[Renaissance of mouse favus : Retrospective analysis of Trichophyton quinckeanum infections at Jena University Hospital in the period 2015-2020]. / Renaissance des Mäusefavus : Retrospektive Analyse der Trichophyton-quinckeanum-Infektionen am Universitätsklinikum Jena im Zeitraum 2015 bis 2020.

The number of Trichophyton quinckeanum infections has increased significantly in recent years. In 2020 in particular, the number of cases increased fivefold compared to 2015. Infections multiplied, especially in the second half of the year, which correlated with the upsurge in field mouse populations. Typical vectors are mice and rats as well as dogs and cats, which hunt the rodents. The animals are usually asymptomatic. In humans, on the other hand, the course is usually more inflammatory corresponding to other zoophilic mycoses. Typical clinical manifestations of the infections are tinea corporis and tinea capitis. Treatment of T. quinckeanum infections is similar to other dermatophyte infections, depending on the severity, location and age of the patient as well as the immune status, previous illnesses and medication. The duration of local therapy should be at least 4 weeks and continued for up to 14 days after the normalization of the skin presentation. Systemic treatment should take place with terbinafine 250 mg once a day orally (in adults). Alternatives are itraconazole, fluconazole and griseofulvin. Only the preparation griseofulvin, which is no longer available in Germany, is approved for children. Alternatively, terbinafine, itraconazole or fluconazole can also be used in children as an "off-label" treatment in an individual healing attempt.

Identification of a 27 kDa protein in patients with anaphylactic reactions to mango.

Mango fruit has become increasingly popular in recent years. We report on 2 patients who developed anaphylactic reactions after the ingestion of fresh mango. Allergy to mango was confirmed by a positive skin prick test result and positive cellular allergen stimulation test results. Neither of the patients had detectable mango-specific immunoglobulin (Ig) E levels. Results were validated by sodium dodecyl sulfate polyacrylamide gel electrophoresis immunoblotting and analyzed using Quantiscan.We identified 2 major allergens with a molecular weight of 27 kDa in both patients, in addition to a 15 kDa allergen in 1 patient and a 32 kDa allergen in the other. Currently available IgE systems seem to be lacking these mango allergens and as such are probably unsuitable for diagnosing type 1 sensitization to mango. Skin prick testing with fresh mango fruit therefore seems to be a much more reliable test method for clinical practice.

Influence of cyclodextrins on the proliferation of HaCaT keratinocytes in vitro.

Safety and efficacy of pharmaceutical agents can be greatly improved by encapsulation within, or covalent attachment to, a biomaterial carrier. Drug delivery systems must deliver the necessary amount of drug to the targeted site for a necessary period of time, both efficiently and precisely. Various kinds of high-performance biomaterials are being constantly developed for this purpose. Cyclodextrins are potential candidates for such a role, because of their ability to alter physical, chemical, and biological properties of guest molecules through the formation of inclusion complexes. The alpha-, beta-, and gamma-cyclodextrins are widely used natural cyclodextrins, consisting of six, seven, and eight D-glucopyranose residues, respectively, linked by -1,4 glycosidic bonds into a macro cycle. Each cyclodextrin has its own ability to form inclusion complexes with specific guests, an ability, which depends on a proper fit of the guest molecule into the hydrophobic cyclodextrin cavity. The most common pharmaceutical application of cyclodextrins is to enhance the solubility, stability, and bioavailability of drug molecules. Such kinds of ligand-receptor complexes can be used for different applications, e.g., for a transdermal therapeutic system (TTS) or in biofunctional textiles. The aim of this study was the investigation of the influence of the different cyclodextrins on the cell proliferation using HaCaT keratinocytes as an in vitro test system. Moreover, the study was performed to find harmless and nontoxic cyclodextrin concentrations for dermal applications. By means of different independent in vitro tests could be confirmed that alpha-, beta-, and gamma-cyclodextrins in concentrations up to 0.1% (w/v) do not show any antiproliferative influence on HaCaT keratinocytes. Sometimes even proliferative effects could be found. However, all used cyclodextrins (besides gamma-cyclodextrin and its derivatives) in concentrations of 0.5 and 1% (w/v), respectively, exert a cytotoxic influence on the proliferation of HaCaT keratinocytes. On the basis of these findings, the following rank order of cyclodextrins regarding their cytotoxicity was proposed: M-beta-CD > beta-CD > HP-beta-CD > alpha-CD > (gamma-CD). It could be confirmed that beta-CD and M-beta-CD trigger the activity of the effectors caspases -3 and -7. A significant increase of LDH release could be found for beta-CD and methyl-beta-CD in concentrations of 0.5 and 1% (w/v). The calculated cytotoxicity amounted 45 and 79%, respectively. The measurements of the interleukins IL-6 and IL-8 confirmed the findings of the proliferation assays as well as the LDH measurements. These findings may provide further rationale to the use of CDs in topical formulations for dermal and transdermal drug delivery or as raw material to functionalize textiles for medical applications.

Anaphylactic reaction to lychee in a 12-year-old girl: cross-reactivity to latex?

There are very few case reports on allergic reactions to lychee in the literature - so far only in adults. We report on a 12-year-old girl who developed swelling of lips, pruritus, generalized urticaria and dyspnea 30 min after eating a raw lychee. A second event occurred after eating a piece of cake covered with a fruit cocktail. All other foods were well tolerated. In infancy the girl had suffered from atopic dermatitis, which disappeared in childhood; for the previous 2 yr she had presented with seasonal allergic rhinoconjunctivitis. Upon oral provocation, she developed restlessness, flush, generalized urticaria and inspiratory stridor 50 min after eating half a lychee. The diagnostic work up showed a clear positive skin prick test to raw lychee and specific immunoglobulin E (IgE) in serum to latex but not to lychee. In the cellular antigen stimulation test (CAST) carried out with lychee extracts in several concentrations, the same positive results could be found confirming an allergic reaction. Cross-reactivity of lychee to latex was shown by inhibition experiments using the UniCAP 100-system. In conclusion, it seems worthwhile considering the rare allergy to lychee in the case of unclear food-allergic reactions and lychee should be added to the list of foods cross-reacting with latex.

Nonallergic anaphylaxis to pantoprazole.

Consider reactions to proton pump blockers in suspected food hypersensitivity

Tissue expansion in pig skin--a histochemical approach.

In the present study, a porcine model for controlled skin expansion was investigated to improve our understanding of epidermal and vascular responses following stretching. The model is of outstanding importance not only for the clinical use of tissue expansion but provides interesting data for skin physiology and oncology, too. Thirteen out of 15 animals, who underwent silicone tissue expander implantation showed good clinical results. In all of them, skin biopsies were taken at the end of a controlled tissue expansion procedure (final expander volumes 350 or 500 ccm): one tissue specimen was obtained from the centre of the expanded skin area and a second from the neighbouring but nonexpanded skin. The tissue specimens were immediately frozen in liquid nitrogen and processed to 4 microns thick acetone-fixed frozen sections. Lectin histochemistry and immunohistology were performed using the following techniques: direct and indirect immunofluorescence technique (DIFT, IIFT), immunoperoxidase technique (POX) with either 3,3'-diamino-benzidine (DAB) or 3-amino-9-ethyl-carbazole (AEC). The histochemical findings were supplemented by measurements of the number of vital epidermal cell layers, the epidermal thickness (microns), and the papillary vascular count per visual field. There was a significant diminuation of the vascular count (mean +/- S.D. = 55.0% +/- 12.5%; U-test: p less than 5%). By immunohistochemistry, a loss of the basal cell reactivity for the following antibodies was noted: ACAM (against calmodulin), K 8.12 (against keratins 13 +/- 16) and A51-B/H4 (against keratins 8, 14, 18). There was a remarkable increase of filaggrin expression in the uppermost spinal cell layers in expanded skin, which was most pronounced in those specimens with the shortest interval to the last fluid injection into the expander. We gained no evidence for alterations of the expression of suprabasal epidermal keratins, lectin binding sites (UEA I, PNA, ConA, WGA), and vascular lectin- and immunoreactivity due to tissue expansion. The subdermal capsule, which had formed around the silicone expander, was strongly vimentin-reactive. In conclusion, controlled tissue expansion is capable to change the basal cell phenotype--a feature which is shared with a number of conditions with increased proliferative activity and with the epidermis covering different skin tumours. The regular expression of suprabasal keratins and epidermal lectin binding sites provides evidence for a normal epidermal cell differentiation. Furthermore, the porcine skin is a reliable model for studying physiology and pathophysiology of human skin.

[Unilateral systematic linear porokeratosis. Immuno- and lectin histochemistry]. / Unilaterale systematische lineäre Porokeratose. Immun- und Lektinhistochemie.

An uncommon case of unilateral systemic linear porokeratosis in a women aged 22 years is reported in this paper. The results obtained from frozen-section investigations into lectin binding were indicative of reduced epidermal fucosylation and sialinization beneath the cornoid lamella. The basal stratum failed to react with a polyclonal antibody against calmodulin. Epidermal reaction, with AS-6 staining against urokinase, was of higher intensity. The above findings, as a whole, are likely to suggest accelerated keratinocyte migration to the stratum corneum in cases of linear porokeratosis and and should actually support assignment of the latter to the group of dermatoses with transepidermal elimination.

Histochemistry of the porcine pilosebaceous unit.

The present study describes lectin and immunoreactivity in the pilosebaceous unit of porcine skin. Complex carbohydrates of mucin and biantennary Man/Gluc types were distributed among hair follicle epithelia (hair root sheaths, cuticula, shaft, and shaft matrix). Sebaceous glands expressed biantennary Man/Gluc carbohydrates and GalNAc residues. The expression of simple-type and epidermis-like keratins was confirmed by immunohistochemistry with monoclonal antibodies. Filaggrin-positive cells were found in the keratinizing zone of Henle's layer in anagen follicles. The innermost layer of the outer hair root sheath was stained with antibodies against the epidermal growth factor-receptor, keratin 10 and Ki67 antigen. The differences to humans were remarkably small.

Human eccrine sweat glands--a histochemical approach.

Histogenesis of eccrine sweat glands is incompletely understood. Histochemistry of the human eccrine sweat gland of adult skin by the use of lectins as well as antibodies to neuroglandular antigen (NGA) and urokinase was in favour of a relative independent differentiation from interfollicular epidermis. Expression of NGA by sweat glands is a feature unique among skin appendages. The possible impact of our findings for sweat gland histogenesis is briefly discussed.

[A combination of psoriasis vulgaris and nevus cell nevus--clinical, histopathologic and histochemical findings]. / Kombination von Psoriasis vulgaris und Nävuszellnävus--Klinische, histopathologische und histochemische Befunde.

In a study on 76 patients suffering from psoriasis, we found melanocytic nevi (MCN) within psoriatic lesions in 7%, and in perilesional areas of about 2 cm in 13% of the patients. Under magnification (operating microscope), we failed to detect any signs of psoriasis in both the epidermis covering the MCN and the adjacent epidermis. Histopathologically, 6 out of 7 MCN examined did not show any psoriatic alterations of the epidermis, and in all the 7 cases, the adjacent epidermis was free of psoriasis. Using unfixed frozen sections in histochemistry, we studied the lectin binding of FITC-labeled ConA and UEA I in 5 MCN. The epidermal reaction was comparable to that of psoriatic lesions. In contrast to psoriatic lesions, there was no staining of the spinous layer with a polyclonal antiserum against calmodulin, but only the staining of basal cells as in non-lesional psoriasis. We discuss possible 'protective' factors against psoriasis.

[Seborrheic keratoses. Intact epidermal differentiation despite disordered morphogenesis]. / Seborrhoische Keratosen (SK). Intakte epidermale Differenzierung trotz Morphogenesestörung.

Seborrheic keratoses were investigated by means of histo- and biochemical techniques in order to define the epidermal differentiation and proliferation of this most common epithelial tumor in adults. The following markers have been used in our study: cytokeratins, epidermal proteins binding zinc, insulin receptors, tissue plasminogen activator (tPA), as well as calmodulin (immunohistochemical and quantitative evaluation). Immunohistochemical investigation of seborrheic keratoses revealed a decreased tPA expression; their epidermal concentration of calmodulin was doubled. The differentiation markers failed to show any significant deviation from normal skin. Thus, seborrheic keratoses are associated with normal epidermal differentiation in spite of morphogenic alterations. Pathogenetically, we have to consider epidermaldermal interactions.

[Acrosyringial keratinocytes--no abnormal differentiation in psoriasis vulgaris]. / Keratinozyten des Acrosyringiums--keine Differenzierungsstörung bei Psoriasis vulgaris.

Histochemical investigations were performed in normal and psoriatic epidermis to evaluate possible differences in the acrosyringial reactivity. Luminal (abundant in glycoconjugates, immunoreactive) and outer (almost nonreactive) epithelial cells could be distinguished. Psoriasis did not affect the staining pattern. The findings argue against a primary involvement of acrosyringial keratinocytes in the abnormal differentiation pathway of psoriatic epidermal cells. Moreover, they underline the relative independence of the acrosyringium from interfollicular epidermis.

[Clinical studies of the possible antimycotic effects of the Helix pomatia lectin anti-AHP]. / Klinische Untersuchungen zur Frage möglicher antimykotischer Effekte des Helix pomatia-Lektins Anti-AHP.

In a pilot study the antimycetic effect of the lectin anti-AHP in 40 patients suffering from different mycoses was studied. The treatment with an aqueous solution of anti-AHP resulted in a complete healing in 15 of 40 cases and in 16 patients in a remarkable improvement, whereas in 9 cases such an effect has not been observed. The mode of operations remains still unknown, possible actions of anti-AHP on fungi and stratum corneum are discussed.

Testicular lectinhistochemistry in the Sertoli-cell-only-syndrome.

Glycoconjugate expression was studied in tissue specimens of the Sertoli-cell-only-syndrome by lectinhistochemistry. Both ConA and WGA marked the cell surface of Sertoli cells fainty. UEA I labelled their nucleoli. PNA and RCA failed to stain Sertoli cells. These staining patterns resembled those of normal human testis. The thickened tubular walls in the Sertoli-cell-only-syndrome were abundant in binding sites for WGA, PNA, UEA I, and RCA. ConA stained the outer part of the wall heavily, but failed to react with the adluminal part. It is suggested, that the Sertoli-cell-only-syndrome is accompanied by a selective loss of mannosyl residues in the adluminal part of thickened tubular walls.

[Psoriasis vulgaris--unchanged endothelial reactivity with histochemical markers]. / Psoriasis vulgaris--unveränderte Endothelreaktivität mit histochemischen Markern.

Frozen sections from psoriatic lesions were investigated regarding their reactivity with endothelial markers (UEA I, EEA I, LTA, Con A, factor VIII-related antigen). We compared the findings obtained with those of both uninvolved psoriatic skin and normal skin. Although all lectins showed altered epidermal binding in comparison to the controls, the endothelial lectin binding as well as the expression of factor VIII-related antigen were the same in both psoriatric lesions and controls. Our findings argue for (1) intact dimorphic genetic control of ABH expression in both epidermal and endothelial cells, (2) altered epidermal differentiation of lesional psoriatric skin, and (3) secondary vascular alterations.

[Histochemical studies of transepidermal elimination of nevus cells in nevus cell nevi of the corium]. / Histochemische Untersuchungen zur transepidermalen Elimination von Nävuszellen bei korialen Nävuszellnävi.

Dermal nevocytic nevi (NN) were histochemically studied with the help of FITC-conjugated lectins as well as antisera against keratin and plasminogen activators of the urokinase type. 3 out of 18 NN showed interpenetrating nevus cells in atrophic parts of the epidermis. These cells revealed strong lectin reactivity both with Con A (cytoplasmatic binding) and WGA/RCA II (membraneous binding). In addition we found membraneous reaction with anti-urokinase, whereas there was no anti-keratin staining. Our findings suggest active transepidermal elimination of nevus cells in dermal nevocytic nevi.

[Lectin histochemical studies of nevus cell nevi of the corium]. / Lektinhistochemische Untersuchungen korialer Nävuszellnävi.

Using 11 different kinds of lectins, we histochemically studied 18 dermal nevocytic nevi (NCN). The investigation included both unfixed frozen sections and pretreated sections fixed with acetone (pretreatment: chloroform/methanol, Triton X-100, neuraminidase). In this way, we hoped to get some information both on the expression of surface glycoconjugates and the chemical nature of the sites of lectin binding. Our results argue for an abundance of glucosyl, mannosyl, galactosyl, and N-acetyl galactosamine residues on the surface of nevus cells. In comparison to keratinocytes, we found a greater sensitivity to chloroform/methanol, which suggests a relative increase of glycolipids. Dermal NCN showed heterogenic lectin binding: The highest intensity was seen in the marginal nevus cells, the lowest in the central cells of epidermal nests. Dermal cells showed a moderate binding intensity. Epidermal cells lying above the NCN disclosed some modifications of their lectin binding pattern. In contrast to normal epidermis, basal keratinocytes failed to bind LCA; suprabasal cells showed cytoplasmic staining. In some NCN, we observed an intensive perinuclear staining of the upper keratinocytes with granular ConA. Our results suggest (1) a modified lectin binding pattern of nevus cells depending on their microenvironment, as well as (2) a distinctly altered lectin binding of keratinocytes in the adjacent epidermis.

Lectin-binding sites in testis of men with acrosomeless round-headed spermatozoa.

We report herein about lectin histochemistry of seminiferous epithelia in two infertile men with exlusely acrosomeless round-headed spermatozoa. FITC-conjugated lectins (ConA, PNA, RCA II, WGA) have been employed on tissue sections of Bouin fixed testicular biopsies. RCA II gave a dot-like fluorescence of the acrosomal region and WGA gave a cap-like acrosomal fluorescence of spermatids. PNA-a marker of acrosomal differentiation-failed to stain spermatids. The binding of ConA to germ cells was not influenced by this syndrome. In conclusion, the syndrome of acrosomeless round-headed spermatozoa is associated with selective perturbations of testicular lectin-binding sites. They might contribute of the inability of sperm cells to adhere to and penetrate into ova.

[Eruptive capillary hemangioma following argon laser therapy of naevus flammeus]. / Eruptives kapilläres Hämangiom nach Argonlaser-Therapie eines Naevus flammeus.

A typical eruptive capillary hemangioma developed at the margin of an argon laser-treated nevus flammeus. The relationship of argon laser-induced vascular reactions to eruptive capillary hemangioma is discussed.