1
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Schmidt CM, Toma M, Hein R, Sirokay JD. Pitfalls in evaluating FDG-PET/CT results in melanoma patients - A case series. J Dtsch Dermatol Ges 2023; 21:904-906. [PMID: 37125485 DOI: 10.1111/ddg.15073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 02/25/2023] [Indexed: 05/02/2023]
Affiliation(s)
- Christiane M Schmidt
- Department of Dermatology and Allergy, Biederstein, Technical University of Munich, Munich, Germany
- Department of Dermatology, Artemed Fachklinik, Munich, Germany
| | - Marieta Toma
- Department of Pathology University, Hospital Bonn, Bonn, Germany
| | - Rüdiger Hein
- Department of Dermatology and Allergy, Biederstein, Technical University of Munich, Munich, Germany
| | - Judith D Sirokay
- Department of Dermatology and Allergy University, Hospital Bonn, Bonn, Germany
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2
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Schmidt CM, Toma M, Hein R, Sirokay JD. Fallstricke bei der Einordnung von FDG-PET/CT-Befunden bei Melanompatienten - eine Fallserie. J Dtsch Dermatol Ges 2023; 21:904-906. [PMID: 37574690 DOI: 10.1111/ddg.15073_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 02/25/2023] [Indexed: 08/15/2023]
Affiliation(s)
- Christiane M Schmidt
- Klinik und Poliklinik für Dermatologie und Allergologie am Biederstein, Technische Universität München
- Abteilung für Dermatologie, Artemed Fachklinik, München
| | - Marieta Toma
- Institut für Pathologie, Universitätsklinikum Bonn
| | - Rüdiger Hein
- Klinik und Poliklinik für Dermatologie und Allergologie am Biederstein, Technische Universität München
| | - Judith D Sirokay
- Klinik und Poliklinik für Dermatologie und Allergologie, Universitätsklinikum Bonn
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3
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Peyronnet B, Cornu JN, Belas O, Capon G, Biardeau X, Lecoanet P, Castro-Sader L, Borojeni S, Hein R, Hascoet J, Thibault F, Dubois F, Cardot V, Vidart A, Descazeaud A, Fournier G, Van Der Aa F. Robot-assisted artificial urinary sphincter implantation in female patients: An international multicenter series of 182 patients. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00658-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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4
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Rauch L, Hein R, Biedermann T, Eyerich K, Lauffer F. Bisphosphonates for the Treatment of Calcinosis Cutis-A Retrospective Single-Center Study. Biomedicines 2021; 9:biomedicines9111698. [PMID: 34829927 PMCID: PMC8615716 DOI: 10.3390/biomedicines9111698] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 11/11/2021] [Accepted: 11/12/2021] [Indexed: 11/18/2022] Open
Abstract
(1) Background: Calcinosis cutis is a frequent symptom of autoimmune connective tissue diseases leading to pain, transcutaneous expulsion of calcified material and bacterial superinfection. There is a high need for new therapeutic options as no standardized treatment algorithm is established. While case reports indicate beneficial effects of bisphosphonates, standardized evaluation of treatment effects is missing. (2) Methods: In this retrospective analysis we evaluate the effects of intravenous pamidronate, a second-generation bisphosphonate, in seven patients with calcinosis cutis using consecutive clinical pictures, radiological examinations and patient’s subjective evaluation. (3) Results: 5/6 patients reported a reduction of pain, improvement of general condition and cessation of calcinosis progression. Regression of skin lesions was detectable in clinical pictures of 2/6 patients, while 1/6 patients had stable disease. Radiological examination revealed improvement or stable disease in 3/5 patients. Fever was the most common side effect. One out of seven patients developed osteonecrosis of the jaw. (4) Conclusions: Bisphosphonates appear to have beneficial effects in a subgroup of calcinosis cutis patients. While patient’s subjective evaluation was mainly positive, objective assessments showed improvement in approximately half of the cases. With regard to potential severe side effects, a careful risk-benefit evaluation is necessary before treatment initiation.
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Affiliation(s)
- Lilian Rauch
- Department of Dermatology and Allergy, Technical University of Munich, 80802 Munich, Germany; (L.R.); (R.H.); (T.B.); (K.E.)
| | - Rüdiger Hein
- Department of Dermatology and Allergy, Technical University of Munich, 80802 Munich, Germany; (L.R.); (R.H.); (T.B.); (K.E.)
| | - Tilo Biedermann
- Department of Dermatology and Allergy, Technical University of Munich, 80802 Munich, Germany; (L.R.); (R.H.); (T.B.); (K.E.)
| | - Kilian Eyerich
- Department of Dermatology and Allergy, Technical University of Munich, 80802 Munich, Germany; (L.R.); (R.H.); (T.B.); (K.E.)
- Center for Molecular Medicine, Division of Dermatology and Venereology, Department of Medicine Solna, Karolinska Institute, 17177 Stockholm, Sweden
| | - Felix Lauffer
- Department of Dermatology and Allergy, Technical University of Munich, 80802 Munich, Germany; (L.R.); (R.H.); (T.B.); (K.E.)
- Correspondence: ; Tel.: +49-89-4140-3170
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5
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Peyronnet B, Capon G, Belas O, Biardeau X, Lecoanet P, Castro-Sader L, Allue M, Hein R, Daher M, Hascoet J, Auble A, Thibault F, Cornu J, Dubois F, Gamé X, Cardot V, Vidart A, Descazeaud A, Fournier G, Van Der Aa F. Implantation robot-assistée du sphincter artificiel urinaire AMS-800 chez la femme : une série multicentrique internationale de 125 patientes. Prog Urol 2020. [DOI: 10.1016/j.purol.2020.07.104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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6
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Eberlein B, Biedermann T, Hein R, Posch C. Photosensitivität unter Vemurafenib. J Dtsch Dermatol Ges 2020; 18:1079-1084. [DOI: 10.1111/ddg.14140_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 02/07/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Bernadette Eberlein
- Klinik und Poliklinik für Dermatologie und Allergologie am Biederstein, Fakultät für Medizin Technische Universität München Deutschland
| | - Tilo Biedermann
- Klinik und Poliklinik für Dermatologie und Allergologie am Biederstein, Fakultät für Medizin Technische Universität München Deutschland
| | - Rüdiger Hein
- Klinik und Poliklinik für Dermatologie und Allergologie am Biederstein, Fakultät für Medizin Technische Universität München Deutschland
| | - Christian Posch
- Klinik und Poliklinik für Dermatologie und Allergologie am Biederstein, Fakultät für Medizin Technische Universität München Deutschland
- Fakultät für Medizin Sigmund Freud Privatuniversität Wien Österreich
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7
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Abstract
More than 100 trillion symbiotic microorganisms constitutively colonize throughout the human body, including the oral cavity, the skin, and the gastrointestinal tract. The oral cavity harbors one of the most diverse and abundant microbial communities within the human body, second to the community that resides in the gastrointestinal tract, and is composed of >770 bacterial species. Advances in sequencing technologies help define the precise microbial landscape in our bodies. Environmental and functional differences render the composition of resident microbiota largely distinct between the mouth and the gut and lead to the development of unique microbial ecosystems in the 2 mucosal sites. However, it is apparent that there may be a microbial connection between these 2 mucosal sites in the context of disease pathogenesis. Accumulating evidence indicates that resident oral bacteria can translocate to the gastrointestinal tract through hematogenous and enteral routes. The dissemination of oral microbes to the gut may exacerbate various gastrointestinal diseases, including irritable bowel syndrome, inflammatory bowel disease, and colorectal cancer. However, the precise role that oral microbes play in the extraoral organs, including the gut, remains elusive. Here, we review the recent findings on the dissemination of oral bacteria to the gastrointestinal tract and their possible contribution to the pathogenesis of gastrointestinal diseases. Although little is known about the mechanisms of ectopic colonization of the gut by oral bacteria, we also discuss the potential factors that allow the oral bacteria to colonize the gut.
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Affiliation(s)
- S. Kitamoto
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
| | - H. Nagao-Kitamoto
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
| | - R. Hein
- Department of Ecology and Evolutionary Biology, University of Michigan, Ann Arbor, MI, USA
| | - T.M. Schmidt
- Department of Ecology and Evolutionary Biology, University of Michigan, Ann Arbor, MI, USA
| | - N. Kamada
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
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Wang R, Uretzki M, Boehmer D, Hein R, Biedermann T, Posch C. Severe thrombocytopenia and excellent response following combined immune checkpoint inhibition for metastatic malignant melanoma. J Eur Acad Dermatol Venereol 2020; 35:e89-e92. [PMID: 32701189 DOI: 10.1111/jdv.16829] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- R Wang
- Department of Dermatology and Allergy Biederstein, Technical University Munich, Munich, Germany
| | - M Uretzki
- Department of Dermatology and Allergy Biederstein, Technical University Munich, Munich, Germany
| | - D Boehmer
- Department of Dermatology and Allergy Biederstein, Technical University Munich, Munich, Germany
| | - R Hein
- Department of Dermatology and Allergy Biederstein, Technical University Munich, Munich, Germany
| | - T Biedermann
- Department of Dermatology and Allergy Biederstein, Technical University Munich, Munich, Germany
| | - C Posch
- Department of Dermatology and Allergy Biederstein, Technical University Munich, Munich, Germany
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9
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Peyronnet B, Capon G, Biardeau X, Belas O, Lecoanet P, Castro-Sader L, Allue M, Hein R, Daher M, Manunta A, Robert G, Hascoet J, Dubois F, Thibault F, Cardot V, Vidart A, Descazeaud A, Fournier G, Everaerts W, Van Der Aa F. Robot-assisted artificial urinary sphincter implantation in female patients: An international multicenter study. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)32974-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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10
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Eberlein B, Biedermann T, Hein R, Posch C. Vemurafenib-related photosensitivity. J Dtsch Dermatol Ges 2020; 18:1079-1083. [PMID: 32558291 DOI: 10.1111/ddg.14140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 02/07/2020] [Indexed: 12/01/2022]
Abstract
Increased photosensitivity is a common cutaneous adverse effect associated with the BRAF inhibitor vemurafenib. Clinically, it presents as an immediate sensation of heat and edematous erythema during sun exposure, as well as a sunburn reaction in terms of a late reaction. Phototesting has shown that the UVA range (320 nm to 400 nm), triggers both the immediate and the late reaction. In terms of pathogenesis, photochemical studies have suggested that exposure of vemurafenib to UVA radiation produces an UVA-absorbing photoproduct. In vitro studies on various cell models have also demonstrated that the phototoxic effects of vemurafenib are exclusively caused by UVA irradiation. This latter mechanism is probably responsible for the photosensitivity clinically observed in patients receiving vemurafenib. In addition, vemurafenib is able to inhibit ferrochelatase. The resulting increase in protoporphyrin IX has also been observed in some human studies involving the drug. However, it is yet unproven whether porphyrins actually contribute to the immediate skin reactions seen in individuals on vemurafenib, even though the clinical presentation is similar to that found in erythropoietic protoporphyria with a comparable pathomechanism. Other BRAF inhibitors, such as dabrafenib and encorafenib, are associated with significantly lower photosensitivity. It is essential that patients treated with vemurafenib are informed about immediate and delayed reactions potentially caused even by low doses of UVA. This includes counseling on photoprotective measures.
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Affiliation(s)
- Bernadette Eberlein
- Department of Dermatology and Allergology, Biederstein, School of Medicine, Technical University, Munich, Germany
| | - Tilo Biedermann
- Department of Dermatology and Allergology, Biederstein, School of Medicine, Technical University, Munich, Germany
| | - Rüdiger Hein
- Department of Dermatology and Allergology, Biederstein, School of Medicine, Technical University, Munich, Germany
| | - Christian Posch
- Department of Dermatology and Allergology, Biederstein, School of Medicine, Technical University, Munich, Germany.,Medical Faculty, Sigmund Freud Private University, Vienna, Austria
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11
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Eberlein B, Darsow U, Eyerich K, Konstantinow A, Posch C, Volz T, Zink A, Brockow K, Hein R, Köberle M, Möckel S, Schnopp N, Biedermann T. 50 Jahre Universitäts-Hautklinik am Biederstein in München. Akt Dermatol 2019. [DOI: 10.1055/a-0880-3256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
ZusammenfassungDie Klinik und Poliklinik für Dermatologie und Allergologie am Biederstein der Technischen Universität München (TUM) wurde 1969 in Betrieb genommen und feiert daher im Jahr 2019 ihr 50-jähriges Bestehen. Die Ursprünge dieser Klink gehen aber wie an vielen Orten auf ältere Versorgungsstrukturen zurück. Anlässlich des 50-jährigen Bestehens soll dieser Artikel die Entwicklung und aktuelle Ausrichtung der Klinik illustrieren und dabei auch die Wertschätzung für unsere Vorgänger ausdrücken, die sich auf den verschiedenen Positionen für unsere Patienten eingesetzt und so die Basis für eine erfolgreiche Klinik in Krankenversorgung, Forschung und Lehre geschaffen haben. Die Klinik und Poliklinik für Dermatologie und Allergologie am Biederstein gehört zum Universitätsklinikum, dem Klinikum rechts der Isar, der Technischen Universität München (TUM), sie selbst liegt jedoch links der Isar, im schönen Schwabing unweit des Englischen Gartens. Sie ist eine von 3 Hautkliniken in München, die im Rahmen der Münchner Dermatologischen Gesellschaft (MDG e. V.) regelmäßig Fortbildungen ausrichten. Die MDG am Biederstein wird sich im Jahr 2019 neben der Fortbildung auch dem Jubiläum dieser Klinik widmen.Die Klinik als universitäre Einrichtung umfasst den Bereich medizinische Versorgung mit 74 Betten auf 4 Stationen, einen ambulanten Bereich mit einer großen Poliklinik für Allgemein- und Privatpatienten (jährlich mehr als 60 000 Patientenbesuche), den Bereich Forschung mit verschiedenen Forschungsgruppen und großen Laboratorien sowie den Bereich Lehre, Weiter- und Fortbildung. Ein Schwerpunkt in der klinischen Versorgung und in der Forschung war bereits zur Zeit der Gründung der Klinik 1969 die Allergologie. Weiterhin bestehen Schwerpunkte im Bereich der entzündlichen Hauterkrankungen, der Dermatoonkologie, der Dermatoinfektiologie, der Dermatochirurgie und der Wundversorgung. Die Klinik hat das Comprehensive Allergy Center der Technischen Universität München (ACTUM) und EU-Exzellenz-Zentrum für Allergie auf den Weg gebracht und ist Teil der Krebszentren Comprehensive Cancer Center München der Technischen Universität München (CCC MünchenTUM) und des Comprehensive Cancer Center München (CCCM). Pro Semester werden etwa 450 Studenten im Rahmen von Vorlesungen, Seminaren und Praktika betreut. Neben Kongressen wie der Jahrestagung der Arbeitsgemeinschaft Dermatologische Forschung (ADF) im Jahr 2019 oder der European Society for Dermatological Research (ESDR) im Jahre 2016 richten die Klinik und der Lehrstuhl regelmäßige Fortbildungsveranstaltungen im Rahmen des Biedersteiner Symposiums, des Biedersteiner Kolloquiums und der MDG aus.
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Affiliation(s)
- B. Eberlein
- Klinik und Poliklinik für Dermatologie und Allergologie am Biederstein, Fakultät für Medizin, Technische Universität München
| | - U. Darsow
- Klinik und Poliklinik für Dermatologie und Allergologie am Biederstein, Fakultät für Medizin, Technische Universität München
| | - K. Eyerich
- Klinik und Poliklinik für Dermatologie und Allergologie am Biederstein, Fakultät für Medizin, Technische Universität München
| | - A. Konstantinow
- Klinik und Poliklinik für Dermatologie und Allergologie am Biederstein, Fakultät für Medizin, Technische Universität München
| | - C. Posch
- Klinik und Poliklinik für Dermatologie und Allergologie am Biederstein, Fakultät für Medizin, Technische Universität München
| | - T. Volz
- Klinik und Poliklinik für Dermatologie und Allergologie am Biederstein, Fakultät für Medizin, Technische Universität München
| | - A. Zink
- Klinik und Poliklinik für Dermatologie und Allergologie am Biederstein, Fakultät für Medizin, Technische Universität München
| | - K. Brockow
- Klinik und Poliklinik für Dermatologie und Allergologie am Biederstein, Fakultät für Medizin, Technische Universität München
| | - R. Hein
- Klinik und Poliklinik für Dermatologie und Allergologie am Biederstein, Fakultät für Medizin, Technische Universität München
| | - M. Köberle
- Klinik und Poliklinik für Dermatologie und Allergologie am Biederstein, Fakultät für Medizin, Technische Universität München
| | - S. Möckel
- Klinik und Poliklinik für Dermatologie und Allergologie am Biederstein, Fakultät für Medizin, Technische Universität München
| | - N. Schnopp
- Klinik und Poliklinik für Dermatologie und Allergologie am Biederstein, Fakultät für Medizin, Technische Universität München
| | - T. Biedermann
- Klinik und Poliklinik für Dermatologie und Allergologie am Biederstein, Fakultät für Medizin, Technische Universität München
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Lammer J, Hein R, Roenneberg S, Biedermann T, Volz T. Drug-induced Linear IgA Bullous Dermatosis: A Case Report and Review of the Literature. Acta Derm Venereol 2019; 99:508-515. [PMID: 30809685 DOI: 10.2340/00015555-3154] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Linear IgA bullous dermatosis (LABD) is a rare subepidermal autoimmune blistering disease characterized by linear deposition of IgA along the basement membrane zone. Although most reported cases are idiopathic, there is a subset of patients with drug-induced LABD. Various drugs have been associated with the drug-induced form of the disease. This paper reviews the literature on drugs reported to elicit linear IgA dermatosis and its specific clinical presentation. In addition, a case report of a 77-year-old male patient with linear IgA dermatosis induced by vancomycin is described. The aim of this paper is to emphasize the need to include this differential diagnosis in cases of suspected adverse drug reactions, as well as to highlight the role of drugs in LABD.
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Affiliation(s)
- Judith Lammer
- Department of Dermatology and Allergology, Technical University Munich, DE-80802 Munich, Germany
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13
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Hein R, Gross L, Trenk D, Jacobshagen C, Geisler T, Hadamitzky M, Huber K, Nagy F, Dezsi CA, Merkely B, Huczek Z, Koltowski L, Massberg S, Aradi D, Sibbing D. P2267De-escalation of antiplatelet therapy after percutaneous coronary intervention in acute coronary syndrome patients: outcome of diabetics in the randomized TROPICAL-ACS trial. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- R Hein
- Ludwig-Maximilians University, Department of Cardiology, Munich, Germany
| | - L Gross
- Ludwig-Maximilians University, Department of Cardiology, Munich, Germany
| | - D Trenk
- University Heart Center Freiburg-Bad Krozingen, Bad Krozingen, Germany
| | - C Jacobshagen
- University Medical Center Gottingen (UMG), Department of Cardiology and Pneumology, Gottingen, Germany
| | - T Geisler
- University Hospital of Tubingen, Department of Cardiology, Tubingen, Germany
| | - M Hadamitzky
- German Heart Center of Munich, Department of Radiology, Munich, Germany
| | - K Huber
- Wilhelminen Hospital, 3rd Medical Department for Cardiology and Emergency Medicine, Vienna, Austria
| | - F Nagy
- University of Szeged, First Department of Internal Medicine, Szeged, Hungary
| | - C A Dezsi
- Petz Aladár County Teaching Hospital, Department of Cardiology, Gyor, Hungary
| | - B Merkely
- Semmelweis University, Heart and Vascular Centre, Budapest, Hungary
| | - Z Huczek
- Medical University of Warsaw, 1st Department of Cardiology, Warsaw, Poland
| | - L Koltowski
- Medical University of Warsaw, 1st Department of Cardiology, Warsaw, Poland
| | - S Massberg
- Ludwig-Maximilians University, Department of Cardiology, Munich, Germany
| | - D Aradi
- Semmelweis University, Heart Centre Balatonfüred and Heart and Vascular Centre, Budapest, Hungary
| | - D Sibbing
- Ludwig-Maximilians University, Department of Cardiology, Munich, Germany
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14
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Franz R, Hein R, Biedermann T, Andres C. Eine ungewöhnliche erythematöse Plaque am Rücken einer älteren Frau. J Dtsch Dermatol Ges 2018; 16:940-944. [DOI: 10.1111/ddg.13558_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Regina Franz
- Klinik für Dermatologie und Allergologie; Technische Universität München; München Deutschland
| | - Rüdiger Hein
- Klinik für Dermatologie und Allergologie; Technische Universität München; München Deutschland
| | - Tilo Biedermann
- Klinik für Dermatologie und Allergologie; Technische Universität München; München Deutschland
| | - Christian Andres
- Klinik für Dermatologie und Allergologie; Technische Universität München; München Deutschland
- Labor für Dermatohistologie München, Sonnenstr. 7; 80331 München Deutschland
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15
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Franz R, Hein R, Biedermann T, Christian A. An unusual erythematous plaque on the back of an elderly woman. J Dtsch Dermatol Ges 2018; 16:940-944. [PMID: 29927549 DOI: 10.1111/ddg.13558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Regina Franz
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - Rüdiger Hein
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - Tilo Biedermann
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - Andres Christian
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany.,Labor für Dermatohistologie München, Sonnenstrasse 7, 80331, Munich, Germany
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16
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Affiliation(s)
- A.G.S. Zink
- Department of Dermatology and Allergy Technical University of Munich Biedersteiner Straße 29 80802 Munich Germany
| | - A. Steimle‐Grauer
- Department of Dermatology and Allergy Technical University of Munich Biedersteiner Straße 29 80802 Munich Germany
| | - R. Hein
- Department of Dermatology and Allergy Technical University of Munich Biedersteiner Straße 29 80802 Munich Germany
| | - T. Biedermann
- Department of Dermatology and Allergy Technical University of Munich Biedersteiner Straße 29 80802 Munich Germany
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17
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Abstract
Cutaneous sarcomas comprise a heterogeneous group of mesenchymal spindle cell tumors of the dermis and subcutis, one of the best-known entities being dermatofibrosarcoma protuberans. Other sarcomas addressed in this review include a typical fibroxanthoma, cutaneous undifferentiated pleomorphic sarcoma, leiomyosarcoma, liposarcoma, and angiosarcoma. With the exception of dermatofibrosarcoma protuberans, which has its peak incidence in middle-aged adults, cutaneous sarcomas usually occur in elderly individuals starting in the sixth or seventh decade of life. The pathogenesis of the various disease entities is not uniform and has not been definitively ascertained. Histology is the key to arriving at a correct diagnosis, and should always include ruling out other dermal neoplasms such as melanoma. In recent years, molecular genetic methods have provided greater insight into the pathogenesis, thus paving the way for new targeted therapies. Treatment of choice for cutaneous sarcomas is excision with sufficient surgical margins. Adjuvant and neoadjuvant therapeutic concepts include radiation therapy and the use of targeted therapies or chemotherapies. Local recurrences have frequently been reported in cutaneous sarcomas. Unlike soft tissue sarcomas, the prognosis in terms of survival - with the exception of angiosarcoma - is very good if treated adequately, a fact that should be emphasized to patients.
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Affiliation(s)
- Judith Kohlmeyer
- Klinik und Poliklinik für Dermatologie und Allergologie, Technische Universität München
| | | | - Rüdiger Hein
- Klinik und Poliklinik für Dermatologie und Allergologie, Technische Universität München
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Chylla R, Hein R, Biedermann T, Eyerich K. Rezidivierende Ohrschwellung. J Dtsch Dermatol Ges 2018; 16:96-98. [DOI: 10.1111/ddg.13399_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Ricarda Chylla
- Klinik und Poliklinik für Dermatologie und Allergologie; Technische Universität München
| | - Rüdiger Hein
- Klinik und Poliklinik für Dermatologie und Allergologie; Technische Universität München
| | - Tilo Biedermann
- Klinik und Poliklinik für Dermatologie und Allergologie; Technische Universität München
| | - Kilian Eyerich
- Klinik und Poliklinik für Dermatologie und Allergologie; Technische Universität München
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Chylla R, Hein R, Biedermann T, Eyerich K. Recurrent swelling of the ear. J Dtsch Dermatol Ges 2017; 16:96-98. [PMID: 29266874 DOI: 10.1111/ddg.13399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Ricarda Chylla
- Department of Dermatology and Allergology, Technical University of Munich
| | - Rüdiger Hein
- Department of Dermatology and Allergology, Technical University of Munich
| | - Tilo Biedermann
- Department of Dermatology and Allergology, Technical University of Munich
| | - Kilian Eyerich
- Department of Dermatology and Allergology, Technical University of Munich
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Tomsitz D, Hein R, Biedermann T, Kohlmeyer J. Treatment of a patient with HIV and metastatic melanoma with consequitive ipilimumab and nivolumab. J Eur Acad Dermatol Venereol 2017; 32:e26-e28. [DOI: 10.1111/jdv.14450] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- D. Tomsitz
- Department of Dermatology and Allergy; Technical University of Munich; Munich Germany
| | - R. Hein
- Department of Dermatology and Allergy; Technical University of Munich; Munich Germany
| | - T. Biedermann
- Department of Dermatology and Allergy; Technical University of Munich; Munich Germany
| | - J. Kohlmeyer
- Department of Dermatology and Allergy; Technical University of Munich; Munich Germany
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Affiliation(s)
- Judith Kohlmeyer
- Department of Dermatology and Allergology; Munich Technical University; Munich Germany
| | | | - Rüdiger Hein
- Department of Dermatology and Allergology; Munich Technical University; Munich Germany
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Andres C, Andres-Belloni B, Hein R, Biedermann T, Schäpe A, Brieu N, Schönmeyer R, Yigitsoy M, Ring J, Schmidt G, Harder N. iDermatoPath - a novel software tool for mitosis detection in H&E-stained tissue sections of malignant melanoma. J Eur Acad Dermatol Venereol 2017; 31:1137-1147. [PMID: 28107565 DOI: 10.1111/jdv.14126] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Accepted: 12/12/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND Malignant Melanoma (MM) is characterized by a growing incidence and a high malignant potential. Besides well-defined prognostic factors such as tumour thickness and ulceration, the Mitotic Rate (MR) was included in the AJCC recommendations for diagnosis and treatment of MM. In daily routine, the identification of a single mitosis can be difficult on haematoxylin and eosin slides alone. Several studies showed a big inter- and intra-individual variability in detecting the MR in MM even by very experienced investigators, thus raising the question for a computer-assisted method. OBJECTIVE The objective was to develop a software system for mitosis detection in MM on H&E slides based on machine learning for diagnostic support. METHODS We developed a computer-aided staging support system based on image analysis and machine learning on the basis of 59 MM specimens. Our approach automatically detects tumour regions, identifies mitotic nuclei and classifies them with respect to their diagnostic relevance. A convenient user interface enables the investigator to browse through the proposed mitoses for fast and efficient diagnosing. RESULTS A quantitative evaluation on manually labelled ground truth data revealed that the tumour region detection yields a medium spatial overlap index (dice coefficient) of 0.72. For the mitosis detection, we obtained high accuracies of above 83%. CONCLUSION On the technical side, the developed iDermatoPath software tool provides a novel approach for mitosis detection in MM, which can be further improved using more training data such as dermatopathologist annotations. On the practical side, a first evaluation of the clinical utility was positive, albeit this approach provides most benefit for difficult cases in a research setting. Assuming all slides to be digitally processed and reported in the near future, this method could become a helpful additional tool for the pathologist.
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Affiliation(s)
- C Andres
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany.,Labor für Dermatohistologie, Munich, Germany
| | - B Andres-Belloni
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - R Hein
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - T Biedermann
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | | | - N Brieu
- Definiens AG, Munich, Germany
| | | | | | - J Ring
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
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Bassani-Sternberg M, Bräunlein E, Klar R, Engleitner T, Sinitcyn P, Audehm S, Straub M, Weber J, Slotta-Huspenina J, Specht K, Martignoni ME, Werner A, Hein R, H. Busch D, Peschel C, Rad R, Cox J, Mann M, Krackhardt AM. Direct identification of clinically relevant neoepitopes presented on native human melanoma tissue by mass spectrometry. Nat Commun 2016; 7:13404. [PMID: 27869121 PMCID: PMC5121339 DOI: 10.1038/ncomms13404] [Citation(s) in RCA: 466] [Impact Index Per Article: 58.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Accepted: 09/30/2016] [Indexed: 02/07/2023] Open
Abstract
Although mutations may represent attractive targets for immunotherapy, direct identification of mutated peptide ligands isolated from human leucocyte antigens (HLA) on the surface of native tumour tissue has so far not been successful. Using advanced mass spectrometry (MS) analysis, we survey the melanoma-associated immunopeptidome to a depth of 95,500 patient-presented peptides. We thereby discover a large spectrum of attractive target antigen candidates including cancer testis antigens and phosphopeptides. Most importantly, we identify peptide ligands presented on native tumour tissue samples harbouring somatic mutations. Four of eleven mutated ligands prove to be immunogenic by neoantigen-specific T-cell responses. Moreover, tumour-reactive T cells with specificity for selected neoantigens identified by MS are detected in the patient's tumour and peripheral blood. We conclude that direct identification of mutated peptide ligands from primary tumour material by MS is possible and yields true neoepitopes with high relevance for immunotherapeutic strategies in cancer.
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Affiliation(s)
- Michal Bassani-Sternberg
- Department of Proteomics and Signal Transduction, Max Planck Institute of Biochemistry, Am Klopferspitz 18, Martinsried 82152, Germany
| | - Eva Bräunlein
- IIIrd Medical Department, Klinikum rechts der Isar, Technische Universität München, Ismaningerstr. 22, Munich 81675, Germany
| | - Richard Klar
- IIIrd Medical Department, Klinikum rechts der Isar, Technische Universität München, Ismaningerstr. 22, Munich 81675, Germany
| | - Thomas Engleitner
- IInd Medical Department, Klinikum rechts der Isar, Technische Universität München, Ismaningerstr. 22, Munich 81675, Germany
- German Cancer Consortium of Translational Cancer Research (DKTK) and German Cancer Research Center (DKFZ), Heidelberg 69120, Germany
| | - Pavel Sinitcyn
- Department of Proteomics and Signal Transduction, Max Planck Institute of Biochemistry, Am Klopferspitz 18, Martinsried 82152, Germany
| | - Stefan Audehm
- IIIrd Medical Department, Klinikum rechts der Isar, Technische Universität München, Ismaningerstr. 22, Munich 81675, Germany
| | - Melanie Straub
- Institute of Pathology, Technische Universität München, Ismaningerstr. 22, Munich 81675, Germany
| | - Julia Weber
- IInd Medical Department, Klinikum rechts der Isar, Technische Universität München, Ismaningerstr. 22, Munich 81675, Germany
- German Cancer Consortium of Translational Cancer Research (DKTK) and German Cancer Research Center (DKFZ), Heidelberg 69120, Germany
| | - Julia Slotta-Huspenina
- Institute of Pathology, Technische Universität München, Ismaningerstr. 22, Munich 81675, Germany
- MRI-TUM-Biobank at the Institute of Pathology, Technische Universität München, Ismaningerstr. 22, Munich 81675, Germany
| | - Katja Specht
- Institute of Pathology, Technische Universität München, Ismaningerstr. 22, Munich 81675, Germany
| | - Marc E. Martignoni
- Surgery Department, Klinikum rechts der Isar, Technische Universität München, Ismaningerstr. 22, Munich, 81675, Germany
| | - Angelika Werner
- Surgery Department, Klinikum rechts der Isar, Technische Universität München, Ismaningerstr. 22, Munich, 81675, Germany
| | - Rüdiger Hein
- Dermatology Department, Klinikum rechts der Isar, Technische Universität München, Biedersteiner Str 29, Munich 80802, Germany
| | - Dirk H. Busch
- Institute for Medical Microbiology, Immunology and Hygiene, Technische Universität München, Trogerstr. 30, Munich 81675, Germany
| | - Christian Peschel
- IIIrd Medical Department, Klinikum rechts der Isar, Technische Universität München, Ismaningerstr. 22, Munich 81675, Germany
- German Cancer Consortium of Translational Cancer Research (DKTK) and German Cancer Research Center (DKFZ), Heidelberg 69120, Germany
| | - Roland Rad
- IInd Medical Department, Klinikum rechts der Isar, Technische Universität München, Ismaningerstr. 22, Munich 81675, Germany
- German Cancer Consortium of Translational Cancer Research (DKTK) and German Cancer Research Center (DKFZ), Heidelberg 69120, Germany
| | - Jürgen Cox
- Department of Proteomics and Signal Transduction, Max Planck Institute of Biochemistry, Am Klopferspitz 18, Martinsried 82152, Germany
| | - Matthias Mann
- Department of Proteomics and Signal Transduction, Max Planck Institute of Biochemistry, Am Klopferspitz 18, Martinsried 82152, Germany
| | - Angela M. Krackhardt
- IIIrd Medical Department, Klinikum rechts der Isar, Technische Universität München, Ismaningerstr. 22, Munich 81675, Germany
- German Cancer Consortium of Translational Cancer Research (DKTK) and German Cancer Research Center (DKFZ), Heidelberg 69120, Germany
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Ritter N, Franz R, Hein R, Biedermann T, Eyerich K, Garzorz-Stark N, Andres C. 482 Toll-like receptor 7: A new marker for differentaiation of nonmelanoma skin cancer? J Invest Dermatol 2016. [DOI: 10.1016/j.jid.2016.06.504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Ibrahim T, Dirschinger R, Hein R, Jaitner J. Downstream Panniculitis Secondary to Drug-Eluting Balloon Angioplasty. JACC Cardiovasc Interv 2016; 9:e177-9. [DOI: 10.1016/j.jcin.2016.06.017] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Accepted: 06/03/2016] [Indexed: 11/28/2022]
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Riechers E, Baerlecken N, Baraliakos X, Achilles-Mehr Bakhsh K, Aries P, Bannert B, Becker K, Brandt-Jürgens J, Braun J, Ehrenstein B, Euler H, Fleck M, Hein R, Karberg K, Köhler L, Matthias T, Max R, Melzer A, Meyer-Olson D, Rech J, Rockwitz K, Rudwaleit M, Schweikhard E, Sieper J, Stille C, von Hinüber U, Wagener P, Weidemann H, Zinke S, Witte T. THU0414 Inter SPA: Sensitivity and Specifity of Autoantibodies against CD74 in Early Axial Spondyloarthritis. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.2317] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Moinzadeh P, Riemekasten G, Fierlbeck G, Henes J, Blank N, Melchers I, Mueller-Ladner U, Kreuter A, Susok L, Guenther C, Zeidler G, Pfeiffer C, Worm M, Aberer E, Genth E, Distler J, Hein R, Sárdy M, Mensing H, Koetter I, Sunderkoetter C, Hellmich M, Krieg T, Hunzelmann N. SAT0440 New Data on Renal Crisis and Predictive Markers from More Than 3000 Patients. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.4669] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Affiliation(s)
- R Hein
- Dermatologische Klinik der Universität Regensburg, BRD
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Moinzadeh P, Elisabeth A, Blank N, Distler J, Fierlbeck G, Genth E, Guenther C, Hein R, Henes J, Hellmich M, Herrgott I, Koetter I, Kreuter A, Krieg T, Melchers I, Mensing H, Mueller-Ladner U, Pfeiffer C, Riemekasten G, Sárdy M, Susok L, Worm M, Wozel G, Zeidler G, Sunderkoetter C, Hunzelmann N. FRI0488 Analysis of REAL Life Vasoactive Therapy in over 3000 Patients with Systemic Sclerosis (SSC) Reveals Considerable Undertreatment and Significant Changes of Treatment Practice since 2004. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.4946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Jaeger T, Mourantchanian V, Gutermuth J, Hein R, Andres C, Ring J, Brockow K. Periorbital edema. Int J Dermatol 2014; 53:937-9. [PMID: 24738945 DOI: 10.1111/ijd.12478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Teresa Jaeger
- Department of Dermatology and Allergy Biederstein, Technische Universität München, Munich, Germany; Center of Allergy and Environment (ZAUM), Technische Universität München and Helmholtz Center, Munich, Germany
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Kolk A, Wolff KD, Smeets R, Kesting M, Hein R, Eckert AW. Melanotic and non-melanotic malignancies of the face and external ear - A review of current treatment concepts and future options. Cancer Treat Rev 2014; 40:819-37. [PMID: 24814015 DOI: 10.1016/j.ctrv.2014.04.002] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Revised: 04/01/2014] [Accepted: 04/05/2014] [Indexed: 12/11/2022]
Abstract
Skin has the highest incidence and variety of tumors of all organs. Its structure is of great complexity, and every component has the potential to originate a skin neoplasm (SN). Because of its exposed nature, skin is vulnerable to carcinogenic stimuli such as UV radiation. Various entities can cause SN. Nonmelanotic skin cancers (NMSC) are the most common of all cancers, with over one million cases diagnosed annually in the US. Basal cell carcinoma (BCC) accounts for approximately 80% of all NMSC, most of the remaining 20% being squamous cell carcinoma (SCC). The skin of the head and neck is the most common site for tumors, accounting for more than 80% of all NMSC. BCC, SCC, and malignant melanomas (MM) represent 85-90% of all SN. Merkel cell tumors (MCC), lymphoepithelioma-like carcinomas of the skin (LELCS), dermato-fibro-sarcomas, leiomyosarkomas, and Kaposi-sarcomas are less frequent in the facial skin region and the external ear. Based on data from the German Federal Cancer Registry (2003/2004), 140,000 people in Germany were affected by SN (100,000 BCC, 22,000 SCC, 22,000 MM). This number increases considerably if malignant precursors, such as actinic keratosis, are included. Each year, the frequency of SN diagnosis rises by 3-7%. Among all known malignant tumors, MM exhibits the highest rate of increase in incidence. In the past, SN was primarily diagnosed in people aged 50 years or older. However, recently, the risk for developing SN has shifted, and younger people are also affected. Early diagnosis is significantly correlated with prognosis. Resection of SN creates defects that must be closed with local or microvascular flaps to avoid functional disturbing scar formation and deflection of the nose, eyelids, or lips. All therapeutic strategies for SN, the current standard for adjuvant and systemic treatment, and the management of the increasing number of patients under permanent blood thinner medication are described with regard to the treatment of SN.
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Affiliation(s)
- Andreas Kolk
- Department of Oral and Cranio-Maxillofacial Surgery, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
| | - Klaus-Dietrich Wolff
- Department of Oral and Cranio-Maxillofacial Surgery, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
| | - Ralf Smeets
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Marco Kesting
- Department of Oral and Cranio-Maxillofacial Surgery, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
| | - Rüdiger Hein
- Department of Dermatology and Allergology, Technische Universität München, Munich, Germany.
| | - Alexander W Eckert
- Department of Oral and Maxillofacial Plastic Surgery, Martin Luther University Halle-Wittenberg, Germany.
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Ugurel S, Mentzel T, Utikal J, Helmbold P, Mohr P, Pföhler C, Schiller M, Hauschild A, Hein R, Kämpgen E, Kellner I, Leverkus M, Becker JC, Ströbel P, Schadendorf D. Neoadjuvant imatinib in advanced primary or locally recurrent dermatofibrosarcoma protuberans: a multicenter phase II DeCOG trial with long-term follow-up. Clin Cancer Res 2014; 20:499-510. [PMID: 24173542 DOI: 10.1158/1078-0432.ccr-13-1411] [Citation(s) in RCA: 104] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE Dermatofibrosarcoma protuberans (DFSP) is a rare cutaneous tumor. COL1A1-PDGFB gene fusion is frequent in DFSP, rendering tumor cell proliferation and survival dependent on PDGFRβ (platelet-derived growth factor receptor β) signaling. This trial investigated imatinib as neoadjuvant treatment of DFSP, including long-term follow-up. EXPERIMENTAL DESIGN The primary endpoint of this multicenter phase II trial was response; secondary endpoints were safety, tumor relapse, and response biomarkers. Patients with advanced primary or locally recurrent DFSP and measurable disease by RECIST (response evaluation criteria in solid tumors) were eligible and received imatinib 600 mg/d until definitive surgery with histopathologic proof of tumor-free margins. RESULTS Sixteen patients received imatinib, and 14 patients were evaluable for all endpoints. Median treatment duration was 3.1 months; median tumor shrinkage was 31.5%. Best overall response was 7.1% complete response (CR), 50.0% partial response (PR), 35.7% stable disease, and 7.1% progressive disease (PD). Toxicity was moderate with 25.0% grade 3 and 4 events. During a median follow-up of 6.4 years, one patient developed secondary resistance to imatinib but responded to second-line sunitinib. This patient also presented local recurrence, distant metastasis, and death from DFSP. Exploratory analysis showed that response to imatinib was associated with decreased tumor cellularity and formation of strong hyalinic fibrosis. Weak PDGFRB phosphorylation and pigmented-type DFSP were associated with nonresponse. Additional to PDGFRB, the kinases EGFR and insulin receptor were found activated in a high percentage of DFSPs. CONCLUSION The neoadjuvant use of imatinib 600 mg/d in DFSP is efficacious and well tolerated. Long-term follow-up results do not definitely support smaller surgical margins after successful imatinib pretreatment, and presume that secondary resistance to imatinib might promote accelerated disease progression.
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Affiliation(s)
- Selma Ugurel
- Authors' Affiliations: Department of Dermatology, University of Würzburg, Würzburg; Dermatopathology Bodensee, Friedrichshafen; Skin Cancer Unit, German Cancer Research Center, Heidelberg; Department of Dermatology, University Hospital Heidelberg, Heidelberg; Department of Dermatology, University Medical Center Mannheim, University of Heidelberg, Mannheim; Department of Dermatology, Martin Luther University, Halle/Saale; Department of Dermatology, Elbe Klinikum Buxtehude, Buxtehude; Department of Dermatology, Saarland University Hospital, Homburg, Saarland; Department of Dermatology, University Hospital of Münster, Münster; Department of Dermatology, University of Kiel, Kiel; Department of Dermatology, Technical University Munich, Munich; Department of Dermatology, University Hospital Erlangen, Erlangen; Department of Dermatology, Helios Klinikum Erfurt, Erfurt; Department of Pathology, University of Göttingen, Göttingen; Department of Dermatology, University of Essen, Essen, Germany; and Department of Dermatology, Medical University Graz, Graz, Austria
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Mihaljevic AL, Rieger A, Belloni B, Hein R, Okur A, Scheidhauer K, Schuster T, Friess H, Martignoni ME. Transferring innovative freehand SPECT to the operating room: first experiences with sentinel lymph node biopsy in malignant melanoma. Eur J Surg Oncol 2013; 40:42-8. [PMID: 24084086 DOI: 10.1016/j.ejso.2013.09.005] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2013] [Revised: 07/12/2013] [Accepted: 09/01/2013] [Indexed: 11/20/2022] Open
Abstract
PURPOSE The purpose of this study was to report on the first experiences with freehand single-photon emission-computed tomography (freehand SPECT) in sentinel lymph node biopsy (SLNB) in patients with malignant melanoma. Freehand SPECT is a novel imaging modality combining gamma probes, surgical navigation systems, and emission tomography algorithms, designed to overcome some of the limitations of conventional gamma probes. METHODS In this study 20 patients with malignant melanoma underwent conventional planar scintigraphy prior to surgery. In the operating room, the number and location of separable SLNs were detected first by a pre-incisional scan with freehand SPECT to render a 3D-image of the target site and afterwards by a scan with a conventional gamma probe. After SLNB another scan was performed to document the removal of all targeted SLNs. RESULTS Planar scintigraphy identified 40 SLNs in 26 nodal basins. Pre-incisional freehand SPECT mapped 38 of these nodes as well as one additional node in one patient (95.0% node based sensitivity). The results of freehand SPECT were identical to those of planar scintigraphy in 25 basins, while it missed one basin (96.2% basin based sensitivity). In comparison, the gamma probe failed to detect 7 nodes in 4 basins (82.5% node based sensitivity and 84.6% basin based sensitivity). After resection freehand SPECT detected 9 remaining radioactive spots, two of whichwere resected as they matched the position of SLNs detected on preoperative planar scintigraphy. CONCLUSIONS Freehand SPECT provides a real-time, intraoperative 3D-image of the radioactive labelled SLNs, facilitating their detection and resection.
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Affiliation(s)
- A L Mihaljevic
- Department of Surgery, Klinikum rechts der Isar, Technische Universität München, Ismaningerstrasse 22, 81675 Munich, Germany
| | - A Rieger
- Department of Surgery, Klinikum rechts der Isar, Technische Universität München, Ismaningerstrasse 22, 81675 Munich, Germany
| | - B Belloni
- Department of Dermatology, Technische Universität München, Biedersteiner Str. 29, 80802 Munich, Germany
| | - R Hein
- Department of Dermatology, Technische Universität München, Biedersteiner Str. 29, 80802 Munich, Germany
| | - A Okur
- Department of Nuclear Medicine, Klinikum rechts der Isar, Technische Universität München, Ismaningerstrasse 22, 81675 Munich, Germany
| | - K Scheidhauer
- Department of Nuclear Medicine, Klinikum rechts der Isar, Technische Universität München, Ismaningerstrasse 22, 81675 Munich, Germany
| | - T Schuster
- Institute for Medical Statistics and Epidemiology, Klinikum rechts der Isar, Technische Universität München, Ismaningerstrasse 22, 81675 Munich, Germany
| | - H Friess
- Department of Surgery, Klinikum rechts der Isar, Technische Universität München, Ismaningerstrasse 22, 81675 Munich, Germany
| | - M E Martignoni
- Department of Surgery, Klinikum rechts der Isar, Technische Universität München, Ismaningerstrasse 22, 81675 Munich, Germany.
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Thum D, Seidl HP, Hein R, Ring J, Andres C, Mempel M. Aktuelle Resistenzmuster von Staphylococcus aureus gegenüber topischen Antibiotika und relevanten Antiseptika bei Patienten mit atopischem Ekzem und Impetigo. J Dtsch Dermatol Ges 2013. [DOI: 10.1111/ddg.12111_suppl] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Dolores Thum
- Klinik und Poliklinik für Dermatologie und Allergologie am Biederstein der Technischen Universität München
| | - Hans-Peter Seidl
- Klinik und Poliklinik für Dermatologie und Allergologie am Biederstein der Technischen Universität München
| | - Rüdiger Hein
- Klinik und Poliklinik für Dermatologie und Allergologie am Biederstein der Technischen Universität München
| | - Johannes Ring
- Klinik und Poliklinik für Dermatologie und Allergologie am Biederstein der Technischen Universität München
| | | | - Martin Mempel
- Abteilung für Dermatologie; Venerologie und Allergologie; Universitätsklinikum Göttingen
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Abbas S, Ihle P, Hein R, Schubert I. [Rehabilitation in geriatric patients after ischemic stroke--a comparison of 2 organisational systems in Germany using claims data of a statutory health insurance fund]. REHABILITATION 2013; 52:375-82. [PMID: 23824567 DOI: 10.1055/s-0033-1334914] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
UNLABELLED Due to historical aspects in some federal states in Germany rehabilitation of geriatric patients is organized in geriatric departments in hospitals (§ 109 SGB V). In other states rehabilitation of these patients is mainly realized in geriatric rehabilitation facilities outside hospital care after approval by the health insurance (§ 111 SGB V). Thus, it is of interest to compare both types of health care with respect to differences in population characteristics, resource utilization and outcome parameters (i.e., excess costs, rehospitalization, fracture risk and mortality) using a common geriatric indication, the ischemic stroke, as an example. METHODS Claims data of the AOK (Local Health Care Fund) from seven federal states in Germany were used. Insured persons with a documented hospital stay with discharge diagnosis cerebral infarction/stroke (ICD-10 I63, I64, below denoted by "ischemic stroke") in 2007 (N=39,887) were included and allocated to the respective form of rehabilitative health care via the OPS (German procedure classification for inpatient procedures) procedure 8-550 (§ 109, N=1,272) or via admission to a geriatric rehabilitation unit within 1 month after hospital discharge (§ 111, N=2,200). All direct costs were ascertained and presented with and without costs of long-term care. Excess costs were calculated as the difference of costs between the first year after insult and the costs in the previous year. Excess costs in the 2 types of care were compared using multivariate quantile regression analysis. Risk of hospitalization (due to ischemic stroke or fracture) and risk of death in a 1-year follow-up was analysed using multivariate cox regression. RESULTS Insured members treated according to health care type § 109 were somewhat older (mean: 81 vs. 80 years of age), more frequently female (72 vs. 67%), more often receiving long-term care (27 vs. 19%) and had more often documented sequelae after insult (>=4 diseases 39 vs. 28%). No significant differences in excess costs between both types of care were observed (quantile regression: 25%-percentile-comparison: p=0.49 and 0.11; median-comparison: p=0.99 and 0.13; 75%-percentile-comparison: p=0.13 and 0.30, with and without costs of long-term care, respectively). Moreover, no significant differences were observed related to the outcomes 'rehospitalization due to ischemic stroke' (hazard ratio - HR [95% confidence interval - CI])=1.12 [0.85-1.48], p=0.43) and death (HR [95% CI]=1.03 [0.88-1.20], p=0.75) in the multivariate model (reference: health care type § 111). Insured members in health care type § 109 had a significant lower risk of rehospitalization due to fracture (HR [95% CI]=0.61 [0.40-0.93], p=0.02). CONCLUSION According to health care type § 109 and § 111, geriatric patients differ in certain characteristics such as gender, statutory care and documented sequelae after insult. Except for the outcome 'fracture', no significant differences between both types of care have been observed in the selected outcomes. Primary studies with more differentiated data collection may focus on specific treatment and on aims and achievements of rehabilitation.
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Affiliation(s)
- S Abbas
- PMV forschungsgruppe an der Klinik und Poliklinik für Psychiatrie und Psychotherapie des Kindes- und Jugendalters, Universität zu Köln
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Thum D, Seidl HP, Hein R, Ring J, Andres C, Mempel M. Current resistance patterns ofStaphylococcus aureustowards topical antibiotics and relevant antiseptics in patients with atopic dermatitis and impetigo. J Dtsch Dermatol Ges 2013; 11:875-8. [DOI: 10.1111/ddg.12111] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Dolores Thum
- Department of Dermatology and Allergology Biederstein of the Technical University of Munich; Germany
| | - Hans-Peter Seidl
- Department of Dermatology and Allergology Biederstein of the Technical University of Munich; Germany
| | - Rüdiger Hein
- Department of Dermatology and Allergology Biederstein of the Technical University of Munich; Germany
| | - Johannes Ring
- Department of Dermatology and Allergology Biederstein of the Technical University of Munich; Germany
| | | | - Martin Mempel
- Department of Dermatology; Venereology and Allergolo-gy; University of Göttingen; Germany
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Schubert-Fritschle G, Schlesinger-Raab A, Hein R, Stolz W, Volkenandt M, Hölzel D, Engel J. Quality of life and comorbidity in localized malignant melanoma: results of a German population-based cohort study. Int J Dermatol 2013; 52:693-704. [DOI: 10.1111/j.1365-4632.2011.05401.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Voskens CJ, Goldinger SM, Loquai C, Robert C, Kaehler KC, Berking C, Bergmann T, Bockmeyer CL, Eigentler T, Fluck M, Garbe C, Gutzmer R, Grabbe S, Hauschild A, Hein R, Hundorfean G, Justich A, Keller U, Klein C, Mateus C, Mohr P, Paetzold S, Satzger I, Schadendorf D, Schlaeppi M, Schuler G, Schuler-Thurner B, Trefzer U, Ulrich J, Vaubel J, von Moos R, Weder P, Wilhelm T, Göppner D, Dummer R, Heinzerling LM. The price of tumor control: an analysis of rare side effects of anti-CTLA-4 therapy in metastatic melanoma from the ipilimumab network. PLoS One 2013; 8:e53745. [PMID: 23341990 PMCID: PMC3544906 DOI: 10.1371/journal.pone.0053745] [Citation(s) in RCA: 358] [Impact Index Per Article: 32.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2012] [Accepted: 12/03/2012] [Indexed: 01/17/2023] Open
Abstract
Background Ipilimumab, a cytotoxic T-lymphocyte antigen-4 (CTLA-4) blocking antibody, has been approved for the treatment of metastatic melanoma and induces adverse events (AE) in up to 64% of patients. Treatment algorithms for the management of common ipilimumab-induced AEs have lead to a reduction of morbidity, e.g. due to bowel perforations. However, the spectrum of less common AEs is expanding as ipilimumab is increasingly applied. Stringent recognition and management of AEs will reduce drug-induced morbidity and costs, and thus, positively impact the cost-benefit ratio of the drug. To facilitate timely identification and adequate management data on rare AEs were analyzed at 19 skin cancer centers. Methods and Findings Patient files (n = 752) were screened for rare ipilimumab-associated AEs. A total of 120 AEs, some of which were life-threatening or even fatal, were reported and summarized by organ system describing the most instructive cases in detail. Previously unreported AEs like drug rash with eosinophilia and systemic symptoms (DRESS), granulomatous inflammation of the central nervous system, and aseptic meningitis, were documented. Obstacles included patientś delay in reporting symptoms and the differentiation of steroid-induced from ipilimumab-induced AEs under steroid treatment. Importantly, response rate was high in this patient population with tumor regression in 30.9% and a tumor control rate of 61.8% in stage IV melanoma patients despite the fact that some patients received only two of four recommended ipilimumab infusions. This suggests that ipilimumab-induced antitumor responses can have an early onset and that severe autoimmune reactions may reflect overtreatment. Conclusion The wide spectrum of ipilimumab-induced AEs demands doctor and patient awareness to reduce morbidity and treatment costs and true ipilimumab success is dictated by both objective tumor responses and controlling severe side effects.
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Affiliation(s)
| | | | - Carmen Loquai
- Department of Dermatology, University Hospital Mainz, Mainz, Germany
| | - Caroline Robert
- Institute Gustave Roussy, Department of Dermatology, Villejuif, France
| | | | - Carola Berking
- Department of Dermatology and Allergology, University of Munich LMU, Munich, Germany
| | - Tanja Bergmann
- Department of Internal Medicine (Gastroenterology, Endocrinology, and Pneumology), University Hospital Erlangen, Erlangen, Germany
| | - Clemens L. Bockmeyer
- Department of Dermatology and Allergy/Department of Pathology, Skin Cancer Center Hannover/Hannover Medical School, Hannover, Germany
| | - Thomas Eigentler
- Department of Dermatology, University Hospital Tübingen, Tübingen, Germany
| | - Michael Fluck
- Department of Dermatology, Hospital Hornheide, Münster, Germany
| | - Claus Garbe
- Department of Dermatology, University Hospital Tübingen, Tübingen, Germany
| | - Ralf Gutzmer
- Department of Dermatology and Allergy/Department of Pathology, Skin Cancer Center Hannover/Hannover Medical School, Hannover, Germany
| | - Stephan Grabbe
- Department of Dermatology, University Hospital Mainz, Mainz, Germany
| | - Axel Hauschild
- Department of Dermatology, University Hospital Kiel, Kiel, Germany
| | - Rüdiger Hein
- Department of Dermatology/III. Medical Department, Technische Universität München, München, Germany
| | - Gheorghe Hundorfean
- Department of Internal Medicine (Gastroenterology, Endocrinology, and Pneumology), University Hospital Erlangen, Erlangen, Germany
| | - Armin Justich
- Department of Dermatology, University Hospital Graz, Graz, Austria
| | - Ullrich Keller
- Department of Dermatology/III. Medical Department, Technische Universität München, München, Germany
| | - Christina Klein
- Department of Dermatology, University Hospital Mainz, Mainz, Germany
| | - Christine Mateus
- Institute Gustave Roussy, Department of Dermatology, Villejuif, France
| | - Peter Mohr
- Department of Dermatology, Elbe Kliniken Buxtehude, Buxtehude, Germany
| | - Sylvie Paetzold
- Department of Dermatology, University Hospital Frankfurt, Frankfurt, Germany
| | - Imke Satzger
- Department of Dermatology and Allergy/Department of Pathology, Skin Cancer Center Hannover/Hannover Medical School, Hannover, Germany
| | - Dirk Schadendorf
- Department of Dermatology, University Hospital Essen, Essen, Germany
| | - Marc Schlaeppi
- Department of Oncology/Hematology and Dermatology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Gerold Schuler
- Department of Dermatology, University Hospital Erlangen, Erlangen, Germany
| | | | - Uwe Trefzer
- Department of Dermatology, University Hospital Charité Berlin, Berlin, Germany
| | - Jens Ulrich
- Department of Dermatology, Hospital Quedlinburg, Quedlinburg, Germany
| | - Julia Vaubel
- Department of Dermatology, University Hospital Essen, Essen, Germany
| | - Roger von Moos
- Department of Dermatology, Cantonal Hospital Graubünden, Chur, Switzerland
| | - Patrik Weder
- Department of Oncology/Hematology and Dermatology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Tabea Wilhelm
- Department of Dermatology, University Hospital Charité Berlin, Berlin, Germany
| | - Daniela Göppner
- Department of Dermatology, University Hospital Magdeburg, Magdeburg, Germany
| | - Reinhard Dummer
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
| | - Lucie M. Heinzerling
- Department of Dermatology, University Hospital Erlangen, Erlangen, Germany
- Department of Oncology/Hematology and Dermatology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
- * E-mail:
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Affiliation(s)
- Teresa Jaeger
- Klinik und Poliklinik für Dermatologie und Allergologie der Technischen Universität München, Biedersteiner Str. 29, D-80802 München
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Alhathlool A, Hein R, Andres C, Ring J, Eberlein B. Post-Irradiation Morphea: Case report and review of the literature. J Dermatol Case Rep 2012; 6:73-7. [PMID: 23091583 DOI: 10.3315/jdcr.2012.1106] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2012] [Accepted: 05/07/2012] [Indexed: 11/11/2022]
Abstract
BACKGROUND Post-irradiation morphea (PIM) is an entity documented in the literature although still not mentioned in most of the dermatological textbooks with a frequency approximately 2 out of every 1000 patients who received radiotherapy. Most of the cases are misdiagnosed as recurrent or metastatic carcinoma. MAIN OBSERVATIONS We report on a 64-year-old woman who was treated with radiotherapy for breast cancer. Two years and eight months after the first dose of radiotherapy, she developed localized morphea in the irradiated area. CONCLUSION We report on a new case with a literature review and discuss pathogenesis, treatment modalities and post irradiation subcutaneos reactions mimicking PIM. Around 54 cases of post-irradiation morphea (PIM) were identified in the literature.
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Affiliation(s)
- Ammar Alhathlool
- Department of Dermatology and Allergy Biederstein, Technische Universität München, Munich, Germany
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Abbas S, Ihle P, Hein R, Schubert I. Rehabilitation geriatrischer Patienten nach Schlaganfall – Ein Vergleich zweier Versorgungssysteme in Deutschland an Hand von Routinedaten der gesetzlichen Krankenkasse. Dtsch Med Wochenschr 2012. [DOI: 10.1055/s-0032-1323164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Martignoni M, Rieger A, Saeckl J, Hein R, Okur A, Wendler T, Scheidhauer K, Schuster T, Friess H. 91. Transferring innovative freehand SPECT to the operating room – First experiences with sentinel lymphonodectomy in malignant melanoma. Eur J Surg Oncol 2012. [DOI: 10.1016/j.ejso.2012.06.091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Brandt O, Rafei D, Podstawa E, Niedermeier A, Jonkman MF, Terra JB, Hein R, Hertl M, Pas HH, Müller R. Differential IgG Recognition of Desmoglein 3 by Paraneoplastic Pemphigus and Pemphigus Vulgaris Sera. J Invest Dermatol 2012; 132:1738-41. [DOI: 10.1038/jid.2012.1] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Merk T, Adzemovic D, Akinli A, Hein R, Hetzel M. Pulmonale Infiltrate und tracheobronchialer Schleimhautbefall durch ein Hodgkin-Lymphom. Pneumologie 2012. [DOI: 10.1055/s-0032-1302770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Prettner R, Merk T, Hein R, Regnath T, Hetzel M. EBUS gesteuerte Feinnadelaspiration bei V.a. Lymphknotentuberkulose – Ein Fallbericht. Pneumologie 2012. [DOI: 10.1055/s-0032-1302669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Gelb J, Jackwood DJ, Mundt E, Pope CR, Hein R, Slacum G, Harris JM, Ladman BS, Lynch P, Bautista DA, Ruano JM, Troeber MM. Characterization of Infectious Bursal Disease Viruses Isolated in 2007 from Delmarva Commercial Broiler Chickens. Avian Dis 2012; 56:82-9. [DOI: 10.1637/9842-062411-reg.1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Zink A, Gensbaur A, Zirbs M, Seifert F, Léon Suárez I, Liptak J, Eichhorn L, Onken A, Mempel M, Huss-Marp J, Hein R, Ring J, Ollert M. Sequential IgE-Targeted Therapy Combining Immunapheresis And Omalizumab In Patients With Severe Atopic Dermatitis And Grossly Elevated Total Serum IgE Levels - A Pilot Trial. J Allergy Clin Immunol 2012. [DOI: 10.1016/j.jaci.2012.01.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Krönig H, Julia Falchner K, Odendahl M, Brackertz B, Conrad H, Muck D, Hein R, Blank C, Peschel C, Haller B, Schulz S, Bernhard H. PD-1 expression on Melan-A-reactive T cells increases during progression to metastatic disease. Int J Cancer 2012; 130:2327-36. [PMID: 21717461 DOI: 10.1002/ijc.26272] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2011] [Accepted: 06/06/2011] [Indexed: 01/08/2023]
Abstract
Programmed death 1 (PD-1) is known as an important factor for the development of tolerogenicity. This has been proven in chronic viral infections and different tumor models. To address the role of PD-1 and its ligand programmed death ligand 1 (PD-L1) in different stages of malignant melanoma, we investigated peripheral blood and tumor tissues in regard to overall survival (OS) and prognostic relevance. One hundred samples of peripheral blood mononuclear cells from HLA-A2(+) patients with malignant melanoma (Stages I-IV) were analyzed in seven color FACS combined with multimer analyses for the immunodominant epitope of Melan-A (peptide A2/Melan-A(p26-35mod) ). Corresponding formalin-fixed paraffin-embedded tissues of primary tumor and distant organ metastases from 37 cases were analyzed by immunohistochemistry for Melan-A, PD-L1 and PD-1 expression. Compared to the total CD8(+) T cell population, PD-1 expression by A2/Melan-A(+) CD8(+) T cells was over-represented in melanoma stages III and IV (p < 0.001). Although elevation of PD-1(+) Melan-A(+) CD8(+) T cells had no significant influence on OS, a positive correlation was observed between PD-L1 expression on melanoma cells and OS (p = 0.05). Correlation of advanced tumor stage with increased A2/Melan-A-multimer(+) PD-1(+) T cells in the peripheral blood suggest that blocking of PD-1 could have therapeutic potential in advanced stage melanoma.
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Affiliation(s)
- Holger Krönig
- Department of Hematology, Universität München, Munich, Germany.
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Mierau R, Moinzadeh P, Riemekasten G, Melchers I, Meurer M, Reichenberger F, Buslau M, Worm M, Blank N, Hein R, Müller-Ladner U, Kuhn A, Sunderkötter C, Juche A, Pfeiffer C, Fiehn C, Sticherling M, Lehmann P, Stadler R, Schulze-Lohoff E, Seitz C, Foeldvari I, Krieg T, Genth E, Hunzelmann N. Frequency of disease-associated and other nuclear autoantibodies in patients of the German Network for Systemic Scleroderma: correlation with characteristic clinical features. Arthritis Res Ther 2011; 13:R172. [PMID: 22018289 PMCID: PMC3308107 DOI: 10.1186/ar3495] [Citation(s) in RCA: 109] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2011] [Revised: 08/23/2011] [Accepted: 10/21/2011] [Indexed: 02/01/2023] Open
Abstract
Introduction In the present study, we analysed in detail nuclear autoantibodies and their associations in systemic sclerosis (SSc) patients included in the German Network for Systemic Scleroderma Registry. Methods Sera of 863 patients were analysed according to a standardised protocol including immunofluorescence, immunoprecipitation, line immunoassay and immunodiffusion. Results Antinuclear antibodies (ANA) were detected in 94.2% of patients. In 81.6%, at least one of the autoantibodies highly associated with SSc or with overlap syndromes with scleroderma features was detected, that is, anti-centromere (35.9%) or anti-topoisomerase I (30.1%), followed in markedly lower frequency by antibodies to PM-Scl (4.9%), U1-ribonucleoprotein (U1-RNP) (4.8%), RNA polymerases (RNAPs) (3.8%), fibrillarin (1.4%), Ku (1.2%), aminoacyl-transfer RNA synthetases (0.5%), To (0.2%) and U11-RNP (0.1%). We found that the simultaneous presence of SSc-associated autoantibodies was rare (1.6%). Furthermore, additional autoantibodies were detected in 55.4% of the patients with SSc, of which anti-Ro/anti-La, anti-mitochondrial and anti-p25/p23 antibodies were most frequent. The coexistence of SSc-associated and other autoantibodies was common (43% of patients). SSc-associated autoantibodies disclosed characteristic associations with clinical features of patients, some of which were previously not acknowledged. Conclusions This study shows that five autoantigens (that is, centromere, topoisomerase I, PM-Scl, U1-RNP and RNAP) detected more than 95% of the known SSc-associated antibody responses in ANA-positive SSc patients and characterise around 79% of all SSc patients in a central European cohort. These data confirm and extend previous data underlining the central role of the determination of ANAs in defining the diagnosis, subset allocation and prognosis of SSc patients.
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Affiliation(s)
- Rudolf Mierau
- Laboratory at Rheumaklinik Aachen, Hauptstrasse 21, Aachen, D-52066, Germany.
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Braun M, Hein R, Mayet W, Schleiffer T, Becker-Capeller D. Rituximab-Therapie in der täglichen Praxis: besseres Therapieansprechen nach wiederholten Infusionszyklen. AKTUEL RHEUMATOL 2011. [DOI: 10.1055/s-0031-1283198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
| | - R. Hein
- Praxis für Innere Medizin – Rheumatologie – Osteologie DVO
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