[Drug-induced lupus erythematosus tumidus during treatment with adalimumab]. / Medikamenteninduzierter Lupus erythematodes tumidus unter Adalimumab-Therapie.

Patients treated with TNF-alpha inhibitors frequently have serum autoantibodies, but only a few develop clinically apparent lupus erythematosus. The TNF-alpha inhibitor adalimumab is a fully humanized antibody and seems to induce autoantibodies less frequently than other drugs of this group. We report on a patient with rheumatoid arthritis, who developed anti-histone antibodies and lupus tumidus after eight months on adalimumab therapy.

[Brownish plaques on both sides of the nose]. / Bräunliche Plaques an beiden Nasenseiten.

Granuloma fissuratum (Gf) is painful granular tissue caused by constant pressure exerted by glasses. The differential diagnosis includes further granulomatous dermatoses such as cutaneous sarcoidosis, mycobacterioses and autoimmune diseases. It is also important to rule out a basal cell carcinoma. The simplest and most effective treatment of Gf is to correct the glasses frame or, even better, to avoid wearing glasses to correct eyesight. Topical antiseptic/antibiotic treatment is recommended for superinfected lesions. The Gf usually heals within 1-6 months after correction of the glasses. If the lesion does not heal on its own, complete excision is recommended.

[Vaginal atresia as a rare cause of a cyst in the fetal lower abdomen. Pre- and postnatal diagnosis/therapy]. / Vaginalatresie als seltene Ursache eines fetalen zystischen Unterbauchtumors. Prä- und postnatale Diagnostik/Therapie.

This is a report on the course of a cystic mass in the lower abdomen of a female fetus, which could bei seen by prenatal ultrasound. We are describing differential diagnosis, pre- and postnatal therapy and the origin, as well as the risks of vaginal atresia.

[Doppler ultrasound study of a twin pregnancy with feto-fetal transfusion syndrome]. / Dopplersonographische Untersuchung einer Geminischwangerschaft mit feto-fetalem Transfusionssyndrom.

A report is made on a typical case of twin-twin transfusion syndrome of monozygotic twins with severe polyhydramnios. By treatment with decompression amniocentesis, we achieved prolongation of the pregnancy by 10 weeks. Daily performed Doppler velocimetry showed, that the resistance values did not differ before and after amniocentesis. We found the greatest differences between the pulsatility indices of the umbilical cords and the aortae. The arteriovenous anastomosis was visualized by colour flow mapping.

[Mucocele of the appendix as a rare differential diagnosis of adnexa tumor]. / Mukozele der Appendix als seltene Differentialdiagnose eines Adnextumors.

It will be reported of a 68 year old woman, who underwent a laparotomy because of a tumor of the right ovary, which was ultrasonographically suspicious of being malign. During the operation, it was diagnosed as a mucocele of the appendix. It will be discussed, whether ultrasound is able to differentiate tumors of the lower right abdomen. Mechanisms of development and clinical signs of the mucocele of the appendix will also be described.

[Changes in cervix cytology in women with liver transplants treated with immunosuppressive therapy]. / Veränderungen der Zervixzytologie bei lebertransplantierten Frauen unter immunsuppressiver Therapie.

During the time 1989 to 1992 we collected PAP smears of 58 women before and several times after a liver transplantation. Five of the patients (= 8.6%) showed a suspicious PAP smear, although pre-transplantation they had a normal cervical cytology. Histological one woman even had a higher grade dysplasia. 30 women received FK 506 after the liver transplantation, 28 patients Cyclosporin A as long-term medication. Likewise kidney and liver transplanted women have a higher risk to be affected by a cervical neoplasia. A acceleration of malignant growth seems to be likely. The influence on the cervical cells of both immunosuppressive drugs Cyclosporin A (Sandimmun) and FK 506 seem to be similar. It should be recommended to perform a close-meshed cervical cytology control when following -up the female liver transplant recipients.