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Gherghel N, Technau-Hafsi K, Mockenhaupt M, Eyerich K, Schempp CM. [Urticarial dermatitis with blister formation]. Dermatologie (Heidelb) 2024; 75:268-270. [PMID: 38214726 DOI: 10.1007/s00105-023-05279-3] [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] [Subscribe] [Scholar Register] [Accepted: 11/30/2023] [Indexed: 01/13/2024]
Affiliation(s)
- Nicole Gherghel
- Klinik für Dermatologie und Venerologie, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Hauptstr. 7, 79104, Freiburg, Deutschland
| | - Kristin Technau-Hafsi
- Klinik für Dermatologie und Venerologie, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Hauptstr. 7, 79104, Freiburg, Deutschland
| | - Maja Mockenhaupt
- Klinik für Dermatologie und Venerologie, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Hauptstr. 7, 79104, Freiburg, Deutschland
| | - Kilian Eyerich
- Klinik für Dermatologie und Venerologie, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Hauptstr. 7, 79104, Freiburg, Deutschland
| | - Christoph M Schempp
- Klinik für Dermatologie und Venerologie, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Hauptstr. 7, 79104, Freiburg, Deutschland.
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Rafei-Shamsabadi D, Scholten L, Lu S, Castiglia D, Zambruno G, Volz A, Arnold A, Saleva M, Martin L, Technau-Hafsi K, Meiss F, von Bubnoff D, Has C. Epidermolysis-Bullosa-Associated Squamous Cell Carcinomas Support an Immunosuppressive Tumor Microenvironment: Prospects for Immunotherapy. Cancers (Basel) 2024; 16:471. [PMID: 38275911 PMCID: PMC10814073 DOI: 10.3390/cancers16020471] [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: 11/16/2023] [Revised: 01/09/2024] [Accepted: 01/14/2024] [Indexed: 01/27/2024] Open
Abstract
Cutaneous squamous cell carcinomas (SCCs) are a major complication of some subtypes of epidermolysis bullosa (EB), with high morbidity and mortality rates and unmet therapeutic needs. The high rate of endogenous mutations and the fibrotic stroma are considered to contribute to the pathogenesis. Patients with dystrophic EB (DEB) and Kindler EB (KEB) have the highest propensity for developing SCCs. Another patient group that develops high-risk SCCs is immunosuppressed (IS) patients, especially after organ transplantation. Herein, we interrogate whether immune checkpoint proteins and immunosuppressive enzymes are dysregulated in EB-associated SCCs as an immune resistance mechanism and compare the expression patterns with those in SCCs from IS patients, who frequently develop high-risk tumors and sporadic SCCs, and immunocompetent (IC) individuals. The expression of indoleamine 2,3-dioxygenase (IDO), programmed cell death protein-1 (PD-1), programmed cell death ligand-1 (PD-L1), T cell immunoglobulin and mucin-domain-containing protein-3 (TIM-3), lymphocyte activation gene-3 (LAG-3), and inflammatory infiltrates (CD4, CD8, and CD68) was assessed via immunohistochemistry and semi-quantitative analysis in 30 DEB-SCCs, 22 KEB-SCCs, 106 IS-SCCs, and 100 sporadic IC-SCCs. DEB-SCCs expressed significantly higher levels of IDO and PD-L1 in tumor cells and PD-1 in the tumor microenvironment (TME) compared with SCCs from IC and IS individuals. The number of CD4-positive T cells per mm2 was significantly lower in DEB-SCCs compared with IC-SCCs. KEB-SCCs showed the lowest expression of the exhaustion markers TIM-3 and LAG-3 compared with all other groups. These findings identify IDO, PD-1, and PD-L1 to be increased in EB-SCCs and candidate targets for combinatory treatments, especially in DEB-SCCs.
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Affiliation(s)
- David Rafei-Shamsabadi
- Department of Dermatology, Medical Center—University of Freiburg, Faculty of Medicine, 79104 Freiburg, Germany; (L.S.); (S.L.); (K.T.-H.); (F.M.); (C.H.)
| | - Lena Scholten
- Department of Dermatology, Medical Center—University of Freiburg, Faculty of Medicine, 79104 Freiburg, Germany; (L.S.); (S.L.); (K.T.-H.); (F.M.); (C.H.)
| | - Sisi Lu
- Department of Dermatology, Medical Center—University of Freiburg, Faculty of Medicine, 79104 Freiburg, Germany; (L.S.); (S.L.); (K.T.-H.); (F.M.); (C.H.)
- Department of Obstetrics and Gynaecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Daniele Castiglia
- Laboratory of Molecular and Cell Biology, Istituto Dermopatico dell’Immacolata Istituto di Ricovero e Cura a Carattere Scientifico (IDI-IRCCS), Via Monti di Creta 104, 00167 Rome, Italy;
| | - Giovanna Zambruno
- Genetics and Rare Diseases Research Division, Bambino Gesù Children’s Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), 00165 Rome, Italy;
| | - Andreas Volz
- Dermatologie am Rhein, 4051 Basel, Switzerland (A.A.)
| | | | - Mina Saleva
- Department of Dermatology and Venereology, University Hospital “Alexandrovska”, Faculty of Medicine, Sofia University of Medicine, 1431 Sofia, Bulgaria;
| | - Ludovic Martin
- MAGEC Nord Reference Center for Rare Skin Diseases, Department of Dermatology, Angers University Hospital, 49933 Angers, France;
| | - Kristin Technau-Hafsi
- Department of Dermatology, Medical Center—University of Freiburg, Faculty of Medicine, 79104 Freiburg, Germany; (L.S.); (S.L.); (K.T.-H.); (F.M.); (C.H.)
| | - Frank Meiss
- Department of Dermatology, Medical Center—University of Freiburg, Faculty of Medicine, 79104 Freiburg, Germany; (L.S.); (S.L.); (K.T.-H.); (F.M.); (C.H.)
| | - Dagmar von Bubnoff
- Department of Dermatology, Allergology and Venerology, University Hospital Schleswig-Holstein, Campus Lübeck, 23538 Lübeck, Germany;
| | - Cristina Has
- Department of Dermatology, Medical Center—University of Freiburg, Faculty of Medicine, 79104 Freiburg, Germany; (L.S.); (S.L.); (K.T.-H.); (F.M.); (C.H.)
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Li D, Technau-Hafsi K, Giehl K, Hoeger PH, Has C. Targeted anti-interleukin-17 therapy for linear porokeratosis. Br J Dermatol 2023; 189:630-631. [PMID: 37406221 DOI: 10.1093/bjd/ljad223] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 06/27/2023] [Accepted: 08/05/2023] [Indexed: 07/07/2023]
Abstract
We report a case involving a 12-year-old female patient with linear porokeratosis (LP) associated with the PMVK pathogenic variant c.329C>A, p.R110Q (monoallelic in DNA from blood and biallelic in DNA from LP). Therapeutic measures, which included a statin/cholesterol cream, did not ameliorate the patient’s skin lesions. Our findings demonstrate a strong interleukin (IL)-17A-positive inflammatory infiltrate, upregulation of IL-17-responsive genes and a significant clinical response to anti-IL-17A therapy in LP.
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Affiliation(s)
- Donglin Li
- Department of Dermatology, Medical Center - University of Freiburg, Freiburg, Germany
| | - Kristin Technau-Hafsi
- Department of Dermatology, Medical Center - University of Freiburg, Freiburg, Germany
| | - Katrin Giehl
- Department of Dermatology, Ludwig Maximilian University of Munich, Munich, Germany
| | - Peter H Hoeger
- Catholic Children's Hospital, Wilhelmstift, Hamburg, Germany
| | - Cristina Has
- Department of Dermatology, Medical Center - University of Freiburg, Freiburg, Germany
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Trefzer L, Hess ME, Scholten L, Technau-Hafsi K, Meiss F, Boerries M, Has C, Rafei-Shamsabadi D. Variable Outcome of Immunotherapy in Advanced Multiple Cutaneous Squamous Cell Carcinomas in Two Patients with Recessive Dystrophic Epidermolysis Bullosa. Acta Derm Venereol 2023; 103:adv4870. [PMID: 37338146 DOI: 10.2340/actadv.v103.4870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 03/14/2023] [Indexed: 06/21/2023] Open
Abstract
Cutaneous squamous cell carcinoma (cSCC) is a major complication of recessive dystrophic epidermolysis bullosa (RDEB) that has high morbidity and mortality rates and unmet therapeutic needs. The aim of this study was to evaluate the molecular pattern of cSCC and the clinical course of immunotherapy in 2 RDEB patients with multiple advanced cSCC. Clinical course and disease staging were evaluated retrospectively. The tumour tissues were subjected to immunohistochemical staining. DNA from the blood and cSCC samples was subjected to massive parallel sequencing, and somatic mutations were determined. Patient 1 survived for over 2 years as disease control was achieved with cemiplimab and intralesional interleukin-2. The target advanced cSCC demonstrated a high rate of somatic mutations and strong expression of the immune markers, indoleamine 2,3-dioxygenase, programmed cell death protein ligand 1, and lymphocyte-activation gene 3. The patient ultimately succumbed to complications of oesophageal carcinoma. Patient 2 had an undifferentiated cSCC on the foot, which displayed a low mutational burden and did not express immune markers. The tumour progressed quickly even with cemiplimab therapy. These 2 cases underscore the challenges of cSCC treatment for RDEB. Multiple tumours with different molecular and immune profiles occur concomitantly or sequentially, and surgical excision is not always possible because of the anatomical and tissue constraints imposed by the disease itself. In conclusion, programmed cell death protein 1 inhibitors are approved and effective in treating metastatic and locally advanced cSCC. Our experience and the literature suggest that cemiplimab is an option in patients with RDEB if surgery is not. Somatic mutations and the immune microenvironment should be characterized to predict therapeutic response, particularly in aggressive undifferentiated tumours.
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Affiliation(s)
- Laura Trefzer
- Department of Dermatology, Medical Centre - University of Freiburg, Faculty of Medicine, Freiburg, Germany
| | - Maria E Hess
- Institute of Medical Bioinformatics and System Medicine, Medical Centre - University of Freiburg, Faculty of Medicine, Freiburg, Germany
| | - Lena Scholten
- Department of Dermatology, Medical Centre - University of Freiburg, Faculty of Medicine, Freiburg, Germany
| | - Kristin Technau-Hafsi
- Department of Dermatology, Medical Centre - University of Freiburg, Faculty of Medicine, Freiburg, Germany
| | - Frank Meiss
- Department of Dermatology, Medical Centre - University of Freiburg, Faculty of Medicine, Freiburg, Germany
| | - Melanie Boerries
- Institute of Medical Bioinformatics and System Medicine, Medical Centre - University of Freiburg, Faculty of Medicine, Freiburg, Germany
| | - Cristina Has
- Department of Dermatology, Medical Centre - University of Freiburg, Faculty of Medicine, Freiburg, Germany.
| | - David Rafei-Shamsabadi
- Department of Dermatology, Medical Centre - University of Freiburg, Faculty of Medicine, Freiburg, Germany
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Technau-Hafsi K, Garzorz-Stark N, Eyerich K. [Molecular diagnosis of hand eczema]. Dermatologie (Heidelb) 2023:10.1007/s00105-023-05148-z. [PMID: 37272967 DOI: 10.1007/s00105-023-05148-z] [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] [Subscribe] [Scholar Register] [Accepted: 03/29/2023] [Indexed: 06/06/2023]
Abstract
BACKGROUND Because hand eczema is a diagnostic challenge even for experienced dermatologists, a correct diagnosis is essential to ensure success of specific therapies. OBJECTIVES Prerequisites for successful molecular diagnostics in general and in hand eczema in particular are discussed. MATERIALS AND METHODS Basic research and opinion statement on new developments in molecular diagnostics are considered with a special focus on hand eczema. RESULTS The first molecular classifier to distinguish psoriasis from (hand) eczema signature has been introduced as CE-marked in vitro diagnostics (CE-IVD); many more biomarkers associated with diagnostics, theranostics, or natural course of the disease are currently being investigated. CONCLUSIONS Diagnosis of hand eczema will be supported by molecular diagnostics in the near future; we are at the beginning of the molecular era in dermatology.
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Affiliation(s)
- Kristin Technau-Hafsi
- Klinik für Dermatologie und Venerologie, Medizinische Fakultät, Universität Freiburg, Freiburg, Deutschland.
- Universitäts-Hautklinik Freiburg, Hauptstr. 7, 79104, Freiburg, Deutschland.
| | - Natalie Garzorz-Stark
- Division of Dermatology, Department of Medicine, Karolinska Insitutet, Stockholm, Schweden
- Klinik und Poliklinik für Dermatologie und Allergologie am Biederstein, Technische Universität München, München, Deutschland
- Dermagnostix GmbH, Hamburg, Deutschland
| | - Kilian Eyerich
- Klinik für Dermatologie und Venerologie, Medizinische Fakultät, Universität Freiburg, Freiburg, Deutschland
- Division of Dermatology, Department of Medicine, Karolinska Insitutet, Stockholm, Schweden
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Frommherz L, Komlosi K, Hewel C, Kopp J, Dewenter M, Zimmer A, Bartsch O, Linke M, Technau-Hafsi K, Gerber S, Fischer J, Has C. Acral lamellar ichthyosis with amino acid substitution in the C-terminus of keratin 2. J Eur Acad Dermatol Venereol 2023; 37:817-822. [PMID: 36331357 DOI: 10.1111/jdv.18719] [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: 07/03/2022] [Accepted: 10/25/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Most cases of hereditary ichthyoses present with generalized scaling and skin dryness. However, in some cases skin involvement is restricted to particular body regions as in acral lamellar ichthyosis. OBJECTIVES We report on the genetic basis of acral ichthyosis in two families presenting with a similar phenotype. METHODS Genetic testing was performed by targeted next generation sequencing and whole-exome sequencing. For identity-by-descent analysis, the parents were genotyped and data analysis was performed with the Chromosome Analysis Suite Software. RT-PCR with RNA extracted from skin samples was used to analyse the effect of variants on splicing. RESULTS Genetic testing identified a few heterozygous variants, but only the variant in KRT2 c.1912 T > C, p.Phe638Leu segregated with the disease and remained the strongest candidate. Pairwise identity-by-descent analysis revealed no indication of family relationship. Phenylalanine 638 is the second last amino acid upstream of the termination codon in the tail of K2, and substitution to leucine is predicted as probably damaging. Assessment of the variant is difficult, in part due to the lack of crystal structures of this region. CONCLUSIONS Altogether, we show that a type of autosomal dominant acral ichthyosis is most probably caused by an amino acid substitution in the C-terminus of keratin 2.
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Affiliation(s)
- Leonie Frommherz
- Department of Dermatology, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Department of Dermatology and Allergy, Ludwig-Maximilians-Universität München (LMU) Munich, University Hospital, Munich, Germany
| | - Katalin Komlosi
- Institute of Human Genetics, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Charlotte Hewel
- Institute of Human Genetics, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Julia Kopp
- Institute of Human Genetics, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Malin Dewenter
- Institute of Human Genetics, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Andreas Zimmer
- Institute of Human Genetics, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Oliver Bartsch
- Institute of Human Genetics, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Matthias Linke
- Institute of Human Genetics, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Kristin Technau-Hafsi
- Department of Dermatology, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Susanne Gerber
- Institute of Human Genetics, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
- Computational Systems Genomics Group, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Judith Fischer
- Institute of Human Genetics, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Cristina Has
- Department of Dermatology, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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Schmidt AC, Technau-Hafsi K, Eyerich K, Schempp CM. [Annular migrating erythema in an 18-year-old man]. Dermatologie (Heidelb) 2023; 74:218-221. [PMID: 36301332 DOI: 10.1007/s00105-022-05074-6] [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] [Subscribe] [Scholar Register] [Accepted: 09/30/2022] [Indexed: 06/16/2023]
Affiliation(s)
- Anna C Schmidt
- Klinik für Dermatologie und Venerologie, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Hauptstr. 7, 79104, Freiburg, Deutschland
| | - Kristin Technau-Hafsi
- Klinik für Dermatologie und Venerologie, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Hauptstr. 7, 79104, Freiburg, Deutschland
| | - Kilian Eyerich
- Klinik für Dermatologie und Venerologie, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Hauptstr. 7, 79104, Freiburg, Deutschland
| | - Christoph M Schempp
- Klinik für Dermatologie und Venerologie, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Hauptstr. 7, 79104, Freiburg, Deutschland.
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Li M, Lay K, Zimmer A, Technau-Hafsi K, Wong J, Reimer-Taschenbrecker A, Rohr J, Abdalla E, Fischer J, Reversade B, Has C. A homozygous p.Leu813Pro gain-of-function NLRP1 variant causes phenotypes of different severity in two siblings. Br J Dermatol 2023; 188:259-267. [PMID: 36763876 DOI: 10.1093/bjd/ljac039] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 09/03/2022] [Accepted: 09/24/2022] [Indexed: 01/22/2023]
Abstract
BACKGROUND A trio exome sequencing study identified a previously unreported NLRP1 gene variant resulting in a p.Leu813Pro substitution of the LRR (leucine-rich repeats) domain of the NLRP1 protein (NACHT, LRR and PYD domains-containing protein 1). This homozygous mutation was shared by two sisters with different clinical presentation: the younger sister had generalized inflammatory nodules with keratotic plugs, clinically resembling multiple keratoacanthomas, while the older had manifestations of familial keratosis lichenoides chronica. OBJECTIVES To analyse the consequences of this NLRP1 variant in two siblings with a different clinical spectrum of severity. METHODS To demonstrate the pathogenicity, p.Leu813Pro was recombinantly expressed, and its effect on inflammasome assembly was assessed. Exome sequencing and RNA-Seq were performed to identify factors with potentially modifying effects on the severity of the skin manifestation between each sibling. RESULTS The variant p.Leu813Pro triggered activation of the NLRP1 inflammasome leading to ASC (apoptosis-associated speck-like protein containing a CARD) speck formation and interleukin (IL)-1β release. The more severely affected sister had several additional genomic variants associated with atopy and psoriasis that were not present in her sibling. IL-5 and IL-17 emerged as dominant cytokines driving prominent inflammation in the skin of the severely affected sibling. CONCLUSIONS To the best of our knowledge, this is the first report of a NLRP1 variant that leads to a different clinical spectrum of severity within the same sibship. IL-5 and IL-17 were the main cytokines expressed in the inflammatory lesions of the severely affected patient and might be regarded as disease modifying factors, and therefore may be considered as therapeutic targets.
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Affiliation(s)
| | - Kenneth Lay
- Laboratory of Human Genetics & Therapeutics, Genome Institute of Singapore (GIS), Agency for Science, Technology and Research (A*STAR), Singapore
| | | | | | - Jasmine Wong
- Laboratory of Human Genetics & Therapeutics, Genome Institute of Singapore (GIS), Agency for Science, Technology and Research (A*STAR), Singapore
| | | | - Jan Rohr
- Department of Paediatrics, Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, Germany
| | - Ebtesam Abdalla
- Department of Human Genetics, Medical Research Institute, Alexandria University, Alexandria, Egypt
| | | | - Bruno Reversade
- Laboratory of Human Genetics & Therapeutics, Genome Institute of Singapore (GIS), Agency for Science, Technology and Research (A*STAR), Singapore
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Haghighi Javid A, Li D, Technau-Hafsi K, Has C. IL-17A immune pattern across genetic acantholytic and blistering disorders. Clin Exp Dermatol 2023; 48:518-523. [PMID: 36632755 DOI: 10.1093/ced/llad012] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 01/05/2023] [Accepted: 01/06/2023] [Indexed: 01/13/2023]
Abstract
There is a high therapeutic need for acantholytic and blistering genodermatoses. Cutaneous inflammation is a reasonable target, although the patterns are not yet fully elucidated. Here we investigated by immunohistochemistry whether IL-17A is expressed in the inflammatory infiltrate in 34 patients with Hailey-Hailey disease, Darier disease, junctional and dystrophic epidermolysis bullosa. There was a 5-7-fold increase in the number IL-17A positive cells in all patients' samples as compared to the normal skin. IL-17A cells were present in the epidermal acantholytic areas and dermal inflammatory infiltrates in Hailey-Hailey and Darier disease. In epidermolysis bullosa samples positive cells were present at the dermal-epidermal junction zone. The IL-17A inflammatory pattern was validated by upregulation of downstream genes/proteins, S100A7, S100A8 and S100A9. These results suggest that IL-17A contributes to skin inflammation and could be a therapeutic target during inflammatory flares in these disorders.
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Affiliation(s)
- Asal Haghighi Javid
- Department of Dermatology, Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, Germany
| | - Donglin Li
- Department of Dermatology, Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, Germany
| | - Kristin Technau-Hafsi
- Department of Dermatology, Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, Germany
| | - Cristina Has
- Department of Dermatology, Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, Germany
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Diehl R, Technau-Hafsi K, Serr A, Hess C, Schauer F. [Painful plaque on the back of the hand : Aggravation by topical steroid treatment]. Dermatologie (Heidelb) 2022; 74:299-301. [PMID: 36583763 DOI: 10.1007/s00105-022-05092-4] [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] [Subscribe] [Scholar Register] [Accepted: 12/01/2022] [Indexed: 12/31/2022]
Affiliation(s)
- Rebecca Diehl
- Klinik für Dermatologie und Venerologie, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Hauptstr. 7, 79104, Freiburg, Deutschland.
| | - Kristin Technau-Hafsi
- Klinik für Dermatologie und Venerologie, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Hauptstr. 7, 79104, Freiburg, Deutschland
| | - Annerose Serr
- Institut für Medizinische Mikrobiologie und Hygiene, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Freiburg, Deutschland
| | - Christina Hess
- Institut für Medizinische Mikrobiologie und Hygiene, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Freiburg, Deutschland
| | - Franziska Schauer
- Klinik für Dermatologie und Venerologie, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Hauptstr. 7, 79104, Freiburg, Deutschland
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Scholl S, Schuster D, Technau-Hafsi K, Stete K, Rieg S, May AM, Bogdan C, Schauer F. Case report: Cutaneous pseudolymphoma caused by a Leishmania infantum infection in a patient treated with anti-TNF antibody for plaque psoriasis. Front Med (Lausanne) 2022; 9:1055703. [DOI: 10.3389/fmed.2022.1055703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 11/11/2022] [Indexed: 12/05/2022] Open
Abstract
For psoriasis, which affects up to 2% of the population and adalimumab is approved from the age of 4 years. Here, we present a middle-aged Italian man with long-term history of plaque psoriasis and psoriasis arthropathica and adalimumab therapy. He developed ulcers or nodules within the psoriatic plaques, resembling cutaneous infection with Leishmania infantum. TNF and other cytokines such as IL-12 and IFN-γ are central in the early control of the infection. Discontinuation of the anti-TNF-treatment resolved the infection without specific therapy.
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Hübner S, Schwieger-Briel A, Technau-Hafsi K, Danescu S, Baican A, Theiler M, Weibel L, Has C. Phänotypisches und genetisches Spektrum von Incontinentia pigmenti – eine große Fallserie. J Dtsch Dermatol Ges 2022; 20:35-44. [PMID: 35040575 DOI: 10.1111/ddg.14638_g] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 08/18/2021] [Indexed: 11/30/2022]
Abstract
HINTERGRUND Incontinentia pigmenti ist eine seltene X-chromosomal dominant vererbte Systemerkrankung, die vor allem die Haut, aber auch andere neuroektodermale Gewebe wie Zähne, Haare, Augen und das zentrale Nervensystem betrifft. PATIENTEN UND METHODIK Diese multizentrische Fallserienstudie wurde an drei europäischen Hautkliniken durchgeführt und umfasste 30 Patienten mit Incontinentia pigmenti. Zwanzig Patienten wurden klinisch und genetisch untersucht, weitere zehn nur genetisch. ERGEBNISSE Die Studie umfasste 28 Frauen und zwei Männer mit einem medianen Alter von drei Jahren. Kutane Manifestationen zeigten sich bei allen 20 Patienten mit klinischen Daten. Stadium I wurde in 90 % dieser Patienten beobachtet. Stadium IV wurde bereits im Alter von einem Jahr beobachtet. Zahn- (81 %), Haar- (78 %) und neurologische Anomalien (53 %) waren häufiger als in bisherigen Berichten. Vierzehn Hautbiopsien zeigten typische Merkmale des entsprechenden Stadiums. Genetische Tests wurden bei 24 Patienten durchgeführt, von denen 14 die häufige Exon 4-10-Deletion und sieben andere pathogene Varianten aufwiesen, darunter drei unveröffentlichte Mutationen. In drei weiteren Fällen wurden keine genetischen Veränderungen gefunden. SCHLUSSFOLGERUNGEN In dieser Studie reichte der Phänotyp von lediglich subtil ausgeprägter Hautbeteiligung bis hin zu schweren Multisystemerkrankungen. Die extrakutane Beteiligung sollte zum Zeitpunkt der Diagnose und in regelmäßigen Abständen evaluiert werden, da sich einige Manifestationen erst mit der Zeit entwickeln. SUMMARY Background and objectives Incontinentia pigmenti is a rare X-linked dominantly inherited systemic disease affecting primarily the skin but also other neuroectodermal tissues such as teeth, hair, eyes, and the central nervous system. Patients and methods This multicenter case series study was conducted at three European departments of Dermatology including 30 patients with incontinentia pigmenti. Twenty patients were evaluated clinically and genetically, another ten only genetically. Results The study included 28 females and two males with a median age of three years. Cutaneous manifestations were present in all 20 patients with clinical data. Stage I was observed in 90 % of those patients. Stage IV was observed as early as one year of age. Dental (81 %), hair (78 %) and neurological anomalies (53 %) were more frequent than previously reported. Fourteen skin biopsies showed typical features of the corresponding stage. Genetic testing of 24 patients revealed the common exon 4-10 deletion in 14 cases and seven other pathogenic variants, including three unpublished mutations. In another three cases, no genetic alterations were found. Conclusions In this study, the phenotype ranged from only subtle cutaneous involvement to severe multisystemic disorders. Extracutaneous involvement should be evaluated at the time of diagnosis and in regular intervals, as some manifestations may develop over time.
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Affiliation(s)
- Stefanie Hübner
- Klinik für Dermatologie und Venerologie, Universitätsklinikum Freiburg, Deutschland
| | | | | | - Sorina Danescu
- Klinik für Dermatologie, Iuliu Haţieganu Universität für Medizin und Pharmazie, Cluj-Napoca, Rumänien
| | - Adrian Baican
- Klinik für Dermatologie, Iuliu Haţieganu Universität für Medizin und Pharmazie, Cluj-Napoca, Rumänien
| | - Martin Theiler
- Pädiatrische Dermatologie, Universitäts-Kinderspital Zürich, Schweiz
| | - Lisa Weibel
- Pädiatrische Dermatologie, Universitäts-Kinderspital Zürich, Schweiz
| | - Cristina Has
- Klinik für Dermatologie und Venerologie, Universitätsklinikum Freiburg, Deutschland.,Europäisches Referenznetzwerk (ERN) für seltene und nicht-diagnostizierte Hauterkrankungen
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Hübner S, Schwieger-Briel A, Technau-Hafsi K, Danescu S, Baican A, Theiler M, Weibel L, Has C. Phenotypic and genetic spectrum of incontinentia pigmenti - a large case series. J Dtsch Dermatol Ges 2021; 20:35-43. [PMID: 34904373 DOI: 10.1111/ddg.14638] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 08/18/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND OBJECTIVES Incontinentia pigmenti is a rare X-linked dominantly inherited systemic disease affecting primarily the skin but also other neuroectodermal tissues such as teeth, hair, eyes, and the central nervous system. PATIENTS AND METHODS This multicenter case series study was conducted at three European departments of Dermatology including 30 patients with incontinentia pigmenti. Twenty patients were evaluated clinically and genetically, another ten only genetically. RESULTS The study included 28 females and two males with a median age of three years. Cutaneous manifestations were present in all 20 patients with clinical data. Stage I was observed in 90 % of those patients. Stage IV was observed as early as one year of age. Dental (81 %), hair (78 %) and neurological anomalies (53 %) were more frequent than previously reported. Fourteen skin biopsies showed typical features of the corresponding stage. Genetic testing of 24 patients revealed the common exon 4-10 deletion in 14 cases and seven other pathogenic variants, including three unpublished mutations. In another three cases, no genetic alterations were found. CONCLUSIONS In this study, the phenotype ranged from only subtle cutaneous involvement to severe multisystemic disorders. Extracutaneous involvement should be evaluated at the time of diagnosis and in regular intervals, as some manifestations may develop over time.
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Affiliation(s)
- Stefanie Hübner
- Department of Dermatology, Medical Center-University of Freiburg, Germany
| | - Agnes Schwieger-Briel
- Pediatric Skin Center, Dermatology Department, University Children's Hospital, Zurich, Switzerland
| | | | - Sorina Danescu
- Department of Dermatology, Iuliu Hat˛ieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Adrian Baican
- Department of Dermatology, Iuliu Hat˛ieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Martin Theiler
- Pediatric Skin Center, Dermatology Department, University Children's Hospital, Zurich, Switzerland
| | - Lisa Weibel
- Pediatric Skin Center, Dermatology Department, University Children's Hospital, Zurich, Switzerland
| | - Cristina Has
- Department of Dermatology, Medical Center-University of Freiburg, Germany.,European Reference Network (ERN) on Rare and Undiagnosed Skin Disorders
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Rafei-Shamsabadi D, Schneider J, Trefzer L, Technau-Hafsi K, Meiss F, Ness T. Case Report: Blurred Vision and Eruptive Nevi - Bilateral Diffuse Uveal Melanocytic Proliferation With Mucocutaneous Involvement in a Lung Cancer Patient. Front Oncol 2021; 11:658407. [PMID: 33928039 PMCID: PMC8076566 DOI: 10.3389/fonc.2021.658407] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 03/24/2021] [Indexed: 11/13/2022] Open
Abstract
We describe a case of a 65-year old patient presenting with unusual mucocutaneous melanocytic proliferations of a Bilateral Diffuse Uveal Melanocytic Proliferation (BDUMP) imitating a multifocal melanoma in situ, which improved dramatically after plasmapheresis. The patient first presented at the dermatology department due to rapidly evolving brown and black macules on the glans penis. Further skin involvement of the perineal and perianal region, mamillae and oral mucosa was stated. Histology from a penile biopsy was compatible with a melanoma in situ. Due to the distribution pattern and elevated serum tumor marker S100B, metastatic melanoma was considered. Staging examinations using PET-CT scan however, revealed a lung tumor, later confirmed as a Non-small-cell lung cancer (NSCLC). Primary radio chemotherapy was initiated to treat NSCLC. Shortly after initiation of radio chemotherapy the patient developed massive vision impairment and a NSCLC-associated BDUMP was diagnosed which led to the correct classification of melanocytic skin lesions as mucocutaneous BDUMP manifestation. Plasmapheresis was started resulting in a rapid improvement of vision starting ten days after the first plasmapheresis. In contrast skin manifestations started to disappear with a marked delay 4 months after the last plasmapheresis cycle. This case highlights the importance of memorizing multiple rapidly progressing melanocytic skin and/or mucous membrane spots together with visual impairment as a possible paraneoplastic BDUMP that needs a fundamentally different therapeutic approach compared to multifocal melanoma in situ. What is already known about this topic? Bilateral Diffuse Uveal Melanocytic Proliferation (BDUMP) is a paraneoplastic syndrome with melanocytic uveal proliferation leading to vision impairment. Extraocular manifestation is rare, mainly affect the subepidermal compartment and is hard to treat. Plasmapheresis has been shown to be an effective treatment mainly for vision improvement in some but not all cases. What does this study add? Our BDUMP case with widespread skin and mucosal involvement initially mimicked a multifocal melanoma in situ and showed an excellent treatment response to plasmapheresis. Improvement of mucocutaneous lesions has not been documented well in the literature so far. We show a more than one year lasting follow up still underlining the beneficial effect of plasmapheresis in this case. In-vitro data supports the hypothesis that plasma exchange eliminates a "Cultured melanocyte elongation and proliferation (CMEP)" factor out of patient blood leading to decreased melanocyte proliferation shown numerically in-vitro and clinically in-vivo. Our case clearly indicates that before establishing a definite diagnosis and therapy in patients with rapidly evolving melanocytic skin and/or mucosal lesions BDUMP mimicking multifocal melanoma in situ should be considered making a thorough diagnostic workup mandatory.
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Affiliation(s)
- David Rafei-Shamsabadi
- Department of Dermatology and Venereology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Johanna Schneider
- Department of Medicine IV, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Laura Trefzer
- Department of Dermatology and Venereology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Kristin Technau-Hafsi
- Department of Dermatology and Venereology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Frank Meiss
- Department of Dermatology and Venereology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Thomas Ness
- Eye Center, University Hospital Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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Saleva-Stateva M, Hess M, Technau-Hafsi K, Weibel L, Badea MA, Boente MDC, Theiler M, Fiandrino MJ, Hoeger P, Zimmer A, Rafei-Shamsabadi D, Balabanova M, Fischer J, Boerries M, Has C. Molecular characterization and natural history of linear porokeratosis: A case series. J Am Acad Dermatol 2020; 85:1603-1606. [PMID: 33279647 DOI: 10.1016/j.jaad.2020.11.061] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 11/17/2020] [Accepted: 11/19/2020] [Indexed: 11/26/2022]
Affiliation(s)
- Mina Saleva-Stateva
- Department of Dermatology, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany; Department of Dermatology and Venereology, Alexandrovska University Hospital, Sofia, Bulgaria
| | - Maria Hess
- Institute of Medical Bioinformatics and System Medicine, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany; Comprehensive Cancer Center Freiburg (CCCF), Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Kristin Technau-Hafsi
- Department of Dermatology, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Lisa Weibel
- Pediatric Skin Center, Dermatology Department, University Children's Hospital Zurich, Zürich, Switzerland
| | - Mihai-Alexandru Badea
- Dermatology Department, University of Medicine, Pharmacy, Science and Technology of Targu-Mures, Targu-Mures, Romania
| | | | - Martin Theiler
- Pediatric Skin Center, Dermatology Department, University Children's Hospital Zurich, Zürich, Switzerland
| | | | - Peter Hoeger
- Catholic Children's Hospital, Wilhelmstift, Hamburg, Germany
| | - Andreas Zimmer
- Institute of Human Genetics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - David Rafei-Shamsabadi
- Department of Dermatology, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Maria Balabanova
- Department of Dermatology and Venereology, Alexandrovska University Hospital, Sofia, Bulgaria
| | - Judith Fischer
- Institute of Human Genetics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Melanie Boerries
- Institute of Medical Bioinformatics and System Medicine, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany; Comprehensive Cancer Center Freiburg (CCCF), Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany; German Cancer Consortium (DKTK), Partner Site Freiburg, Freiburg, Germany; German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Cristina Has
- Department of Dermatology, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany.
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Saleva-Stateva M, Technau-Hafsi K, Frommherz L, Grüninger G, Jägle S, Dourmishev L, Miteva L, Fischer J, Has C. Recurrent MVD mutation in European patients with disseminated porokeratosis. Br J Dermatol 2020; 184:347-348. [PMID: 32767669 DOI: 10.1111/bjd.19467] [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: 06/09/2020] [Revised: 08/04/2020] [Accepted: 08/04/2020] [Indexed: 11/30/2022]
Affiliation(s)
- M Saleva-Stateva
- Department of Dermatology, Medical Center, University of Freiburg, Faculty of Medicine, Freiburg, Germany.,Department of Dermatology and Venereology, Alexandrovska University Hospital, Sofia, Bulgaria
| | - K Technau-Hafsi
- Department of Dermatology, Medical Center, University of Freiburg, Faculty of Medicine, Freiburg, Germany
| | - L Frommherz
- Department of Dermatology, Medical Center, University of Freiburg, Faculty of Medicine, Freiburg, Germany
| | - G Grüninger
- Department of Dermatology, Medical Center, University of Freiburg, Faculty of Medicine, Freiburg, Germany
| | - S Jägle
- Department of Human Genetics, Medical Center, University of Freiburg, Faculty of Medicine, Freiburg, Germany
| | - L Dourmishev
- Department of Dermatology and Venereology, Alexandrovska University Hospital, Sofia, Bulgaria
| | - L Miteva
- Department of Dermatology and Venereology, Alexandrovska University Hospital, Sofia, Bulgaria
| | - J Fischer
- Department of Human Genetics, Medical Center, University of Freiburg, Faculty of Medicine, Freiburg, Germany
| | - C Has
- Department of Dermatology, Medical Center, University of Freiburg, Faculty of Medicine, Freiburg, Germany
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17
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Schauer F, Monasterio C, Technau-Hafsi K, Kern JS, Lazaro A, Deibert P, Hasselblatt P, Schwacha H, Heeg S, Brass V, Küllmer A, Schmidt AR, Schmitt-Graeff A, Kreisel W. Esophageal lichen planus: towards diagnosis of an underdiagnosed disease. Scand J Gastroenterol 2019; 54:1189-1198. [PMID: 31608788 DOI: 10.1080/00365521.2019.1674375] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Background: Although lichen planus (LP) is a common skin disorder, the prevalence of esophageal involvement (ELP) and its clinical manifestations are poorly defined. We aimed to establish diagnostic criteria and characterize disease outcomes of ELP.Methods: Clinical, endoscopic, histological, and immunofluorescence data from consecutive patients with known LP between 2013 and 2018 were analyzed. We established endoscopic (denudation and tearing of the mucosa, hyperkeratosis and trachealization) and histological criteria (mucosal detachment, T-lymphocytic infiltrate, intraepithelial apoptosis, dyskeratosis, and fibrinogen deposits along the basement membrane) to grade disease severity. Endoscopic findings were correlated with clinical symptoms. Response to medical therapy was monitored.Results: Fifty-two consecutive patients (median age 59.5 years) were analyzed. According to our grading system, 16 patients were considered as severe and 18 as mild ELP. Dysphagia was the only symptom which differentiated patients with severe (14/16) or mild ELP (8/18) from patients without ELP (1/18). Concomitant oral and genital involvement of LP was associated with the presence of ELP, while oral involvement alone was not. Follow-up of 14/16 patients with severe EPL for at least one year revealed that most of these patients responded to topical corticosteroids (budesonide: n = 9/10 or fluticasone n = 2/2). Three budesonide patients experienced a resolution of symptomatic esophageal stenosis.Conclusions: Esophageal involvement of LP is frequent, but may be asymptomatic. ELP can be diagnosed using the diagnostic criteria proposed here. Dysphagia and combined oral and genital manifestation are associated with ELP. Therapy with topical corticosteroids appears to be a prudent therapeutic approach for ELP.
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Affiliation(s)
- Franziska Schauer
- Department of Dermatology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Carmen Monasterio
- Department of Medicine II, Gastroenterology, Hepatology, Endocrinology and Infectious Diseases, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Kristin Technau-Hafsi
- Department of Dermatology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Johannes Steffen Kern
- Department of Dermatology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Department of Dermatology, Royal Melbourne Hospital, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Australia
| | - Adhara Lazaro
- Department of Medicine, Institute of Exercise and Occupational Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Peter Deibert
- Department of Medicine, Institute of Exercise and Occupational Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Peter Hasselblatt
- Department of Medicine II, Gastroenterology, Hepatology, Endocrinology and Infectious Diseases, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Henning Schwacha
- Department of Medicine II, Gastroenterology, Hepatology, Endocrinology and Infectious Diseases, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Steffen Heeg
- Department of Medicine II, Gastroenterology, Hepatology, Endocrinology and Infectious Diseases, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Volker Brass
- Kliniken des Landkreises Lörrach GmbH, Gastroenterology, Germany
| | - Armin Küllmer
- Department of Medicine II, Gastroenterology, Hepatology, Endocrinology and Infectious Diseases, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Arthur Robert Schmidt
- Department of Medicine II, Gastroenterology, Hepatology, Endocrinology and Infectious Diseases, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Annette Schmitt-Graeff
- Institute of Clinical Pathology, Medical Center - University of Freiburg, Freiburg, Germany
| | - Wolfgang Kreisel
- Department of Medicine II, Gastroenterology, Hepatology, Endocrinology and Infectious Diseases, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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Abstract
Rosacea, a frequent chronic inflammatory disease of the adnexal structures, is associated with an increased number of demodex mites. In patients with immunosuppression, it can present in fulminant progressions like granulomatous rosacea. In this specific subgroup of patients, treatment is not only complicated by aggressive occurrences, but is also limited by possible drug interactions with immunosuppressive drugs. We present a case of a 66-year-old lung transplant recipient, who was successfully treated with oral metronidazole and ivermectin cream.
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Affiliation(s)
- Claudia Ansorge
- Klinik für Dermatologie und Venerologie, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Hauptstr. 7, 79104, Freiburg, Deutschland.
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Ansorge C, Miocic JM, von Bubnoff D, Technau-Hafsi K. Resources spent on dermatological emergency patients: A twelve-month prospective data collection from Germany. J Dtsch Dermatol Ges 2019; 17:1018-1026. [PMID: 31479574 DOI: 10.1111/ddg.13922] [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: 09/06/2018] [Accepted: 03/07/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND OBJECTIVES Rising numbers of patients consulting emergency units are associated with an increased demand for material and personnel. In order to better quantify these resources, we performed an analysis of diagnostic procedures, treatment types, and the quantity and educational level of staff involved in emergency consultations. PATIENTS AND METHODS The study was conducted as a prospective single-center survey over twelve months in the dermatology unit of a Germany university hospital. 3155 consultations were included by consecutive sampling. RESULTS Diagnostic tests (e.g. microbiological swab, blood testing, punch biopsy) were performed in 29 % of all consultations. Physicians prescribed treatment in 70 % of cases, with steroids and antihistamines being the most frequent topical and systemic treatment, respectively. Each patient was seen by at least one physician and a nurse, and in 25 % of cases an additional physician was involved. Less than thirty minutes was required for the consultation in the vast majority of cases. On average, emergency consultations required two hours per day of the treating physician's time, not including the time of other involved staff such as nurses and laboratory technicians. CONCLUSIONS This study demonstrates the extent of resources involved in the treatment of dermatological emergency consultations.
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Affiliation(s)
- Claudia Ansorge
- Department for Dermatology and Venerology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
| | - Johannes M Miocic
- Institute of Earth and Environmental Sciences, University of Freiburg, Germany
| | - Dagmar von Bubnoff
- Department for Dermatology and Venerology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
| | - Kristin Technau-Hafsi
- Department for Dermatology and Venerology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
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20
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Reimer A, Lu S, He Y, Bruckner-Tuderman L, Technau-Hafsi K, Meiss F, Has C, von Bubnoff D. Combined anti-inflammatory and low-dose antiproliferative therapy for squamous cell carcinomas in recessive dystrophic epidermolysis bullosa. J Eur Acad Dermatol Venereol 2019; 34:e1-e3. [PMID: 31374134 DOI: 10.1111/jdv.15835] [Citation(s) in RCA: 4] [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: 06/10/2019] [Revised: 07/10/2019] [Accepted: 07/19/2019] [Indexed: 12/26/2022]
Affiliation(s)
- A Reimer
- Department of Dermatology, Faculty of Medicine, Medical Center - University of Freiburg, Freiburg, Germany
| | - S Lu
- Department of Dermatology, Faculty of Medicine, Medical Center - University of Freiburg, Freiburg, Germany.,Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Y He
- Department of Dermatology, Faculty of Medicine, Medical Center - University of Freiburg, Freiburg, Germany
| | - L Bruckner-Tuderman
- Department of Dermatology, Faculty of Medicine, Medical Center - University of Freiburg, Freiburg, Germany
| | - K Technau-Hafsi
- Department of Dermatology, Faculty of Medicine, Medical Center - University of Freiburg, Freiburg, Germany
| | - F Meiss
- Department of Dermatology, Faculty of Medicine, Medical Center - University of Freiburg, Freiburg, Germany
| | - C Has
- Department of Dermatology, Faculty of Medicine, Medical Center - University of Freiburg, Freiburg, Germany
| | - D von Bubnoff
- Department of Dermatology, Faculty of Medicine, Medical Center - University of Freiburg, Freiburg, Germany
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21
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Has C, Happle R, Fischer J, Grüninger G, Technau-Hafsi K. Postzygotic HRAS mutation in heterochromia of straight scalp hair. Br J Dermatol 2019; 181:1074-1076. [PMID: 31021405 DOI: 10.1111/bjd.18045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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)
- C Has
- Department of Dermatology, Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, Germany
| | - R Happle
- Department of Dermatology, Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, Germany
| | - J Fischer
- Institute for Human Genetics, Medical Center - University of Freiburg, Freiburg, Germany
| | - G Grüninger
- Department of Dermatology, Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, Germany
| | - K Technau-Hafsi
- Department of Dermatology, Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, Germany
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22
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Has C, Küsel J, Happle R, Steinke H, Technau-Hafsi K, Fischer J. Extending the phenotypic spectrum associated with mosaicism for GJB2 mutations. Br J Dermatol 2019; 181:623-624. [PMID: 30816995 DOI: 10.1111/bjd.17838] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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)
- C Has
- Department of Dermatology, Medical Center - University of Freiburg, Faculty of Medicine, Hauptstraße 7, 79104, Freiburg, Germany
| | - J Küsel
- Institute for Human Genetics, Medical Center - University of Freiburg, Faculty of Medicine, Hauptstraße 7, 79104, Freiburg, Germany
| | - R Happle
- Department of Dermatology, Medical Center - University of Freiburg, Faculty of Medicine, Hauptstraße 7, 79104, Freiburg, Germany
| | - H Steinke
- Department of Dermatology, Medical Center - University of Freiburg, Faculty of Medicine, Hauptstraße 7, 79104, Freiburg, Germany
| | - K Technau-Hafsi
- Department of Dermatology, Medical Center - University of Freiburg, Faculty of Medicine, Hauptstraße 7, 79104, Freiburg, Germany
| | - J Fischer
- Institute for Human Genetics, Medical Center - University of Freiburg, Faculty of Medicine, Hauptstraße 7, 79104, Freiburg, Germany
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Schauer F, Kern JS, Virtic O, Technau-Hafsi K, Meiss F, Thoma K, Athanasiou I, Sitaru C, Di Zenzo G, Izumi K, Nishie W, Shimizu H, Bruckner-Tuderman L, Kiritsi D. A new clinical variant of acquired reactive perforating dermatosis-like bullous pemphigoid. Br J Dermatol 2019; 180:231-232. [PMID: 30188568 DOI: 10.1111/bjd.17146] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- F Schauer
- Department of Dermatology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hauptstraße 7, 79104, Freiburg, Germany
| | - J S Kern
- Department of Dermatology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hauptstraße 7, 79104, Freiburg, Germany
- Royal Melbourne Hospital, Parkville and Box Hill Hospital - Monash University Eastern Health Clinical School, Box Hill, Victoria, Australia
| | - O Virtic
- Department of Dermatology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hauptstraße 7, 79104, Freiburg, Germany
| | - K Technau-Hafsi
- Department of Dermatology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hauptstraße 7, 79104, Freiburg, Germany
| | - F Meiss
- Department of Dermatology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hauptstraße 7, 79104, Freiburg, Germany
| | - K Thoma
- Department of Dermatology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hauptstraße 7, 79104, Freiburg, Germany
| | - I Athanasiou
- Department of Dermatology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hauptstraße 7, 79104, Freiburg, Germany
| | - C Sitaru
- Department of Dermatology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hauptstraße 7, 79104, Freiburg, Germany
| | - G Di Zenzo
- Laboratory of Molecular and Cell Biology, Istituto Dermopatico dell'Immacolata (IDI)-IRCCS, FLMM, Rome, Italy
| | - K Izumi
- Department of Dermatology, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - W Nishie
- Department of Dermatology, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - H Shimizu
- Department of Dermatology, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - L Bruckner-Tuderman
- Department of Dermatology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hauptstraße 7, 79104, Freiburg, Germany
| | - D Kiritsi
- Department of Dermatology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hauptstraße 7, 79104, Freiburg, Germany
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Meiss F, Technau-Hafsi K, Kern JS, May AM. Eosinophilic dermatosis of hematologic malignancy: Correlation of molecular characteristics of skin lesions and extracutaneous manifestations of hematologic malignancy. J Cutan Pathol 2018; 46:175-181. [PMID: 30411384 DOI: 10.1111/cup.13389] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [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: 08/23/2018] [Revised: 10/27/2018] [Accepted: 11/05/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND Skin diseases are frequent in patients with chronic lymphocytic leukemia (CLL) and other hematological neoplasias. Eosinophilic dermatosis (ED) of hematologic malignancy has long been considered a nonspecific cutaneous reaction pattern. Recently neoplastic cells have been shown to be present in ED, thus challenging the classification as a nonspecific dermatosis. METHODS We report five patients with ED in association with CLL. We further investigated the presence of neoplastic B-cells in the skin infiltrate by immunohistochemistry and immunoglobulin heavy chain rearrangement and compared these to extracutaneous manifestations of CLL. RESULTS The phenotype of the lymphocytic infiltrate was predominately CD3+ (range: 60%-90%). CD20+ and CD79a+ lymphocytes were less frequent, accounting for up to 15% (range: absent - 15%). CD23+ lymphocytes represented up to 20% (range: absent - 20%) of the infiltrate. The analysis of the immunoglobulin heavy chain rearrangement in the skin specimens showed clonal rearrangements in 4/5 patients and in three of these four patients clones were identical to extracutaneous CLL manifestations. CONCLUSION Our data show that neoplastic B-cells are very frequently found in ED when systematically evaluated. This findings support the hypothesis that leukemic cells play a pathogenetic role in ED of hematologic malignancy.
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Affiliation(s)
- Frank Meiss
- Department of Dermatology and Venereology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Kristin Technau-Hafsi
- Department of Dermatology and Venereology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Johannes S Kern
- Department of Dermatology and Venereology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Departments of Dermatology, Royal Melbourne Hospital, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville and Box Hill Hospital - Monash University, Eastern Health Clinical School, Melbourne, Victoria, Australia
| | - Annette M May
- Institute for Surgical Pathology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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25
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Ansorge C, Miocic JM, von Bubnoff D, Technau-Hafsi K. Patientencharakteristika der dermatologischen Notfallambulanz an einer Universitätsklinik in Deutschland. J Dtsch Dermatol Ges 2018; 16:1451-1458. [PMID: 30537320 DOI: 10.1111/ddg.13689_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: 04/13/2018] [Accepted: 06/11/2018] [Indexed: 12/01/2022]
Affiliation(s)
- Claudia Ansorge
- Klinik für Dermatologie und Venerologie, Universitätsklinikum Freiburg und Medizinische Fakultät, Universität Freiburg, Deutschland
| | - Johannes M Miocic
- Institut für Geo- und Umweltnaturwissenschaften, Universität Freiburg, Deutschland
| | - Dagmar von Bubnoff
- Klinik für Dermatologie und Venerologie, Universitätsklinikum Freiburg und Medizinische Fakultät, Universität Freiburg, Deutschland
| | - Kristin Technau-Hafsi
- Klinik für Dermatologie und Venerologie, Universitätsklinikum Freiburg und Medizinische Fakultät, Universität Freiburg, Deutschland
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26
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Ansorge C, Miocic JM, von Bubnoff D, Technau-Hafsi K. Dermatological conditions presenting to the emergency dermatological unit of a university hospital in Germany. J Dtsch Dermatol Ges 2018; 16:1451-1456. [PMID: 30417531 DOI: 10.1111/ddg.13689] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 06/08/2018] [Accepted: 06/11/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND OBJECTIVES Recently, there have been increasing numbers of patients consulting emergency units in all medical disciplines. Our aim was to analyze the demographics, referral mode, symptoms, localization of lesions, prior treatment, diagnoses and hospitalization rate of dermatological patients. PATIENT AND METHODS The study was conducted as a prospective single center survey over six months in the dermatology unit of a university hospital in Germany. 1552 consultations were included with consecutive sampling. RESULTS The study cohort had a mean age of 41 years and included 53 % females. Nearly half of the patients lived less than 10 kilometers from the study center. 72 % of patients referred themselves. The main symptoms were itching and occurrence of a rash; these symptoms had been present for more than a week on average. A general manifestation was present on the skin in most cases. 55 % of patients were seen by a dermatologist or a general practitioner before the consultation. Prior treatment had been received in 49 % of cases. Eight percent of patients were hospitalized. Eczema was the most common diagnosis, followed by urticaria and scabies. CONCLUSIONS This study confirms that a considerable number of patients present with non-urgent diagnoses. Careful prescreening and sensitization of the population may be necessary to reverse this trend.
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Affiliation(s)
- Claudia Ansorge
- Department of Dermatology and Venerology, Medical Center - University of Freiburg and Medical Faculty, University of Freiburg, Germany
| | - Johannes M Miocic
- Institute of Earth and Environmental Sciences, University of Freiburg, Germany
| | - Dagmar von Bubnoff
- Department of Dermatology and Venerology, Medical Center - University of Freiburg and Medical Faculty, University of Freiburg, Germany
| | - Kristin Technau-Hafsi
- Department of Dermatology and Venerology, Medical Center - University of Freiburg and Medical Faculty, University of Freiburg, Germany
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27
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Seitz-Alghrouz R, Hidalgo JV, Kayser C, Kreutz C, Technau-Hafsi K, Diaz C, von Deimling A, Timmer J, Werner M, Malkovsky M, Fisch P. BRAF V600E Mutations in Nevi and Melanocytic Tumors of Uncertain Malignant Potential. J Invest Dermatol 2018; 138:2489-2491. [DOI: 10.1016/j.jid.2018.04.035] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 04/10/2018] [Accepted: 04/24/2018] [Indexed: 11/17/2022]
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28
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Swoboda S, Technau-Hafsi K, May AM, Wolter M, Kern JS, Meiss F. Rezidivierende ulzeronekrotische Plaques und Knoten mit spontaner Remission. J Dtsch Dermatol Ges 2018; 16:1155-1158. [DOI: 10.1111/ddg.13626_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)
- Sabrina Swoboda
- Klinik für Dermatologie und Venerologie; Universitätsklinikum Freiburg; Medizinische Fakultät; Albert-Ludwigs-Universität; Freiburg Germany
| | - Kristin Technau-Hafsi
- Klinik für Dermatologie und Venerologie; Universitätsklinikum Freiburg; Medizinische Fakultät; Albert-Ludwigs-Universität; Freiburg Germany
| | - Annette M. May
- Institut für klinische Pathologie; Albert-Ludwigs-Universität; Freiburg Germany
| | - Manfred Wolter
- Klinik für Dermatologie; Venerologie und Allergologie; Universitätsklinikum Frankfurt; Frankfurt Germany
| | - Johannes S. Kern
- Klinik für Dermatologie und Venerologie; Universitätsklinikum Freiburg; Medizinische Fakultät; Albert-Ludwigs-Universität; Freiburg Germany
- Departments of Dermatology; Royal Melbourne Hospital; Faculty of Medicine, Dentistry and Health Sciences; The University of Melbourne, Parkville and Box Hill Hospital - Monash University, Eastern Health Clinical School; Box Hill Victoria Australia
| | - Frank Meiss
- Klinik für Dermatologie und Venerologie; Universitätsklinikum Freiburg; Medizinische Fakultät; Albert-Ludwigs-Universität; Freiburg Germany
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29
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Swoboda S, Technau-Hafsi K, May AM, Wolter M, Kern JS, Meiss F. Recurrent ulceronecrotic plaques and nodules with spontaneous remission. J Dtsch Dermatol Ges 2018; 16:1155-1158. [PMID: 30091519 DOI: 10.1111/ddg.13626] [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)
- Sabrina Swoboda
- Department of Dermatology and Venereology, Freiburg University Medical Center, Albert Ludwigs University, Freiburg, Germany
| | - Kristin Technau-Hafsi
- Department of Dermatology and Venereology, Freiburg University Medical Center, Albert Ludwigs University, Freiburg, Germany
| | - Annette M May
- Institute of Clinical Pathology, Albert Ludwig University, Freiburg, Germany
| | - Manfred Wolter
- Department of Dermatology, Venereology, and Allergology, Frankfurt University Medical Center, Frankfurt, Germany
| | - Johannes S Kern
- Department of Dermatology and Venereology, Freiburg University Medical Center, Albert Ludwigs University, Freiburg, Germany.,Departments of Dermatology, Royal Melbourne Hospital, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville and Box Hill Hospital - Monash University, Eastern Health Clinical School, Box Hill, Victoria, Australia
| | - Frank Meiss
- Department of Dermatology and Venereology, Freiburg University Medical Center, Albert Ludwigs University, Freiburg, Germany
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30
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Andrlová H, Mastroianni J, Madl J, Kern JS, Melchinger W, Dierbach H, Wernet F, Follo M, Technau-Hafsi K, Has C, Rao Mittapalli V, Idzko M, Herr R, Brummer T, Ungefroren H, Busch H, Boerries M, Narr A, Ihorst G, Vennin C, Schmitt-Graeff A, Minguet S, Timpson P, Duyster J, Meiss F, Römer W, Zeiser R. Biglycan expression in the melanoma microenvironment promotes invasiveness via increased tissue stiffness inducing integrin-β1 expression. Oncotarget 2018; 8:42901-42916. [PMID: 28476030 PMCID: PMC5522114 DOI: 10.18632/oncotarget.17160] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [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: 10/04/2016] [Accepted: 03/14/2017] [Indexed: 02/04/2023] Open
Abstract
Novel targeted and immunotherapeutic approaches have revolutionized the treatment of metastatic melanoma. A better understanding of the melanoma-microenvironment, in particular the interaction of cells with extracellular matrix molecules, may help to further improve these new therapeutic strategies.We observed that the extracellular matrix molecule biglycan (Bgn) was expressed in certain human melanoma cells and primary fibroblasts when evaluated by microarray-based gene expression analysis. Bgn expression in the melanoma tissues correlated with low overall-survival and low progression-free-survival in patients. To understand the functional role of Bgn we used gene-targeted mice lacking functional Bgn. Here we observed that melanoma growth, metastasis-formation and tumor-related death were reduced in Bgn-/- mice compared to Bgn+/+ mice. In vitro invasion of melanoma cells into organotypic-matrices derived from Bgn-/- fibroblasts was reduced compared to melanoma invasion into Bgn-proficient matrices. Tissue stiffness as determined by atomic-force-microscopy was reduced in Bgn-/- matrices. Isolation of melanoma cells and fibroblasts from the stiffer Bgn+/+ matrices revealed an increase in integrin-β1 expression compared to the Bgn-/- fibroblast matrices. Overexpression of integrin-β1 in B16-melanoma cells abolished the survival benefit seen in Bgn-/- mice. Consistent with the studies performed in mice, the abundance of Bgn-expression in human melanoma samples positively correlated with the expression of integrin-β1, which is in agreement with results from the organotypic invasion-assay and the in vivo mouse studies.This study describes a novel role for Bgn-related tissue stiffness in the melanoma-microenvironment via regulation of integrin-β1 expression by melanoma cells in both mice and humans.
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Affiliation(s)
- Hana Andrlová
- Department of Hematology and Oncology, University Medical Center, Faculty of Medicine, Freiburg, Germany
| | - Justin Mastroianni
- Department of Hematology and Oncology, University Medical Center, Faculty of Medicine, Freiburg, Germany
| | - Josef Madl
- Faculty of Biology, Albert Ludwigs University, Freiburg, Germany.,BIOSS Centre for Biological Signalling Studies, Albert Ludwigs University Freiburg, Freiburg, Germany
| | - Johannes S Kern
- Department of Dermatology and Venereology, University Medical Center, Freiburg, Germany
| | - Wolfgang Melchinger
- Department of Hematology and Oncology, University Medical Center, Faculty of Medicine, Freiburg, Germany
| | - Heide Dierbach
- Department of Hematology and Oncology, University Medical Center, Faculty of Medicine, Freiburg, Germany
| | - Florian Wernet
- Department of Hematology and Oncology, University Medical Center, Faculty of Medicine, Freiburg, Germany
| | - Marie Follo
- Department of Hematology and Oncology, University Medical Center, Faculty of Medicine, Freiburg, Germany
| | - Kristin Technau-Hafsi
- Department of Dermatology and Venereology, University Medical Center, Freiburg, Germany
| | - Cristina Has
- Department of Dermatology and Venereology, University Medical Center, Freiburg, Germany
| | | | - Marco Idzko
- Department of Pneumology, University Medical Center, Freiburg, Germany
| | - Ricarda Herr
- Institut für Molekulare Medizin und Zellforschung, University Medical Center, Freiburg, Germany
| | - Tilman Brummer
- Institut für Molekulare Medizin und Zellforschung, University Medical Center, Freiburg, Germany
| | | | - Hauke Busch
- First Department of Medicine, University of Lübeck, Lübeck, Germany.,German Cancer Consortium (DKTK), Freiburg, Germany.,Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany.,German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Melanie Boerries
- Institut für Molekulare Medizin und Zellforschung, University Medical Center, Freiburg, Germany.,German Cancer Consortium (DKTK), Freiburg, Germany.,German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Andreas Narr
- Department of Immunology, BIOSS Center for Biological Signaling Studies, Faculty of Biology, Albert-Ludwigs-University of Freiburg, Freiburg, Germany.,Center of Chronic Immunodeficiency CCI, University Clinics and Medical Faculty, Freiburg, Germany
| | - Gabriele Ihorst
- Clinical Trials Unit, University Medical Center, Freiburg, Germany
| | - Claire Vennin
- The Garvan Institute of Medical Research and The Kinghorn Cancer Centre, Sydney, Australia
| | - Annette Schmitt-Graeff
- Department of Pathology, University Medical Center, Faculty of Medicine, Freiburg, Germany
| | - Susana Minguet
- Department of Immunology, BIOSS Center for Biological Signaling Studies, Faculty of Biology, Albert-Ludwigs-University of Freiburg, Freiburg, Germany.,Center of Chronic Immunodeficiency CCI, University Clinics and Medical Faculty, Freiburg, Germany
| | - Paul Timpson
- The Garvan Institute of Medical Research and The Kinghorn Cancer Centre, Sydney, Australia
| | - Justus Duyster
- Department of Hematology and Oncology, University Medical Center, Faculty of Medicine, Freiburg, Germany
| | - Frank Meiss
- Department of Dermatology and Venereology, University Medical Center, Freiburg, Germany
| | - Winfried Römer
- Faculty of Biology, Albert Ludwigs University, Freiburg, Germany.,BIOSS Centre for Biological Signalling Studies, Albert Ludwigs University Freiburg, Freiburg, Germany
| | - Robert Zeiser
- Department of Hematology and Oncology, University Medical Center, Faculty of Medicine, Freiburg, Germany.,BIOSS Centre for Biological Signalling Studies, Albert Ludwigs University Freiburg, Freiburg, Germany
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31
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Haiges D, Kurz P, Laaff H, Meiss F, Kutzner H, Technau-Hafsi K. Malignant PEComa. J Cutan Pathol 2017; 45:84-89. [PMID: 29044701 DOI: 10.1111/cup.13061] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 09/08/2017] [Accepted: 10/12/2017] [Indexed: 12/13/2022]
Affiliation(s)
- Daniela Haiges
- Department of Dermatology and Venereology, Medical Center, University of Freiburg, Freiburg im Breisgau, Germany.,Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - Philipp Kurz
- Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany.,Department of Pathology, Medical Center, University of Freiburg, Freiburg im Breisgau, Germany
| | - Helmut Laaff
- Dermatohistologisches Labor Freiburg, Freiburg, Germany
| | - Frank Meiss
- Department of Dermatology and Venereology, Medical Center, University of Freiburg, Freiburg im Breisgau, Germany.,Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - Heinz Kutzner
- Dermatopathologie Friedrichshafen/Bodensee, Friedrichshafen, Germany
| | - Kristin Technau-Hafsi
- Department of Dermatology and Venereology, Medical Center, University of Freiburg, Freiburg im Breisgau, Germany.,Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
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32
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Wessbecher R, Technau-Hafsi K, Meiss F, Schauer F. Papulopustulose des Gesichts und des Capillitiums. J Dtsch Dermatol Ges 2017; 15:755-757. [DOI: 10.1111/ddg.13265_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)
- Robert Wessbecher
- Abteilung für Dermatologie und Allergologie; Knappschafts-Klinik der Knappschaft Bahn See; Reha-Zentrum Borkum
| | - Kristin Technau-Hafsi
- Klinik für Dermatologie und Venerologie, Universitätsklinikum Freiburg, Medizinische Fakultät; Albert-Ludwigs-Universität Freiburg; Deutschland
| | - Frank Meiss
- Klinik für Dermatologie und Venerologie, Universitätsklinikum Freiburg, Medizinische Fakultät; Albert-Ludwigs-Universität Freiburg; Deutschland
| | - Franziska Schauer
- Klinik für Dermatologie und Venerologie, Universitätsklinikum Freiburg, Medizinische Fakultät; Albert-Ludwigs-Universität Freiburg; Deutschland
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33
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Wessbecher R, Technau-Hafsi K, Meiss F, Schauer F. Papulopustular lesions of the face and scalp. J Dtsch Dermatol Ges 2017; 15:755-757. [PMID: 28612972 DOI: 10.1111/ddg.13265] [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)
- Robert Wessbecher
- Department of Dermatology and Allergology, Knappschafts-Klinik der Knappschaft Bahn See, Rehabilitation Center Borkum, Borkum, Germany
| | - Kristin Technau-Hafsi
- Department of Dermatology and Venereology, Medical Center - University of Freiburg, Faculty of Medicine, University Freiburg, Germany
| | - Frank Meiss
- Department of Dermatology and Venereology, Medical Center - University of Freiburg, Faculty of Medicine, University Freiburg, Germany
| | - Franziska Schauer
- Department of Dermatology and Venereology, Medical Center - University of Freiburg, Faculty of Medicine, University Freiburg, Germany
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34
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Affiliation(s)
- Barbara Miernik
- Department of Dermatology and Venerology, University Medical Centre, Hauptstraße 7, D-79104 Freiburg, Germany.
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35
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Möbes M, Pfaff L, Usadel S, Technau-Hafsi K. Verkrustete Papulopusteln, Plaques und Ulzerationen. J Dtsch Dermatol Ges 2017; 15:104-107. [DOI: 10.1111/ddg.13087_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)
- Monica Möbes
- Klinik für Dermatologie und Venerologie; Universitätsklinikum Freiburg im Breisgau
| | | | - Susanne Usadel
- Infektiologikum Freiburg & Abteilung Infektiologie; Universitätsklinikum Freiburg im Breisgau
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36
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Möbes M, Pfaff L, Usadel S, Technau-Hafsi K. Crusted papulopustular lesions, plaques and ulcers. J Dtsch Dermatol Ges 2016; 15:101-104. [PMID: 28036130 DOI: 10.1111/ddg.13087] [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)
- Monica Möbes
- Department of Dermatology, University Medical Center, Freiburg im Breisgau, Germany
| | - Lorenz Pfaff
- Private Dermatology Practice, Waldkirch, Germany
| | - Susanne Usadel
- Infektiologikum Freiburg & Division for Infectious Diseases, University Medical Center, Freiburg im Breisgau, Germany
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Abstract
Palmoplantar keratodermas comprise a diverse group of acquired and hereditary disorders marked by excessive thickening of the epidermis of palms and soles. Early onset and positive family history suggest a genetic cause. While hereditary forms of palmoplantar keratoderma (PPK) may represent the sole or dominant clinical feature, they may also be associated with other ectodermal defects or extracutaneous manifestations. In recent years, much progress has been made in deciphering the genetic basis of PPK, which has led to the emergence of new disorders and syndromes. The elucidation of disease mechanisms has opened new avenues for specific therapies, increasingly sparking interest in this field. Given the high heterogeneity with respect to clinical features, genetic defects, and disease mechanisms, the classification of PPK is based on various criteria. These include extent of disease manifestations, morphology of palmoplantar skin involvement, inheritance patterns, and molecular pathogenesis. Though not always feasible, the clinical distinction of various PPK entities is based on fine-tuned criteria or clues. Remarkably, apparently distinct disorders have been shown to be allelic, as they are caused by mutations in the same gene. By contrast, similar clinical pictures may result from mutations in different genes. Because of this complexity, mutation analysis is required to determine the precise type of PPK. The best-defined entities are described in this review.
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Affiliation(s)
- Cristina Has
- Department of Dermatology, University of Freiburg Medical Center, Freiburg, Germany
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38
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Butzmann CM, Technau-Hafsi K, Bross F. [Silver man" argyria of the skin after ingestion of a colloidal silver solution]. J Dtsch Dermatol Ges 2016; 13:1030-2. [PMID: 26408471 DOI: 10.1111/ddg.80_12502] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Carina M Butzmann
- Klinik für Dermatologie und Venerologie, Universitätsklinikum Freiburg
| | | | - Felix Bross
- Klinik für Dermatologie und Venerologie, Universitätsklinikum Freiburg
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Butzmann CM, Technau-Hafsi K, Bross F. "Silver man" argyria of the skin after ingestion of a colloidal silver solution. J Dtsch Dermatol Ges 2016; 13:1030-2. [PMID: 26408472 DOI: 10.1111/ddg.12502] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Carina M Butzmann
- Department of Dermatology and Venereology, University Hospital Freiburg, Germany
| | | | - Felix Bross
- Department of Dermatology and Venereology, University Hospital Freiburg, Germany
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von Bubnoff D, Rubel F, Kern J, Technau-Hafsi K, Meiss F. Correlation of indoleamine 2,3-dioxygenase expression in primary cutaneous melanoma with Breslow thickness and peritumoral inflammation. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.9580] [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: 11/20/2022] Open
Affiliation(s)
- Dagmar von Bubnoff
- Deparment of Dermatology and Venereology, University of Freiburg, Germany, Freiburg, Germany
| | - Felicia Rubel
- Deparment of Dermatology and Venereology, University of Freiburg, Germany, Freiburg, Germany
| | - Johannes Kern
- 2Royal Melbourne Hospital, Box Hill Hospital and Skin & Cancer Foundation Inc., Victoria, Australia, Victoria, Australia
| | - Kristin Technau-Hafsi
- Deparment of Dermatology and Venereology, University of Freiburg, Germany, Freiburg, Germany
| | - Frank Meiss
- Department of Dermatology and Venereology, University Medical Center, Freiburg, Germany, Freiburg, Germany
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Andrlova H, Mastroianni J, Madl J, Kern JS, Melchinger W, Follo M, Technau-Hafsi K, Mittapali VR, Brummer T, Timpson P, Ungefroren H, Duyster J, Meiss F, Römer W, Zeiser R. Effect of biglycan on melanoma invasiveness via increased tissue stiffness and integrin-β1 expression. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.11526] [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: 11/20/2022] Open
Affiliation(s)
- Hana Andrlova
- Department of Hematology and Oncology, University Medical Center, Freiburg, Germany, Freiburg, Germany
| | - Justin Mastroianni
- Department of Hematology and Oncology, University Medical Center, Freiburg, Germany, Freiburg, Germany
| | - Josef Madl
- BIOSS Centre for Biological Signalling Studies, Albert-Ludwigs-University Freiburg, Freiburg, Germany, Freiburg, Germany
| | - Johannes Steffen Kern
- Department of Dermatology and Venereology, University Medical Center, Freiburg, Germany, Freiburg, Germany
| | - Wolfgang Melchinger
- Department of Hematology and Oncology, University Medical Center, Freiburg, Germany, Freiburg, Germany
| | - Marie Follo
- Department of Hematology and Oncology, University Medical Center, Freiburg, Germany, Freiburg, Germany
| | - Kristin Technau-Hafsi
- Department of Dermatology and Venereology, University Medical Center, Freiburg, Germany, Freiburg, Germany
| | - Venugopal Rao Mittapali
- Department of Dermatology and Venereology, University Medical Center, Freiburg, Germany, Freiburg, Germany
| | - Tilman Brummer
- Institut für Molekulare Medizin und Zellforschung, University Medical Center, Freiburg, Germany
| | - Paul Timpson
- The Kinghorn Cancer Centre, The Garvan Institute of Medical Research, Sydney, Australia
| | - Hendrik Ungefroren
- First Department of Medicine, University of Lübeck, Lübeck, Germany, Lübeck, Germany
| | - Justus Duyster
- Department of Hematology and Oncology, University Medical Center, Freiburg, Germany, Freiburg, Germany
| | - Frank Meiss
- Department of Dermatology and Venereology, University Medical Center, Freiburg, Germany, Freiburg, Germany
| | - Winfried Römer
- BIOSS Centre for Biological Signalling Studies, Albert-Ludwigs-University Freiburg, Freiburg, Germany, Freiburg, Germany
| | - Robert Zeiser
- Department of Hematology and Oncology, University Medical Center, Freiburg, Germany, Freiburg, Germany
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Welte T, Arnold F, Technau-Hafsi K, Neumann-Haefelin E, Wobser R, Zschiedrich S, Walz G, Kramer-Zucker A. Successful Management of Calciphylaxis in a Kidney Transplant Patient: Case Report. Transplant Direct 2016; 2:e70. [PMID: 27500261 PMCID: PMC4946510 DOI: 10.1097/txd.0000000000000582] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2015] [Accepted: 02/09/2016] [Indexed: 12/19/2022] Open
Abstract
UNLABELLED Calciphylaxis is a rare and often fatal condition mostly associated with end-stage renal disease. The pathophysiology remains elusive and treatment options are scarce. We present a rare case of severe calciphylaxis after kidney transplantation in a patient with persistent hyperparathyroidism. CASE DESCRIPTION A 78-year-old man with a history of end-stage renal disease developed edema and ulcerations on both lower limbs 14 months after kidney transplantation while receiving an mammalian target of rapamycin inhibitor to manage polyoma virus-associated nephropathy. Skin biopsies taken from the ulcerations confirmed calciphylaxis. A multimodal treatment regimen combining medical (calcium-free phosphate binders, cinacalcet, paricalcitol, sodium thiosulfate, antibiotic treatment) and surgical treatments (debridement and autologous skin transplantation) ultimately resulted in successful wound healing. DISCUSSION We describe a case of severe calciphylaxis in a nonuremic patient after kidney transplantation. Rapid diagnosis by skin biopsy and an aggressive multimodal therapy regimen followed by long-term oral sodium thiosulfate treatment were crucial factors for a favorable outcome.
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Affiliation(s)
- Thomas Welte
- Renal Division, University Medical Center Freiburg, Freiburg, Germany
| | - Frederic Arnold
- Renal Division, University Medical Center Freiburg, Freiburg, Germany
| | | | | | - Rika Wobser
- Renal Division, University Medical Center Freiburg, Freiburg, Germany
| | | | - Gerd Walz
- Renal Division, University Medical Center Freiburg, Freiburg, Germany
- Center for Biological Signaling Studies (BIOSS), Freiburg, Germany
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Affiliation(s)
- Sabine Müller
- Allergy Research Group, Department of Dermatology, Medical Center - University of Freiburg, Hauptstrasse 7, DE-79104, Freiburg, Germany
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Has C, Technau-Hafsi K. Keratosis palmoplantaris: klinische und genetische Aspekte. J Dtsch Dermatol Ges 2016. [DOI: 10.1111/ddg.150_12930] [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)
- Cristina Has
- Klinik für Dermatologie und Venerologie; Universitätsklinikum Freiburg; Freiburg
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Schwieger-Briel A, Bast T, Technau-Hafsi K, Kern JS. Vegetierende Plaques bei einem Patienten mit Anfallserkrankung. J Dtsch Dermatol Ges 2015. [DOI: 10.1111/ddg.12631_suppl] [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)
- Agnes Schwieger-Briel
- Klinik für Dermatologie und Venerologie, Medizinisches Zentrum - Universität Freiburg, Deutschland
| | - Thomas Bast
- Epilepsiezentrum Kork, Kehl-Kork, Deutschland
| | - Kristin Technau-Hafsi
- Klinik für Dermatologie und Venerologie, Medizinisches Zentrum - Universität Freiburg, Deutschland
| | - Johannes S. Kern
- Klinik für Dermatologie und Venerologie, Medizinisches Zentrum - Universität Freiburg, Deutschland
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Schwieger-Briel A, Bast T, Technau-Hafsi K, Kern JS. Vegetating plaques in a patient with a seizure disorder. J Dtsch Dermatol Ges 2015; 13:585-6. [PMID: 26018379 DOI: 10.1111/ddg.12631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
| | | | | | - Johannes S Kern
- Department of Dermatology, Medical Center - University of Freiburg, Germany
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Miernik B, Schmidt V, Technau-Hafsi K, Kern JS, Meiss F. Alitretinoin in the treatment of palmoplantar mycosis fungoides: a new and promising therapeutic approach. Clin Exp Dermatol 2014; 40:445-7. [DOI: 10.1111/ced.12516] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/02/2014] [Indexed: 11/28/2022]
Affiliation(s)
- B. Miernik
- Department of Dermatology; University Medical Center Freiburg; Hauptstraße 7 D-79104 Freiburg Germany
| | - V. Schmidt
- Tumor Biology Centre Freiburg; Breisacher Straße 117 D-79106 Freiburg Germany
| | - K. Technau-Hafsi
- Department of Dermatology; University Medical Center Freiburg; Hauptstraße 7 D-79104 Freiburg Germany
| | - J. S. Kern
- Department of Dermatology; University Medical Center Freiburg; Hauptstraße 7 D-79104 Freiburg Germany
| | - F. Meiss
- Department of Dermatology; University Medical Center Freiburg; Hauptstraße 7 D-79104 Freiburg Germany
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Schauer F, Poppert S, Technau-Hafsi K, Mockenhaupt M, Muntau B, Häcker G, Tappe D, Jakob T. Travel-acquired subcutaneous Sparganum proliferum infection diagnosed by molecular methods. Br J Dermatol 2014; 170:741-3. [PMID: 24124973 DOI: 10.1111/bjd.12679] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [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)
- F Schauer
- Department of Dermatology, University Medical Center Freiburg, Hauptstrasse 7, D-79104, Freiburg, Germany
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Schauer F, Renkl A, Technau-Hafsi K, Rafei-Shamsabadi D, Behzad M, Eming R, Kern JS. Pruritic intertriginous vesiculopustular eruption. J Dtsch Dermatol Ges 2014; 12:827-30. [DOI: 10.1111/ddg.12329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
| | | | | | | | - Melika Behzad
- Department of Dermatology and Allergology; Philipps University Marburg
| | - Rüdiger Eming
- Department of Dermatology and Allergology; Philipps University Marburg
| | - Johannes S. Kern
- Department of Dermatology; Medical Center - University of Freiburg
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Schauer F, Renkl A, Technau-Hafsi K, Rafei-Shamsabadi D, Behzad M, Eming R, Kern JS. Juckende eingetrübte Bläschen in den Körperfalten. J Dtsch Dermatol Ges 2014. [DOI: 10.1111/ddg.12329_suppl] [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)
- Franziska Schauer
- Klinik für Dermatologie und Venerologie; Universitätsklinikum Freiburg
| | | | | | | | - Melika Behzad
- Klinik für Dermatologie und Allergologie; Philipps Universität Marburg
| | - Rüdiger Eming
- Klinik für Dermatologie und Allergologie; Philipps Universität Marburg
| | - Johannes S. Kern
- Klinik für Dermatologie und Venerologie; Universitätsklinikum Freiburg
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