Erythema multiforme-like drug eruption with oral involvement after intake of leflunomide.

Leflunomide is an antirheumatic agent of the type of a 'disease-modifying antirheumatic drug'. In rare cases, severe skin reactions up to the extreme expression of toxic epidermal necrolysis have been observed. A female patient with rheumatoid arthritis had been treated with systemic steroids and methotrexate for 2 years.

High plasma levels of 8-methoxypsoralen following bath water delivery in dermatological patients.

With respect to the clinical advantages known for bath PUVA therapy, it was of interest to compare the plasma levels of 8-methoxypsoralen (8-MOP) in bath therapy with those after oral administration for a better insight into the pharmacokinetics of 8-MOP following different modes of application. Considerable high plasma levels of 8-MOP were observed after bath therapy with interindividual variability. The half-life of plasma 8-MOP was markedly shorter after bath PUVA than after oral application.

Diagnostic odyssey of a cutaneous mycobacteriosis rare in central Europe.

Cutaneous infection with Mycobacterium chelonae is an uncommon disease, although this atypical mycobacterium is an acid-fast bacillus ubiquitous in the environment. It is often misdiagnosed and treated as a fungal or common bacterial infection. We report a case of disseminated atypical mycobacterial skin infection of a 72-year-old woman who was treated with different topical and systemic antimycotic and antibiotic drugs over a period of 5 months without remarkable improvement.

Toxicity of methotrexate treatment in psoriasis and psoriatic arthritis--short- and long-term toxicity in 104 patients.

Methotrexate (MTX) is an effective anti-psoriatic agent but there are major concerns about its long-term toxicity, in particular to the liver. Reported frequencies and recommendations for monitoring patients on MTX vary considerably. The aim of this study was to analyse the frequency and severity of MTX-associated adverse drug reactions (ADR) in patients with psoriasis and psoriatic arthritis.

Acquired nevoid telangiectasia.

Background: Acquired nevoid telangiectasia (ANT) is a segmental dilatation of papillary plexus vessels.

Objective: In the present study, the frequency of ANT and its associations with collagen vascular and spinal disease have been investigated.

Methods: 188 unselected patients, seen at an interdisciplinary dermatorheumatologic outpatient clinic, were clinically examined for the presence of ANT and possible associations to preexisting disease.

Radiation therapy for extensive actinic keratosis.

Actinic keratosis in the most common premalignant keratotic tumour of sun-exposed skin. A 66-year-old man developed a large actinic keratosis on his scalp, which did not respond to conventional treatment. Fractionated radiotherapy with a cumulative dose of 28 Gy resulted in complete remission without relapse during a 14-month follow-up.

[Nail changes in rheumatic disease].

Clinically the nail organ ist easy to investigate. When estimating dermato-rheumatological diseases, knowledge of important associated nail symptoms is extremely helpful. In some diseases like osteoarthropathia psoriatica and special variants, Reiter's syndrome and connective tissue disease, typical or even characteristic symptoms can be found.

Lupus erythematosus-associated red lunula.

Background: Red lunulae have only rarely been described in patients with lupus erythematosus.

Objective: We assessed the frequency and classified the type of red lunulae in patients with definite lupus erythematosus seen in an interdisciplinary dermatorheumatologic outpatient clinic.

Methods: We studied 56 patients with either systemic or cutaneous lupus erythematosus for the presence of red lunulae.

Is there a psoriatic osteopathy? -- the activity of bone resorption in psoriatics is related to inflammatory joint process.

The aim of this study was to examine former own histomorphological results by using biochemical markers of bone collagen catabolism in patients with psoriasis vulgaris and psoriatic arthritis and to compare these results with those from rheumatoid arthritis. - The diagnosis of PsA was made according to the diagnostic criteria of Moll and Wright modified by Bennet. Urine was collected from 99 patients with PsA, 21 patients suffering from PS without articular manifestations, 154 patients with RA fulfilling the ACR criteria of 1987, and 80 healthy controls.

[Therapy of hyperhidrosis with tap water iontophoresis. Positive effect on healing time and lack of recurrence in hand-foot eczema].

Hyperhidrosis is due to an overfunction of eccrine glands (triggered by the autonomous nervous system) and may be a cofactor for palmoplantar eczema (dermatitis). Tapwater iontophoresis was used in 54 patients with hyperhidrosis manuum et pedum. After 10 applications directed by the dermatologist, 89% of patients noted an improvement in their hyperhidrosis.

[Hydroxyproline excretion in psoriasis and psoriatic arthritis].

In the morning urine of 24 patients with psoriasis and that of 24 patients with psoriatic arthritis, we determined the excretion of hydroxyproline (mg HP/mumol crea), after preceding diet low in collagen. Surprisingly, psoriatic patients without articular involvement showed a significantly higher excretion of HP than those with psoriatic arthritis. Further differentiation revealed that there were no clear-cut correlations between the amount of HP excretion and the activity of the articular process; we proved, however, that the amount of HP excretion was definitely related to the activity of the skin eruptions in both groups of patients.

[A combination of psoriasis vulgaris and nevus cell nevus--clinical, histopathologic and histochemical findings].

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.

[Physical therapy possibilities in the treatment of collagen diseases].

We report about the rank of physiotherapy in the treatment of connective tissue diseases with special emphasize on scleroderma. Based upon therapeutic aim physiotherapeutic approaches for lupus erythematosus, dermatomyositis, and scleroderma are pointed out.

[The effect of endogenous and exogenous factors on psoriasis vulgaris. A clinical study].

Using computerized data collected from 390 patients we investigated the impact of "endogeneous" factors (infections, menarche, menopause, gravidity, hormonal contraception, stress, nutrition, alcohol consumption, drugs) and "exogenous" factors (seasons, climate, sun exposition, Koebner phenomenon) on the course of psoriasis. We recommend certain rules of behaviour based up on our data and the reviewed literature. It is of importance to inform patients about their skin disease and positive as well as negative modifications of its course by endo- und exogenous factors.

[Effect of dithranol therapy on membrane, basement membrane and nuclear markers in psoriasis lesions].

We investigated the effects of anti-psoriatic therapy with dithranol (1/20-1%) in salicylic acid (0.5%) in white petrolatum on lesional skin. FITC-labeled lectins and pemphigus vulgaris antibodies (PV) served as analytical means to study the glycocalyx.

[Alpha 1-fetoprotein--a marker of potential PUVA side-effects in psoriasis?].

Serum concentrations of alpha 1-fetoprotein (AFP) during PUVA treatment have been analyzed in 12 patients suffering from severe psoriasis or psoriatic arthritis. The results have been compared with AFP levels in psoriatics without PUVA treatment (group II), patients with psoriatic arthritis treated with methotrexate (group III), as well as dermatological patients without psoriasis (group IV). All groups revealed AFP levels below 25 ng/ml.