Publications by authors named "Uwe Wollina"

566 Publications

Updates and new medical treatments for vitiligo (Review).

Exp Ther Med 2021 Aug 25;22(2):797. Epub 2021 May 25.

Department of Dermatology, Faculty of Medicine and University Hospital 'Dr. José Eleuterio González', Universidad Autónoma de Nuevo León, Monterrey, Nuevo León 64460, México.

Vitiligo is a multifactorial disease characterized by the loss of skin pigment, which results in achromic macules and patches. There are currently several medical treatments available, which aim to arrest progression and induce skin repigmentation. These treatments alone or combined have exhibited varying degrees of pigmentation, and the majority are safe and effective. All therapies for vitiligo are limited, and no known treatment can consistently produce repigmentation in all patients. Individualized treatment is appropriate according to the location, clinical presentation and the presence of disease activity. The present review summarizes the medical treatments available for vitiligo: Systemic and topic pharmacological therapies, physical and depigmentation treatments. Several treatments are still underway and have not yet been approved. However, due to the promising preliminary results, these are also mentioned in the present review.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3892/etm.2021.10229DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8170669PMC
August 2021

Cutaneous squamous cell carcinoma of head and neck region: A single center analysis of 1296 tumors with clinical characteristics, comorbidities, treatment, and sun-protection behavior.

Dermatol Ther 2021 May 19:e14992. Epub 2021 May 19.

Department of Dermatology and Allergology, Städtisches Klinikum Dresden, Academic Teaching Hospital, Dresden, Germany.

Cutaneous squamous cell carcinoma (SCC) is the second most common non-melanoma skin cancer among Caucasians. We analyzed our data on tumors been treated between 2006 and 2016 at the Skin Cancer Center of an academic teaching hospital. Thousand hundred and ninety-four patients with 1296 SCC have been identified including 804 males (67.3%) and 390 females (32.7%). The mean age among females was significantly higher with (83.9 ± 7.9) years compared with males ([79.3 ± 8.1] years; P < .001). The most common tumor localizations were outer ears (n = 227, 17.5%), scalp (216, 16.7%), and forehead (215, 16.6%). The majority of tumors was stage I. 31.9% of patients had previous SCC or Bowen's cancer, 29.1% had actinic keratoses. Major non-dermatological comorbidities were cardiovascular diseases and diabetes. SCC were treated by delayed Mohs surgery. First Mohs procedure resulted in R0 status in 83.9%. Most cases with R1 resection were located on nose and eyelids. For a subpopulation of patients (n = 105), a structured questionnaire study evaluated changes in sun protection behavior after skin cancer. After the confirmed diagnosis of a cutaneous SCC concerns about harm to the skin by intense sunlight was reported by 78.4% (76) of participants, with 92.0% among females versus 73.6% among males. Eighty percent of females and 76.8% of males wanted to care more about sun-protection in the future, spend less time 84.0% (females) and 72.5% (males) in the sun, and adapt their leisure activities for a better sun protection in 92.0% (females) and 81.9% (males). Secondary prevention in males needs improvement.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/dth.14992DOI Listing
May 2021

Treatment Update of Port-Wine Stain: A Narrative Review.

J Drugs Dermatol 2021 May;20(5):515-518

Background: Port-wine stain (PWS) is a congenital vascular malformation affecting 0.3–0.5% of normal population. These characteristic lesions arise due to the interplay of vascular, neural, and genetic factors. Treatment options include lasers, cosmetic tattooing, electrotherapy, cryosurgery, derma-abrasion, and skin grafting; however, none of these treatment alternatives appears to be satisfactory and is unable to provide consistent, satisfactory responses or even complete cures. Currently, laser is the treatment of choice, as it is comparatively safe and more effective than other procedures. The most commonly used modality is pulsed dye laser (PDL). The literature research includes peer-reviewed articles (clinical trials or scientific reviews). Studies were identified by searching electronic databases (MEDLINE and PubMed) to January 2020 and reference lists of respective articles. Only articles published in English language were included. J Drugs Dermatol. 20(5): doi:10.36849/JDD.5005.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.36849/JDD.5005DOI Listing
May 2021

[Kerion Celsi due to Microsporum canis infection].

Hautarzt 2021 Apr 21. Epub 2021 Apr 21.

Klinik für Dermatologie und Allergologie, Städtisches Klinikum Dresden, Friedrichstr. 41, 01067, Dresden, Deutschland.

Tinea capitis is seen world-wide among children up to 12 years. The most severe type is Kerion Celsi with painful abscesses and lymphadenopathy. We report on an 11-year-old boy with Kerion Celsi, who was initially treated using antibiotics under the common misdiagnosis of a bacterial infection. Mycological investigations could identify Microsporum canis. The patient was treated orally with griseofulvin, which resulted in complete mycological remission after 8 weeks. Cicatrical alopecia, however, could not be prevented. Purulent infections of the scalp should lead to early mycological diagnostics in children.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00105-021-04817-1DOI Listing
April 2021

Time to Change Theory; Medical Leech from a Molecular Medicine Perspective Leech Salivary Proteins Playing a Potential Role in Medicine.

Adv Pharm Bull 2021 Feb 26;11(2):261-266. Epub 2020 Jul 26.

Department of Dermatology and Allergology, Academic Teaching Hospital Dresden-Friedrichstadt, Dresden, Germany.

Followed by developing modern medicine, leeches did not have extensive use as before; however, in the late 19th century, they were still used in most countries all over the world. Thus far, leeches were utilized in treating various diseases like skin disorders, arthritis, and cancer. In Egypt, using leeches for treatment dates back to early 1500 BC. A medical leech's salivary glands involve over 100 bioactive proteins and the salivary gland secretion contains bacteriostatic, analgesic, and anticoagulation influences; with resolving activity, it causes microcirculation disorders elimination, restoring the hurt vascular permeability of organs and tissues, removing hypoxia, decreasing blood pressure and detoxifying the organism by antioxidant paths. The current work reviews the innovative treatment with medical leech, especially proteins in leech saliva extraction (LSE) with high potential in medicine. The virtue of salivary gland secretions which are proteinaceous enzymes, leech acts on various diseases such as venous congestion in reconstructive and plastic surgery, osteoarthritis, cardiovascular diseases caused by blood coagulation disorders, pain management, priapism, macroglossia, cancer complications, wounds and many other. To confirm the potential therapeutic impacts of leech treatment, more studies are required in more extensive areas with more exact methodologies.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.34172/apb.2021.038DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8046405PMC
February 2021

Plexiform Neurofibroma Without Neurofibromatosis Type 1.

Acta Dermatovenerol Croat 2020 Dec;28(7):245-246

Professor Uwe Wollina, MD, Department of Dermatology and Allergology, Städtisches Klinikum Dresden, Academic Teaching Hospital, Friedrichtstrasse 41, 01067 Dresden, Germany;

Dear Editor, Plexiform neurofibroma (PNF) is a particular subtype of benign nerve sheath tumors with a reticular growth pattern not respecting tissue borders and involving several nerve branches or fascicles. It is most commonly reported in patients with neurofibromatosis type-1 (NF-1) and represents in up to 30% of NF-1 patients (1,2). Other possible associations include schwannomatosis, multiple cutaneous schwannomas syndrome, and rarely neurofibromatosis type-2 (NF-2) (3). PNF develops as a result of tumor proliferation to all parts of the peripheral nervous system. It may cause functional and cosmetic impairment, pain, and a certain risk of malignant transformation in internal organs in some critical cases (4,5). Malignant peripheral nerve sheath tumors occur in about 10% of NF-1 patients (4,5). NF-1 is caused by mutations in the NF-1 tumor-suppressor gene, which encodes a GTPase-Activating Protein (GAP) that negatively regulates p21-RasNF1 (6). These patients have a predisposition to develop both benign and malignant tumors (6). Isolated or NF-1-associated cutaneous or superficial PNF, however, do not transform into their malignant counterpart (1). We report an isolated case of a plexiform PNF in a 16-year-old girl without NF-1. A-16-year-old Caucasian woman presented with a slow-growing exophytic nodule on her right flank. The tumor was asymptomatic, and tumor removal was requested for esthetic reasons. The patient was otherwise healthy. Her family history was negative for hereditary disorders. She was taking no medications at the time. On examination, a 1.8×1.6 cm large, slow-growing, and asymptomatic exophytic asymptomatic tumor was observed on the right flank (Figure 1). The primary suspicion was a complex nevus tumor type such as nevus sebaceous or nevus lipomatosus. The tumor was surgically removed, and the defect was closed by tissue expansion. Histology revealed a spindle-cell proliferation of S-100 positive cells without cellular atypia and myxoid stroma (Figure 2). The diagnosis of PNF was thus established. Healing was uneventful. There were no clinical signs of NF-1 or NF-2. We reported a case of PNF without NF-1 or NF-2. The diagnosis of an isolated PNF is a very rare event (7-10). In a large study from Lima lasting 33 years, only one isolated PNF not associated with NF-1 was observed. In this patient, PNF developed in the oral mucosa (7). An isolated PNF causing an auricular deformity has been previously observed in a 14-year-old boy (8). In India, a 11-year-old girl with an isolated PNF of the tongue was reported (9). Isolated PNFs are not necessarily limited to children and adolescents but may also occur later in life (10). The gold standard of treatment is surgical intervention. In case of unresectable and painful tumors, interferon alfa is a medical option (11). Other drugs are under evaluation, such as oral selumetinib, a selective inhibitor of MAPK kinase 1 and 2, AZD8055, an ATP-competitive "active-site" mTOR inhibitor, or a BromoDomain-containing protein 4-inhibitor (12,13). In conclusion, isolated PNF is a very rare observation. In case of impairment, surgery - whenever possible - is the preferred treatment option (8).
View Article and Find Full Text PDF

Download full-text PDF

Source
December 2020

Novel immunological and genetic factors associated with vitiligo: A review.

Exp Ther Med 2021 Apr 1;21(4):312. Epub 2021 Feb 1.

Dermatology Service, Jose Eleuterio Gonzalez Medicine School and University Hospital, Autonomous University of Nuevo León, Monterrey, Nuevo León 64460, Mexico.

Vitiligo is a skin disorder characterized by depigmentation of the skin due to a lack of melanin. This condition affects men and woman of all ages and its incidence is not restricted by ethnicity or region. Vitiligo is a multifactorial disease, in which melanocytes, which serve important functions in skin pigmentation and immune processes, are impaired. There is sufficient evidence that immunological and genetic factors are primarily responsible for the destruction and dysfunction of melanocytes. Therefore, genetic DNA sequence variants that participate in skin homeostasis, pigmentation and immune response regulation, as well as altered expression patterns, may contribute to the risk of developing vitiligo. The current review presented an overview of the mechanism of pigmentation and of currently known factors involved in depigmentation, as well as the classification, epidemiology, associated comorbidities, risk factors, immunopathogenesis and several genetic and molecular changes associated with vitiligo.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3892/etm.2021.9743DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7885061PMC
April 2021

Chloronychia in Healthcare Workers in COVID-19 Times.

Skin Appendage Disord 2021 Jan 3;7(1):80-81. Epub 2020 Nov 3.

Department of Dermatology and Allergology, Städtisches Klinikum Dresden, Academic Teaching Hospital of the Technical University of Dresden, Dresden, Germany.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1159/000511193DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7705944PMC
January 2021

Koebner Phenomenon Induced by Face Mask Ear Loops.

Maedica (Bucur) 2020 Dec;15(4):561-562

Academic Teaching Hospital Dresden-Friedrichstadt, Dermatology, Venereology and Allergology, Dresden, 01076, Germany.

We present a case of Koebner phenomenon induced by friction due to tightness of ear loops attached to the face mask used as protective measure against spreading COVID-19 infection.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.26574/maedica.2020.15.4.561DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7879359PMC
December 2020

Congenital melanocytic naevi: An up-to-date overview.

Australas J Dermatol 2021 May 16;62(2):e178-e191. Epub 2021 Feb 16.

Department of Dermatology, Robert Wood Johnson Medical Centre, Rutgers University, New Brunswick, New Jersey, USA.

Congenital melanocytic naevi are hamartomas of the neuroectoderm caused by genetic mosaicism. Congenital melanocytic naevi are seen in 1-6% of all live births and commonly classified based on the projected size in adults. Congenital melanocytic naevi appear in different colours, shapes, and sizes, and occasionally present with complications. In this review, we sought to evaluate congenital melanocytic naevi, their clinical, dermatoscopic, and reflectance confocal microscopic features, behavioural pattern over time, new trends in classification, underlying genetic factors and their influence on clinical manifestations and management, associated risks, complications, magnetic resonance imaging findings and their management in the light of recent literature.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/ajd.13535DOI Listing
May 2021

Simvastatin in vitiligo: an update with recent review of the literature.

Int J Dermatol 2021 Feb 7. Epub 2021 Feb 7.

Department of Dermatology, University Medical Center Mainz, Mainz, Germany.

Patients with vitiligo often seek medical attention, as it diminishes their quality of life resulting in significant morbidity. Several topical and systemic therapies are in vogue targeting the immunological aspect of this disease, but results are often unsatisfactory, and complete cure remains elusive. Recently, simvastatin, a 3-hydroxy-3-methylyglutaryl-coenzyme A (HMG-CoA) reductase inhibitor, is being evaluated for vitiligo management because of its multimodal action, easy availability, and low cost. The proposed multimodal actions range from anti-inflammatory, antioxidant, to immunomodulatory properties which may be of therapeutic benefit in vitiligo patients. The authors intend to evaluate the role of simvastatin as a novel therapeutic agent for vitiligo along with relevant review of literature.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/ijd.15330DOI Listing
February 2021

Defect closure after successful skin cancer surgery of the nose: a report of 52 cases.

Acta Dermatovenerol Alp Pannonica Adriat 2020 Dec;29(4):209-214

Department of Dermatology and Allergology, Skin Cancer Center, Dresden Municipal Clinic, Dresden, Germany.

Introduction: Malignant keratinocyte tumors-that is, basal cell carcinoma (BCC) and squamous cell carcinoma (SCC)-are commonly found on sun-exposed body areas such as the nose. The primary aim of tumor surgery is complete excision. Due to anatomical, functional, and aesthetic issues, reconstruction of such defects remains a challenge.

Patients And Methods: We report on a series of 52 patients that were treated from 2015 to 2019 at the Goldman Clinic in Porto Alegre, Brazil. The mean age was 63 years (range 28-82 years, standard deviation 14.25 years). Thirty-nine (75%) patients were male and 13 (25%) female. The histological diagnosis was BCC in 49 patients and SCC in three.

Results: Nasal defect closures were located on the nasal dorsum, tip, alar nose, and nasion. The nasal dorsal and alar region were the regions most commonly involved. All tumor specimens were 3D histologically investigated. A nasolabial flap was the reconstructive option in 40 subjects (76.9%). A bilobed flap was used in six patients (11.5%). Other flaps used for defect closure were a Rintala flap (n = 2), tunneled island flap (n = 1), and frontal flap (n = 1). Adverse events were rare and manageable. Three relapses were noted during follow-up.

Conclusions: Nasal reconstruction requires an armamentarium of surgical techniques to tailor the procedures based on tumor localization, size, and depth, and patients' needs.
View Article and Find Full Text PDF

Download full-text PDF

Source
December 2020

Drug reactions affecting hair and nails.

Clin Dermatol 2020 Nov - Dec;38(6):693-701. Epub 2020 Jun 26.

Department of Dermatology, Andrology and SITs, Ain Shams University Medical College, Cairo, Egypt.

Drug-induced changes of hair and nails have been observed with a variety of different pharmaceutical agents, both topical and systemic. These compounds or their metabolites may interfere with hair cycling and texture, nail matrix, nail bed, nail folds, and microvasculature. Phototoxic reactions may also occur. Before initiating treatment, physicians and patients should be aware of possible adverse events to hair and nails and should be aware of the preventive measures, if available, as quality of life can be reduced, and adherence and compliance to treatment may be impaired.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.clindermatol.2020.06.009DOI Listing
January 2021

Flare-up of Rosacea due to Face Mask in Healthcare Workers During COVID-19.

Maedica (Bucur) 2020 Sep;15(3):416-417

Department of Epidemiology, "Grigore T. Popa" University of Medicine and Pharmacy Iasi, Romania.

COVID-19 (SARS-COV-2) pandemic is associated with aggravation of facial dermatoses caused by professional prophylactic measures, mostly face masks, especially reported in healthcare workers, such as irritant and contact dermatitis, seborrheic dermatitis, rosacea, acne. We present a case of flare-up of rosacea in a nurse working in an Intensive Care Unit for COVID-19 patients, using FFP1 type mask at work and textile or paper mask outside the hospital.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.26574/maedica.2020.15.3.416DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7726500PMC
September 2020

Occlusive treatment enhances efficacy of tacrolimus 0.1% in a pediatric patient with severe alopecia areata: Case report and literature review.

Pediatr Dermatol 2021 Jan 27;38(1):339-340. Epub 2020 Nov 27.

Department of Dermatology and Allergology, Academic Teaching, Hospital Dresden-Friedrichstrasse in Dresden, Dresden, Germany.

Tacrolimus is an immunomodulatory drug, available for topical and systemic treatment of several dermopathies that are characterized by immune dysregulation. In the case of alopecia areata, standard application has proven insufficient to yield satisfactory results. Herein, we present a 6-year-old patient with Down syndrome who was treated with topical tacrolimus 0.1% ointment under occlusion overnight with remarkable clinical improvement within 4 months.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/pde.14474DOI Listing
January 2021

Patterns of care and follow-up care of patients with uveal melanoma in German-speaking countries: a multinational survey of the German Dermatologic Cooperative Oncology Group (DeCOG).

J Cancer Res Clin Oncol 2021 Jun 21;147(6):1763-1771. Epub 2020 Nov 21.

Department of Dermatology and Venerology, University of Cologne, Cologne, Germany.

Purpose: Uveal melanoma (UM) is an orphan cancer of high unmet medical need. Current patterns of care and surveillance remain unclear as they are situated in an interdisciplinary setting.

Methods: A questionnaire addressing the patterns of care and surveillance in the management of patients with uveal melanoma was distributed to 70 skin cancer centers in Austria, Germany and Switzerland. Frequency distributions of responses for each item of the questionnaire were calculated.

Results: 44 of 70 (62.9%) skin cancer centers completed the questionnaire. Thirty-nine hospitals were located in Germany (88.6%), three in Switzerland (6.8%) and two in Austria (4.5%). The majority (68.2%) represented university hospitals. Most patients with metastatic disease were treated in certified skin cancer centers (70.7%, 29/41). Besides, the majority of patients with UM were referred to the respective skin cancer center by ophthalmologists (87.2%, 34/39). Treatment and organization of follow-up of patients varied across the different centers. 35.1% (14/37) of the centers stated to not perform any screening measures.

Conclusion: Treatment patterns of patients with uveal melanoma in Germany, Austria and Switzerland remain extremely heterogeneous. A guideline for the treatment and surveillance is urgently needed.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00432-020-03450-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8076157PMC
June 2021

Introduction of a novel quantitative scoring system for acanthosis nigricans and its validation in a pilot study.

Dermatol Ther 2020 11 7;33(6):e14450. Epub 2020 Nov 7.

Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany.

Inconsistent data exist regarding the diagnostic value of acanthosis nigricans (AN) or skin tags as clinical markers for obesity or diabetes. In an outpatient department-based prospective study, we designed a scoring for AN severity (SCANS) to evaluate AN and skin tags, their correlation with obesity or diabetes. Quantification of AN in six anatomic sites, in consideration of the affected skin surface areas, texture changes, number of skin tags, leads to a total severity score between 0 and 46. Among 336 adult patients (aged ≥18 years) with AN, a higher BMI was associated with AN (r = 0.299, P < .001), but not with diabetes (P = .43), as compared with 243 age- and sex-matched controls without AN. Among nondiabetics, AN scores were significantly correlated with waist circumference (r = 0.131, P = .024) and total cholesterol levels (r = 0.155, P = .04). Skin tags alone in the absence of AN were not associated with obesity (P = .333) or diabetes (P = .164). The total AN scores were positively correlated with the presence of skin tags (r = 0.132, P < .001), and the involvement of anterior neck (r = 0.668, P < .001) and axilla (r = 0.793, P < .001). Knuckles and groins were unaffected in our series. Our results indicate that combination of AN with skin tags can be used as clinical marker for obesity, but not for diabetes. Large-scale studies on patients of different ethnic background are required to further validate our proposed scoring.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/dth.14450DOI Listing
November 2020

Complication of Soft Tissue Fillers: Prevention and Management Review.

J Drugs Dermatol 2020 Sep;19(9):829-832

The use of dermal fillers has increased manifold over the past decade, which has been attributed to the ever-increasing need of the population for being young. Fillers have become quite popular both among patients and treating physicians due to their quick and quite predictable results. Filler injection is a safe procedure in the hands of an experienced provider using appropriate technique. Nevertheless, various adverse effects to fillers have been reported that range from mild injection site complications, such as pain and bruising, to severe complications, like tissue necrosis, retinal artery occlusion, and infections. The esthetic provider should be aware of and be able to quickly recognize such complications, and be confident in managing them. In this article we highlight the various adverse effects noted with the use of fillers and discuss prevention and management. J Drugs Dermatol. 2020;19(9):829-832. doi:10.36849/JDD.2020.5084.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.36849/JDD.2020.10.36849/JDD.2020.5084DOI Listing
September 2020

Comparison of the tissue expressions of glutathione S transferase isoenzymes among patients with morphea and healthy controls: A preliminary study.

Dermatol Ther 2020 11 8;33(6):e14363. Epub 2020 Oct 8.

Department of Dermatology and Allergology, Städtisches Klinikum Dresden, Academic Teaching Hospital of the Technical University, Dresden, Germany.

Morphea is an inflammatory connective tissue disorder, which is characterized by sclerosis in skin and subcutaneous tissues with a chronic progress. The oxidative stress in pathogenesis of sclerosing diseases was proposed in several studies with conflicting results. To explore the tissue expressions of Glutathione S transferase (GST) isoenzymes in patients with morphea and compare these expressions with healthy controls. Twenty-two morphea patients and 20 sex and age matched healthy controls were enrolled in this study. Four millimeter punch biopsies were performed from the active sclerotic plaques of morphea patients. Tissue samples of control group were obtained from nonlesional normal skin biopsy specimens. The protein expressions of GST isoenzymes were analyzed immunohistochemically. Tissue expressions of GSTP1, GSTT1, and GSTA1 isoenzymes in morphea patients were found to be significantly higher than in control tissues. There was no significant difference in GSTM1 isoenzyme expression between the two groups. The increased tissue expressions of GSTA1, GSTP1, and GSTT1 isoenzymes in morphea may represent the activated GST enzymes in response to excessive free radical formation and may also support the hypothesis of increased oxidative stress in morphea etiopathogenesis.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/dth.14363DOI Listing
November 2020

Cause and management of lipedema-associated pain.

Dermatol Ther 2021 01 12;34(1):e14364. Epub 2020 Oct 12.

Department of Dermatology and Allergology, Städtisches Klinikum Dresden, Academic Teaching Hospital of the Technical University, Dresden, Germany.

Lipedema is a painful, underdiagnosed adipose tissue disorder, characterized by symmetrical swelling of the extremities due to subcutaneous fat deposition in the buttocks, thighs, legs, and arms, sparing the most distal part of the extremities. Although etiology and pathogenesis of lipedema is unclear, possible role of hormonal and genetic factors have been proposed previously. Patients with lipedema suffer from pain, easy bruising, tenderness, and disfigurement. Pain is the leading symptom in lipedema. Since the pain is associated with depression and impaired quality of life, reduction of pain is the major therapeutic approach. Pain in lipedema is attributed to allodynia, exaggerated sympathetic signaling, and estrogens. Although the mechanism of pain in lipedema is uncertain, effective treatment of lipedema should provide a satisfactory pain reduction. Efficacy of the conservative treatment is a matter of debate. Microcannular tumescent liposuction is the most effective therapeutic option for lipedema. There is a large body of evidence that this procedure significantly reduces pain in patients with lipedema.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/dth.14364DOI Listing
January 2021

Retronychia-an uncommon cause of chronic proximal nail fold inflammation.

Authors:
Uwe Wollina

Wien Med Wochenschr 2021 Mar 21;171(3-4):53-56. Epub 2020 Sep 21.

Department of Dermatology and Allergology, Academic Teaching Hospital Dresden, Friedrichstraße 41, 01069, Dresden, Germany.

Retronychia is defined as nail plate ingrowth into the proximal nail fold causing pain and perionyxis. We report on a case series of seven patients seen from 2001 to 2020 (mean age 20 years). Xanthonychia was observed in all nails. Total nail avulsion was performed in eight nails. Complete remission was obtained in 100%. During follow-up for up to 24 months, no relapse occurred.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s10354-020-00781-yDOI Listing
March 2021

Facial vascular danger zones for filler injections.

Dermatol Ther 2020 11 18;33(6):e14285. Epub 2020 Sep 18.

Department of Plastic Surgery, Hospital São Lucas da PUCS, Porto Alegre, Brazil.

Filler injections are widely used for facial rejuvenation. The technique is safe as long as some precautions are respected. In this review we will focus on vascular anatomy in the upper, middle and lower face. We performed a PUBMED research on "facial danger zones" and "filler injections" and "hyaluronic acid" and "vascular compromise" with a focus on the last decade. This is of particular importance since vascular compromise is one of the most severe adverse events possibly leading to tissue necrosis and in rare cases to loss of vision. We describe the danger zones in these esthetic units and provide recommendations how to avoid severe adverse events. We report on temporal region, glabella and nose, infraorbital region, nasolabial folds and nasal triangle, lips, and chin. Although we focus on hyaluronic acid fillers, our recommendations will also scope other filler types and autologous adipose tissue transfer. We also take a closer look on innovations to improve the safety of facial filler injections. Facial rejuvenation with hyaluronic acid fillers is a popular method. It is safe if the facial danger zones are recognized and proper injection techniques and fillers are used.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/dth.14285DOI Listing
November 2020

Lip enhancement and mouth corner lift with fillers and botulinum toxin A.

Dermatol Ther 2020 11 7;33(6):e14231. Epub 2020 Sep 7.

Department of Plastic Surgery at Hospital São Lucas da PUCS, Porto Alegre, Brazil.

Beautiful lips are responsible for facial attractiveness and a youthful appearance. During aging process, lips become thinner and the red lips borders get poor defined. Downturn of the corners of the mouth suggests negative emotions. Lip surgery and underlying pathology may result in asymmetries and lip incontinence. Minor invasive procedures with hyaluronic acid fillers and botulinum toxin A are versatile tools to improve appearance of the lips, restore function and improve psycho-social well-being. In this review, we discuss anatomy, safety concerns, injections techniques as well as esthetic and medical indications.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/dth.14231DOI Listing
November 2020

A curious observation of passive transfer of steroid antifungal combination creams to the scrotum in patients of tinea cruris-Is this forme fruste of red scrotum syndrome?

Dermatol Ther 2020 11 7;33(6):e14212. Epub 2020 Sep 7.

Department of Dermatology, KPC Medical college and Hospital, Kolkata, West Bengal, India.

We report 16 patients of tinea cruris who presented with an asymptomatic red scrotum due to fixed dose combination creams containing antifungal agents and topical steroids applied to the thighs as a treatment of tinea cruris. The erythema resolved upon starting appropriate treatment with single molecule antifungal creams and oral antifungal drugs in about six weeks' time in majority of cases. We propose that this clinical presentation may be akin to red scrotum syndrome (RSS). Due to its asymptomatic nature in most of the cases, we propose that this could be a forme fruste of RSS.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/dth.14212DOI Listing
November 2020

Basic teledermatology solving two cases of crusted scabies.

Dermatol Ther 2020 11 9;33(6):e14214. Epub 2020 Sep 9.

Sexually Transmitted Diseases Unit, Ambulatório de Dermatologia Sanitária, State Health Secretariat, Rio Grande, Brazil.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/dth.14214DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7461387PMC
November 2020

Long lasting facial rejuvenation by repeated placement of calcium hydroxylapatite in elderly women.

Dermatol Ther 2020 11 8;33(6):e14183. Epub 2020 Sep 8.

Department of Plastic Surgery, Clinica Goldman, Porto Alegre, Rio Grande do Sul, Brazil.

Calcium hydroxylapatite (CaHA) is a biostimulatory filler with long lasting efficacy after a single injection. Data con the effect of repeated injections, however, are sparse. This is a single-center observational study. Forty Caucasian females of Fitzpatrick skin type I to III, aged between 50 and 95 years (mean age 63 ± 13.4 years), and seeking nonsurgical improvement of facial aging were included. Patients with previous face lifts, threads or other surgical treatments were excluded. Only women ≥50 years of age were included. Midface and lower face were treated, that is, cheeks, tear troughs, jawline, and Marionette lines. The usual time for a repetition of filler injection was 12 to 14 months. Mean follow-up was 36 ± 10.8 months after first injection of Radiesse. Outcome was measured using the Global Aesthetic Improvement Scale (GAIS). Mean patient's GAIS was 2.7 ± 0.7, while physicians GAIS was 2.6 ± 0.6 suggesting a remarkable improvement 12 months after the first procedure. Mean patient's GAIS at 3 and 5 years after first procedure was 2.4 ± 0.8, while physicians GAIS was 2.5 ± 0.7. Repeated injection of CaHA leads to a significant and long-lasting improvement of facial appearance.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/dth.14183DOI Listing
November 2020

Atypical vascular proliferations of the neck.

Wien Med Wochenschr 2021 Mar 5;171(3-4):57-60. Epub 2020 Aug 5.

Department of Dermatology, Istanbul Medeniyet University, School of Medicine, Istanbul, Turkey.

Atypical vascular proliferations (AVP) are a late complication after radiotherapy. Most cases have been reported in female breast cancer patients on the chest wall. These lesions are mostly of the lymphatic type. Herein, we report a blood vascular-type AVP in a male on the neck 60 years after radiotherapy for a benign hemangioma, which makes this case exceptional. We removed the whole chronic radiodermatitis surgically. Histopathology excluded vascular malignancies but confirmed AVP. We discuss the differential diagnoses and treatment.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s10354-020-00774-xDOI Listing
March 2021

Acne keloidalis nuchae with acanthosis nigricans of the neck: The pivotal role of the dermatologist in the early diagnosis of insulin resistance'.

Dermatol Ther 2020 11 19;33(6):e14102. Epub 2020 Aug 19.

Department of Dermatology and Allergology, Städtisches Klinikum Dresden, Dresden, Germany.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/dth.14102DOI Listing
November 2020

Multiple vellus hair cysts of perianal skin.

Dermatol Ther 2020 11 7;33(6):e14047. Epub 2020 Sep 7.

Institute of Pathology "Georg Schmorl", Städtisches Klinikum Dresden, Academic Teaching Hospital of the Technical University of Dresden, Dresden, Germany.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/dth.14047DOI Listing
November 2020

Angiotensin II receptors: Impact for COVID-19 severity.

Dermatol Ther 2020 11 27;33(6):e13989. Epub 2020 Jul 27.

Department of Dermatology and Allergology, Städtisches Klinikum Dresden, Academic Teaching Hospital of the Technical University, Dresden, Germany.

COVID-19 is an outbreak of viral pneumonia which became a global health crisis, and the risk of morbidity and mortality of people with obesity are higher. SARS-CoV-2, the pathogen of COVID-19, enters into cells through binding to the Angiotensin Converting Enzyme (ACE) homolog-2 (ACE2). ACE2 is a regulator of two contrary pathways in renin angiotensin system (RAS): ACE-Ang-II-AT1R axis and ACE2-Ang 1-7-Mas axis. Viral entry process eventuates in downregulation of ACE2 and subsequent activation of ACE-Ang-II-AT1R axis. ACE-Ang II-AT1R axis increases lipid storage, reduces white-to-beige fat conversion and plays role in obesity. Conversely, adipose tissue is an important source of angiotensin, and obesity results in increased systemic RAS. ACE-Ang-II-AT1R axis, which has proinflammatory, profibrotic, prothrombotic, and vasoconstrictive effects, is potential mechanism of more severe SARS-CoV-2 infection. The link between obesity and severe COVID-19 may be attributed to ACE2 consumption and subsequent ACE-Ang-II-AT1R axis activation. Therefore, patients with SARS-CoV-2 infection may benefit from therapeutic strategies that activate ACE2-Ang 1-7-Mas axis, such as Ang II receptor blockers (ARBs), ACE inhibitors (ACEIs), Mas receptor agonists and ACE2.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/dth.13989DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7361069PMC
November 2020