Julia Steinbauer

Randomized placebo-controlled human pilot study of cold atmospheric argon plasma on skin graft donor sites

Cold atmospheric plasma has already been shown to decrease the bacterial load in chronic wounds. However, until now it is not yet known if plasma treatment can also improve wound healing. We aimed to assess the impact of cold atmospheric argon plasma on the process of donor site healing. Forty patients with skin graft donor sites on the upper leg were enrolled in our study. The wound sites were divided into two equally sized areas that were randomly assigned to receive either plasma treatment or placebo (argon gas) for 2 minutes. Donor site healing was evaluated independently by two blinded dermatologists, who compared the wound areas with regard to reepithelialization, blood crusts, fibrin layers, and wound surroundings. From the second treatment day onwards, donor site wound areas treated with plasma (n = 34) showed significantly improved healing compared with placebo‐treated areas (day 1, p = 0.25; day 2, p = 0.011; day 3, p < 0.001; day 4, p < 0.001; day 5, p = 0.004; day 6, p = 0.008; day 7, p = 0.031). Positive effects were observed in terms of improved reepithelialization and fewer fibrin layers and blood crusts, whereas wound surroundings were always normal, independent of the type of treatment. Wound infection did not occur in any of the patients, and no relevant side effects were observed. Both types of treatment were well tolerated. The mechanisms contributing to these clinically observed effects should be further investigated.

Topical photodynamic therapy with porphyrin precursors—assessment of treatment-associated pain in a retrospective study

Photodynamic therapy (PDT) with aminolevulinic acid (ALA) or methyl aminolevulinate (MAL) is an approved modality for the non-invasive treatment of actinic keratoses (AK) and basal cell carcinoma (BCC) offering excellent cosmetic outcome. However, pain during and after illumination is the most frequent and limiting side effect. The aim of this study was to precisely assess how reported pain during PDT is influenced by sex, age, treatment site, disease (AK/BCC) as well as the photosensitizer used. 467 lesions consisting of AK (primary treatments: n=158; follow-up: n=47) or BCC (primary treatments: n=138; follow-up: 124) were treated by ALA- or MAL-PDT using metal halide lamps (580-750 nm). Pain was assessed during illumination using a continuous visual analogue scale (VAS). Factors predictive for higher pain levels during PDT are treatment of the head, treating AK and using ALA. The observed results may improve patient management and predict which level of pain to expect, and what kind of pain relief to prepare.

Quality of life in health care of non-melanoma skin cancer - results of a pilot study.

Background: Modern patient‐oriented medicine increasingly involves psychosocial aspects of disease processes in therapy evaluations. We conducted a pilot study on the implementation of a suitable device assessing the quality of life of patients with non‐melanoma skin cancer (NMSC) in clinical routine.

Photodynamic therapy in dermatology

Photodynamic therapy (PDT) is a modern therapy modality, based upon the application of a photosensitizing agent like aminolevulinic acid, a physiological precursor of porphyrins, onto the tissue followed by illumination with light of the visible wavelength spectrum. During this oxygen‐dependent reaction, reactive oxygen species (ROS) are generated that have immunomodulatory or cytotoxic effects. PDT shows excellent cosmetic results especially for its key indication in dermatology – the treatment of non‐melanoma skin cancer. The associated pain and the low tissue penetration are the most frequent limiting factors of PDT. We review basic principles and recent developments in photosensitizers and light sources. Key oncological and non‐oncological indications are presented as well.

Die photodynamische Therapie in der Dermatologie

Zusammenfassung Die photodynamische Therapie ist eine relativ moderne Behandlungsform, der die Applikation photosensibilisierender Agenzien wie 5-Aminolävulinsäure, einer natürlichen Porphyrinvorstufe, auf zu behandelndes Gewebe mit anschließender Bestrahlung mit Licht aus dem sichtbaren Wellenlängenbereich zugrunde liegt. Aus einer sauerstoffabhängigen Reaktion entstehen Sauerstoffradikale, die immunmodulatorische oder zytotoxische Effekte vermitteln. Dabei werden gerade im Haupteinsatzgebiet der Dermatologie – der Behandlung nicht-melanozytärer Hauttumoren – exzellente kosmetische Ergebnisse erzielt, wobei die mitunter hohe Schmerzhaftigkeit und geringe Tiefenwirkung die bedeutendsten Einschränkungen in der Anwendung darstellen. Basierend auf dem aktuellen Kenntnisstand werden Grundlagen und neue Entwicklungen hinsichtlich der Erforschung von Photosensibilisator-Zubereitungen und Lichtquellen sowie die Indikationsgebiete auf onkologischer wie nicht-onkologischer Basis vorgestellt.

Phototoxic reactions in healthy volunteers following photodynamic therapy with methylaminolevulinate cream or with cream containing 5-aminolevulinic acid: a phase II, randomized study

Background: Photodynamic therapy (PDT) is the selective destruction of abnormal cells through activation of a photosensitizer in the presence of oxygen. Local phototoxic reactions and pain are the most common limiting side effects.

Melanoma promotion after photodynamic therapy of a suspected Bowen's disease lesion.

We report on a 61-year-old male patient who developed a melanoma at the site of a suspected Bowen’s lesion on the right cheek. This lesion had evolved for years and had been treated using photodynamic therapy (PDT) in an outpatient facility. Only a couple of months after a single PDT treatment, a melanoma was histologically diagnosed. After excision, multiple metastases were found. The therapeutic strategy comprised re-excision, neck dissection and lateral parotidectomy – due to a metastasis – as well as subsequent α-interferon injections. The possible role of PDT in the promotion of melanoma is discussed.

Haut und Zähne

Skin and teeth not only share several characteristics in their development but also have a similar ontogenetic origin from the ectoderm. Thus, numerous congenital diseases, such as genetic, infectious, inflammatory, and immune disorders affect both skin and teeth. Particularly skin diseases are often identified by the synopsis of systemic symptoms. The understanding and appreciation of dental abnormalities guides dermatologists in the diagnosis and identification of syndromes as well as in finding an optimal therapy.ZusammenfassungAufgrund erheblicher Gemeinsamkeiten in der Entwicklung und des gemeinsamen ontogenetischen Ursprungs aus dem Ektoderm betrifft eine Reihe angeborener Erkrankungen gleichzeitig Haut und Zähne. Hierzu zählen genetisch bedingte, infektiöse, entzündliche und immunologische Erkrankungen. Gerade Hautkrankheiten lassen sich häufig erst durch die Zusammenschau mit systemischen Symptomen identifizieren; ein geschärfter Blick in den Mund kann dabei für die Diagnosefindung eine entscheidende Rolle spielen und hilft, Syndrome besser zu erkennen und entsprechend optimal zu behandeln.AbstractSkin and teeth not only share several characteristics in their development but also have a similar ontogenetic origin from the ectoderm. Thus, numerous congenital diseases, such as genetic, infectious, inflammatory, and immune disorders affect both skin and teeth. Particularly skin diseases are often identified by the synopsis of systemic symptoms. The understanding and appreciation of dental abnormalities guides dermatologists in the diagnosis and identification of syndromes as well as in finding an optimal therapy.

Quality of life assessment in patients with nonmelanoma skin cancer – psychometric validation of the EORTC QLQ-C30 questionnaire

Nonmelanoma skin cancer (NMSC) is a chronic and sometimes difficult‐to‐treat condition affecting the quality of life (QL). The present study was conducted to investigate whether the European Organization for Research and Treatment of Cancer (EORTC) core QL Questionnaire – Cancer (QLQ‐C30) is a suitable tool for the assessment of QL in patients with NMSC.

Haut und Zähne@@@Skin and teeth

Skin and teeth not only share several characteristics in their development but also have a similar ontogenetic origin from the ectoderm. Thus, numerous congenital diseases, such as genetic, infectious, inflammatory, and immune disorders affect both skin and teeth. Particularly skin diseases are often identified by the synopsis of systemic symptoms. The understanding and appreciation of dental abnormalities guides dermatologists in the diagnosis and identification of syndromes as well as in finding an optimal therapy.ZusammenfassungAufgrund erheblicher Gemeinsamkeiten in der Entwicklung und des gemeinsamen ontogenetischen Ursprungs aus dem Ektoderm betrifft eine Reihe angeborener Erkrankungen gleichzeitig Haut und Zähne. Hierzu zählen genetisch bedingte, infektiöse, entzündliche und immunologische Erkrankungen. Gerade Hautkrankheiten lassen sich häufig erst durch die Zusammenschau mit systemischen Symptomen identifizieren; ein geschärfter Blick in den Mund kann dabei für die Diagnosefindung eine entscheidende Rolle spielen und hilft, Syndrome besser zu erkennen und entsprechend optimal zu behandeln.AbstractSkin and teeth not only share several characteristics in their development but also have a similar ontogenetic origin from the ectoderm. Thus, numerous congenital diseases, such as genetic, infectious, inflammatory, and immune disorders affect both skin and teeth. Particularly skin diseases are often identified by the synopsis of systemic symptoms. The understanding and appreciation of dental abnormalities guides dermatologists in the diagnosis and identification of syndromes as well as in finding an optimal therapy.