgie, Universitätsklinikum Gießen
| | | | - Vinodh Kakkassery
- Klinik für Augenheilkunde, Universitätsklinikum Schleswig-Holstein, Campus Lübeck.,Klinik und Poliklinik für Augenheilkunde, Universitätsmedizin Rostock
| | - Bernhard Klumpp
- Abteilung für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Tübingen.,Radiologie, Rems-Murr-Klinikum Winnenden
| | | | | | - Markus Meissner
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Frankfurt
| | - Michael M Sachse
- Klinik für Dermatologie, Allergologie und Phlebologie, Klinikum Bremerhaven
| | - Max Schlaak
- Klinik und Poliklinik für Dermatologie und Allergologie, Klinikum der Universität München
| | - Michael P Schön
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsmedizin Göttingen
| | | | - Michael Tronnier
- Klinik für Dermatologie, Venerologie und Allergologie, Helios Klinikum Hildesheim
| | - Dirk Vordermark
- Universitätsklinik und Poliklinik für Strahlentherapie, Martin-Luther-Universität Halle-Wittenberg
| | - Julia Welzel
- Klinik für Dermatologie und Allergologie, Klinikum Augsburg
| | - Michael Weichenthal
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel
| | - Susanne Wiegand
- Klinik und Poliklinik für Hals-, Nasen-, Ohrenheilkunde, Universitätsklinikum Leipzig
| | - Roland Kaufmann
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Frankfurt
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Dathe K, Frank J, Padberg S, Hultzsch S, Meixner K, Beck E, Meister R, Schaefer C. Negligible risk of prenatal ductus arteriosus closure or fetal renal impairment after third‐trimester paracetamol use: evaluation of the German Embryotox cohort. BJOG 2019; 126:1560-1567. [DOI: 10.1111/1471-0528.15872] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/05/2019] [Indexed: 11/28/2022]
Affiliation(s)
- K Dathe
- Charité – Universitätsmedizin Berlin Corporate Member of Freie Universität Berlin Humboldt‐Universität zu Berlin, and Berlin Institute of Health Institut für Klinische Pharmakologie und Toxikologie Pharmakovigilanz- und Beratungszentrum für Embryonaltoxikologie Berlin Germany
| | - J Frank
- Charité – Universitätsmedizin Berlin Corporate Member of Freie Universität Berlin Humboldt‐Universität zu Berlin, and Berlin Institute of Health Institut für Klinische Pharmakologie und Toxikologie Pharmakovigilanz- und Beratungszentrum für Embryonaltoxikologie Berlin Germany
| | - S Padberg
- Charité – Universitätsmedizin Berlin Corporate Member of Freie Universität Berlin Humboldt‐Universität zu Berlin, and Berlin Institute of Health Institut für Klinische Pharmakologie und Toxikologie Pharmakovigilanz- und Beratungszentrum für Embryonaltoxikologie Berlin Germany
| | - S Hultzsch
- Charité – Universitätsmedizin Berlin Corporate Member of Freie Universität Berlin Humboldt‐Universität zu Berlin, and Berlin Institute of Health Institut für Klinische Pharmakologie und Toxikologie Pharmakovigilanz- und Beratungszentrum für Embryonaltoxikologie Berlin Germany
| | - K Meixner
- Charité – Universitätsmedizin Berlin Corporate Member of Freie Universität Berlin Humboldt‐Universität zu Berlin, and Berlin Institute of Health Institut für Klinische Pharmakologie und Toxikologie Pharmakovigilanz- und Beratungszentrum für Embryonaltoxikologie Berlin Germany
| | - E Beck
- Charité – Universitätsmedizin Berlin Corporate Member of Freie Universität Berlin Humboldt‐Universität zu Berlin, and Berlin Institute of Health Institut für Klinische Pharmakologie und Toxikologie Pharmakovigilanz- und Beratungszentrum für Embryonaltoxikologie Berlin Germany
| | - R Meister
- Department of Mathematics Beuth Hochschule für Technik—University of Applied Sciences Berlin Germany
| | - C Schaefer
- Charité – Universitätsmedizin Berlin Corporate Member of Freie Universität Berlin Humboldt‐Universität zu Berlin, and Berlin Institute of Health Institut für Klinische Pharmakologie und Toxikologie Pharmakovigilanz- und Beratungszentrum für Embryonaltoxikologie Berlin Germany
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Hermasch MA, Schön MP, Betz RC, Frank J. Zwei Frauen mit Haarverlust. J Dtsch Dermatol Ges 2019; 17:845-847. [DOI: 10.1111/ddg.13886_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: 11/27/2022]
Affiliation(s)
- Matthias A. Hermasch
- Klinik für DermatologieVenerologie und AllergologieUniversitätsmedizin Göttingen
| | - Michael P. Schön
- Klinik für DermatologieVenerologie und AllergologieUniversitätsmedizin Göttingen
| | - Regina C. Betz
- Institut für HumangenetikUniversität Bonn, Medizinische Fakultät und Universitätsklinikum Bonn
| | - Jorge Frank
- Klinik für DermatologieVenerologie und AllergologieUniversitätsmedizin Göttingen
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Hermasch MA, Schön MP, Betz RC, Frank J. Two females with hair loss. J Dtsch Dermatol Ges 2019; 17:845-847. [PMID: 31305016 DOI: 10.1111/ddg.13886] [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: 11/29/2022]
Affiliation(s)
- Matthias A Hermasch
- Department of Dermatology, Venereology and Allergology, Göttingen University Medical Center, Göttingen, Germany
| | - Michael P Schön
- Department of Dermatology, Venereology and Allergology, Göttingen University Medical Center, Göttingen, Germany
| | - Regina C Betz
- Institute of Human Genetics, University of Bonn, Medical Faculty and University Medical Center, Bonn, Germany
| | - Jorge Frank
- Department of Dermatology, Venereology and Allergology, Göttingen University Medical Center, Göttingen, Germany
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Frank J, Betz RC. Haaranomalien bei syndromalen Erkrankungen. Hautarzt 2019; 70:514-519. [DOI: 10.1007/s00105-019-4440-6] [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: 11/30/2022]
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