Der Hautarzt; Zeitschrift für Dermatologie, Venerologie, und verwandte Gebiete
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Case Reports
[Low dosage cyclosporin A therapy in pyoderma gangrenosum. Experiences with 6 patients].
Pyoderma gangraenosum can cause great therapeutic problems. High dosed corticosteroids are the treatment of choice. However, recalcitrant pyoderma gangraenosum or side effects from corticosteroid treatment may require therapeutic alternatives. ⋯ Only one patient suffered a relapse after discontinuation of the treatment. No severe irreversible side effects occurred. The results show that low-dose cyclosporine A treatment can be considered a first-line treatment of pyoderma gangraenosum.
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Case Reports
[Distal edema and hyperhidrosis of the arm. Symptoms of reflex sympathetic dystrophy (Sudeck's disease)].
Reflex sympathetic dystrophy is characterized clinically by the triad of autonomic sympathetic dysfunction, and motor and sensory disturbances of the affected extremity. Typical symptoms are distal generalized edema with cyanotic skin, pathologic function of eccrine sweat glands and diffuse dull pain. ⋯ Pathophysiologically, a functional disturbance of sympathetic nerve fibres may result in a vicious circle of blood flow dysfunction, excitation of afferent nociceptors and maintenance of sympathetic dysfunction at the level of the spinal or central nervous system. In the patient presented in this paper, sympathetic dysregulation of reflex sympathetic dystrophy was cured by means of blockades of the stellate ganglion.
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Review Case Reports
[Pyoderma gangrenosum vegetans. An overview of chronic pyoderma vegetans and pyoderma gangrenosum].
A case simulating extraordinarily extensive chronic vegetating pyoderma revealed itself in its course to be pyoderma gangrenosum. The bacterial flora varied due to a secondary colonization; there was no response to antibiotics but there was to corticosteroid, azathioprine and clofazimine therapy. ⋯ Reviewing the literature available since the turn of this century, chronic vegetating pyoderma is compared with the latter from the viewpoint of clinical features, histopathology, immunology, course and treatment. There are so many convincing parallels between the two conditions that we would like to propose that we stop regarding them as distinct entities and instead view them as parts of a spectrum of the same immunopathological process.
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Xeroderma pigmentosum comprises a heterogeneous group of autosomal recessive hereditary diseases, which are characterized by a number of clinical characteristics and an abnormal DNA repair mechanism. Patients affected show a high frequency of mucocutaneous malignant tumors, especially squamous cell carcinomas and basal cell carcinomas. We report on a 65-year-old patient who successively developed a total of 15 malignant melanomas, 1 squamous cell carcinoma and 1 lymph node metastasis of a malignant melanoma. The clinical diagnosis of xeroderma pigmentosum was confirmed by the complementation analysis, which defined our patient as xeroderma pigmentosum of the complementation group D.
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Bilateral linear frontoparietal scleroderma en coup de sabre is an extremely rare form of localized linear scleroderma. In this paper the case of a 35-year-old woman with bilateral linear temporoparietal scleroderma en coup de sabre is presented. The manifestations that can be associated with linear scleroderma and the serologic abnormalities it involves are briefly discussed.