Monika Arenbergerova

Reducing wound pain in venous leg ulcers with Biatain Ibu : A randomized, controlled double-blind clinical investigation on the performance and safety

Six out of 10 patients with chronic wounds suffer from persistent wound pain. A multinational and multicenter randomized double‐blind clinical investigation of 122 patients compared two moist wound healing dressings: a nonadhesive foam dressing with ibuprofen (62 patients randomized to Biatain Ibu Nonadhesive Coloplast A/S) and a nonadhesive foam without ibuprofen (60 patients to Biatain Non‐Adhesive—comparator). Patients were recruited from September 2005 to April 2006. The ibuprofen foam was considered successful if the pain relief on a five‐point Verbal Rating Scale was higher than the comparator without compromising safety including appropriate healing rate. Additional endpoints were change in persistent wound pain between dressing changes and pain at dressing change on days 1–5 (double blind) and days 43–47 (single blind). The primary response variable, persistent pain relief, was significantly higher in the ibuprofen‐foam group, as compared with the comparator on day 1–5, with a quick onset of action (p<0.05). Wound pain intensity was significantly reduced with the ibuprofen foam during day 1–5 with 40% from baseline, compared with 30% with the comparator (p<0.001). At day 43–47, the patients in the ibuprofen‐foam group had a significant (p<0.05) reemergence of persistent pain and pain at dressing change (p<0.05) when the active dressing was changed to the comparator. Wound healing was similar in the ibuprofen foam and comparator group. No difference in adverse events between the comparator and the ibuprofen foam with local sustained release of low‐dose ibuprofen was observed in this study. It was generally found that women reported less pain intensity than men, and pain intensity decreased with increasing age. In addition, pain intensity increased with initial pain intensity and increasing wound size. This study has demonstrated that the ibuprofen‐foam dressing provided pain relief and reduced pain intensity without compromising healing or other safety parameters.

Light-activated nanofibre textiles exert antibacterial effects in the setting of chronic wound healing.

The maintenance of an aseptic environment for chronic wounds is one of the most challenging tasks in the wound‐healing process. Furthermore, the emergence of antibiotic‐resistant bacterial strains is on the rise, rendering conventional treatments less effective. A new antibacterial material consisting of a polyurethane Tecophilic™ nanofibre textile (NT) that was prepared by electrospinning and doped by a tetraphenylporphyrin (TPP) photosensitizer activated by visible light was tested for use in wound beds and bandages. In vitro experiments were performed to assess the antibacterial activity of the textile against three bacterial strains. Furthermore, the new textile was tested in 162 patients with chronic leg ulcers. A complete inhibition of in vitro growth of the three tested bacterial strains was observed on the surface of NTs that had been illuminated with visible light and was clinically demonstrated in 89 patients with leg ulcers. The application of the textiles resulted in a 35% decrease in wound size, as assessed via computer‐aided wound tracing. Wound‐related pain, which was estimated using a visual analogue scale, was reduced by 71%. The results of this trial reveal that the photoinactivation of bacteria through the photosensitized generation of short‐lived, highly reactive singlet oxygen O2(1Δg) results in relatively superficial antibacterial effects in comparison with standard antiseptic treatment options. Thus, such treatment does not interfere with the normal healing process. This method therefore represents a suitable alternative to the use of topical antibiotics and antiseptics and demonstrates potentially broad applications in medicine.

Less pain with Biatain-Ibu: initial findings from a randomised, controlled, double-blind clinical investigation on painful venous leg ulcers

Six out of 10 patients with chronic wounds suffer from persistent wound pain. A multinational and multicentre, randomised, double‐blind clinical investigation of 122 patients compared two moist wound‐healing dressings, a non adhesive foam dressing with ibuprofen (62 patients randomised to Biatain‐Ibu non adhesive, Coloplast A/S) with a non adhesive foam without ibuprofen (60 to Biatain non adhesive).The ibuprofen‐foam was regarded successful, if the pain relief on a 5‐point verbal rating scale was higher than the comparator without compromising safety, including appropriate healing rate. Additional endpoints were change in persistent wound pain between dressing changes and pain at dressing change on days 1–5 and days 43–47. The primary response variable, persistent pain relief, was significantly higher in the ibuprofen‐foam group compared with the comparator on days 1–5, with a quick onset of action (P < 0·05). The patients in the ibuprofen‐foam group had a significant (P < 0·05) higher reduction in the persistent wound pain from baseline (40%) as the comparator (30%). Women reported less pain intensity than men, and pain intensity decreased with increasing age. In addition, pain intensity increased with increasing initial pain intensity and increasing wound size. Wound healing was similar in the ibuprofen‐foam group to that of the comparator group. No difference in adverse events between placebo and local sustained release of low‐dose ibuprofen was observed in this study. This study has demonstrated that the ibuprofen‐foam dressing provided pain relief and reduced pain intensity without compromising healing or other safety parameters. The full report of this study will be published in Wound Repair and Regeneration.

Effective long‐term control of refractory hidradenitis suppurativa with adalimumab after failure of conventional therapy

Background  Hidradenitis suppurativa is a chronic suppurative condition featuring inflammatory nodules, fistulas and scars. It occurs predominantly in the axillae and groin. The disease is poorly responsive to any treatment and is connected with significant morbidity. Systemic therapy, including oral antibiotics, retinoids and antiandrogens, usually has only limited effect. Surgical treatment of affected areas is necessary in advanced stages.

Multimarker real-time reverse transcription-PCR for quantitative detection of melanoma-associated antigens : a novel possible staging method

Background  Detection of melanoma cells in peripheral blood is a promising method for monitoring haematogenous spread of melanoma cells. It enables us to detect early metastasis and to better stratify candidates for adjuvant immunotherapy. Inconsistent data on the sensitivity and clinical relevance of this method have been reported.

Quantitative detection of melanoma‐associated antigens by multimarker real‐time RT‐PCR for molecular staging: results of a 5 years study

Please cite this paper as: Quantitative detection of melanoma‐associated antigens by multimarker real‐time RT‐PCR for molecular staging: results of a 5 years study. Experimental Dermatology 2010; 19: 994–999.

Successful radiotherapy of facial angiosarcoma

Cutaneous angiosarcoma of the face and scalp is a rare malignant vascular tumor that affects mostly Caucasian elderly males. At present, connections concerning the etiology of this neoplasm with radiation therapy, exposure to environmental carcinogens and chronic lymphedema have been described. Due to the difficult histologic evaluation, high local recurrence and tendency to early metastasing, angiosarcoma poses generally a very poor prognosis. We report the case of an 80‐year‐old patient who experienced successful removal of large, exophytic growing angiosarcoma of the face achieved with radiotherapy with long‐term relapse‐free survival.

Effect of topical heparin and levomenol on atopic dermatitis: a randomized four‐arm, placebo‐controlled, double‐blind clinical study

Background  The aim of the controlled double‐blind trial was to demonstrate the superiority of a topical combination product over its single constituents.

Impact of adalimumab treatment on cardiovascular risk biomarkers in psoriasis: Results of a pilot study.

Psoriasis is a chronic systemic immune‐mediated inflammatory dermatosis associated with several comorbidities. Psoriasis patients are at increased risk of developing cardiovascular diseases (CVD), namely, coronary heart disease, stroke or peripheral vascular disease, and psoriasis seems to be an independent cardiovascular risk factor. Antipsoriatic systemic therapy, especially anti‐tumor necrosis factor (TNF)‐α, seems to exert a beneficial effect on these comorbidities. The purpose of this study was: (i) to measure the level of cardiovascular serum markers in psoriasis patients in comparison with healthy volunteers; and (ii) to compare the serum level of the same markers in patients before and 3 months after adalimumab therapy. We investigated six biomarkers connected to CVD: C‐reactive protein (measured high sensitively, hsCRP), oxidized low‐density lipoproteins (oxLDL), oxLDL/β‐glycoprotein I complex (oxLDL/β2GPI), vascular endothelial adhesion molecule 1 (VCAM‐1), E‐selectin and interleukin (IL)‐22. These biomarkers were measured in 21 patients with moderate/severe psoriasis before and after treatment with adalimumab and in healthy volunteers. hsCRP (P < 0.05), oxLDL‐β2GPI complex (P < 0.05), E‐selectin (P < 0.001) and IL‐22 (P < 0.001) were significantly increased in comparison with healthy controls, whereas oxLDL and VCAM‐1 were also higher in psoriasis patients but the difference did not reach statistical significance. A decrease of E‐selectin (P < 0.001) and IL‐22 (P < 0.001) was observed after 3 months of adalimumab therapy. Inhibition of TNF‐α seems to not only improve psoriasis but also decreases serum cardiovascular biomarkers. E‐selectin and IL‐22 could serve for monitoring of the efficacy of antipsoriatic systemic therapy on cardiovascular risk.

Orofacial granulomatosis associated with hypersensitivity to dental amalgam

Orofacial granulomatosis is a clinicopathologic entity characterized by chronic swelling of the lip and possible soft tissues in the orofacial region owing to granulomatous inflammation of unknown cause. We present 3 cases of orofacial granulomatosis associated with allergic contact dermatitis to dental materials. Previous treatment with corticosteroids did not have any therapeutic effect. Patch testing revealed a positive reaction to several allergens, including dental amalgam and mercury in 2 cases. A lymphocyte transformation test modified for metals was used to evaluate lymphocyte reactivity. After the removal of the suspected allergens, all patients experienced recovery within 1 month, with the exception of the lip swelling, which gradually subsided over several months.