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1.
Hautarzt ; 69(7): 586-590, 2018 Jul.
Artículo en Alemán | MEDLINE | ID: mdl-29299628

RESUMEN

We report the case of a 59-year-old woman who simultaneously suffered from psoriasis and vitiligo. The depigmented areas were predominantly but not exclusively limited to current or former psoriatic plaques. These two diseases share many common features, e. g., both are T­cell-mediated autoimmune diseases in which the Koebner phenomenon occurs. However, it is still not known whether the coincidence is random or significant. Prospective clinical and epidemiological research will hopefully reveal the association soon.


Asunto(s)
Enfermedades Autoinmunes , Psoriasis , Vitíligo , Femenino , Humanos , Persona de Mediana Edad , Estudios Prospectivos , Psoriasis/complicaciones , Psoriasis/diagnóstico , Linfocitos T , Vitíligo/complicaciones , Vitíligo/diagnóstico
2.
Hautarzt ; 68(1): 64-66, 2017 Jan.
Artículo en Alemán | MEDLINE | ID: mdl-27385108

RESUMEN

Pigmentary nail changes may have a variety of causes, e. g., chronic inflammation, and occur more often in patients of African descent compared to Caucasians. Subungual malignant melanoma is the most important differential diagnosis and must be ruled out in any case. Dermatoscopy might be helpful. If no biopsy is taken, clinical follow-ups are necessary at short intervals. In case of chronic paronychia, optimization of occupational skin protection measures may contribute to the healing process.


Asunto(s)
Enfermedades de la Uña/diagnóstico , Enfermedades de la Uña/terapia , Trastornos de la Pigmentación/diagnóstico , Trastornos de la Pigmentación/terapia , Adulto , Dermoscopía/métodos , Diagnóstico Diferencial , Femenino , Humanos , Enfermedades de la Uña/etnología , Trastornos de la Pigmentación/etnología
4.
Dtsch Med Wochenschr ; 139(43): 2184-7, 2014 Oct.
Artículo en Alemán | MEDLINE | ID: mdl-25317648

RESUMEN

HISTORY AND ADMISSION FINDINGS: A 53-year-old woman suffering from brown plaques occasionally ulcerating at both lower legs and in the course of disease on the back of the foot presented at our department. Moreover she complained about an increasing sclerosis of her skin at the back over the last 15 years. She had suffered from diabetes mellitus type-1 for more than 40 years. INVESTIGATIONS: Skin biopsies form the ulcerated plaques showed changes typical for necrobiosis lipoidica. Biopsies of the back were diagnosed as scleredema adultorum Buschke. Laboratory tests displayed a normal antinuclear antibody titer. The differential diagnosis of systemic sclerosis could be ruled out. TREATMENT AND COURSE: We repeatedly performed debridement of ulcers, cream-PUVA therapy, applied a vacuum-sealing and topical corticosteroids at the lower legs. Meanwhile she received oral pentoxyfillin. The scleredema was treated with UVA-1 phototherapy but had to be stopped for high photosensitivity. Additionally physiotherapy was prescribed. Nonetheless the course of disease was chronic and therapy-resistant. CONCLUSION: Skin diseases are common in diabetes mellitus. Necrobiosis lipoidica and scleredema adultorum Buschke are rare complications but often refractory to treatment.


Asunto(s)
Diabetes Mellitus Tipo 1/diagnóstico , Necrobiosis Lipoidea/diagnóstico , Escleredema del Adulto/diagnóstico , Biopsia , Terapia Combinada , Diabetes Mellitus Tipo 1/patología , Diagnóstico Diferencial , Progresión de la Enfermedad , Femenino , Humanos , Dermatosis de la Pierna/diagnóstico , Dermatosis de la Pierna/patología , Dermatosis de la Pierna/terapia , Persona de Mediana Edad , Necrobiosis Lipoidea/patología , Escleredema del Adulto/patología , Piel/patología
5.
Br J Dermatol ; 171(2): 304-12, 2014 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-24397866

RESUMEN

BACKGROUND: Health-related quality of life (HRQOL) is widely used as a patient-reported outcome to evaluate clinical trials. In routine care it can also be used to improve treatment strategies or to enhance patients' self-awareness and empowerment. Therefore a disease-specific instrument is needed that assesses in detail all the impairments caused by the disease of interest. For patients with hand eczema (HE) such an instrument was developed by an international expert group, but its measurement properties are unknown. OBJECTIVES: To validate the German version of the Quality of Life in Hand Eczema Questionnaire (QOLHEQ), which covers the domains of (i) symptoms, (ii) emotions, (iii) functioning and (iv) treatment and prevention. METHODS: The QOLHEQ was assessed up to three times in 316 patients with HE to test reliability and sensitivity to change. To test construct validity we also assessed several reference measures. The scale structure was analysed using the Rasch model for each subscale and a structural equation model was used to test the multi domain structure of the QOLHEQ. RESULTS: After minor adaptions of the scoring structure, all four subscales of the QOLHEQ did not significantly misfit the Rasch model (α > 0·05). The fit indices of the structural equation model showed a good fit of the multi domain construct with four subscales assessing HRQOL. Nearly all a priori-defined hypotheses relating to construct validity could be confirmed. The QOLHEQ showed a sensitivity to change that was superior compared with all reference measures. CONCLUSIONS: The QOLHEQ is ready to be used in its German version as a sensitive outcome measure in clinical trials and for routine monitoring. The treatment-relevant subscales enable its use to enhance patients' self-awareness and to monitor treatment decisions.


Asunto(s)
Eccema/psicología , Dermatosis de la Mano/psicología , Calidad de Vida , Encuestas y Cuestionarios/normas , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Reproducibilidad de los Resultados , Adulto Joven
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