@article{ThomasZengRiviereetal.2016, author = {Thomas, Anna C. and Zeng, Zhiqiang and Rivi{\`e}re, Jean-Baptiste and O'Shaughnessy, Ryan and Al-Olabi, Lara and St.-Onge, Judith and Atherton, David J. and Aubert, H{\´e}l{\`e}ne and Bagazgoitia, Lorea and Barbarot, S{\´e}bastien and Bourrat, Emmanuelle and Chiaverini, Christine and Chong, W. Kling and Duffourd, Yannis and Glover, Mary and Groesser, Leopold and Hadj-Rabia, Smail and Hamm, Henning and Happle, Rudolf and Mushtaq, Imran and Lacour, Jean-Philippe and Waelchli, Regula and Wobser, Marion and Vabres, Pierre and Patton, E. Elizabeth and Kinsler, Veronica A.}, title = {Mosaic activating mutations in GNA11 and GNAQ are associated with phakomatosis pigmentovascularis and extensive dermal melanocytosis}, series = {Journal of Investigative Dermatology}, volume = {136}, journal = {Journal of Investigative Dermatology}, number = {4}, doi = {10.1016/j.jid.2015.11.027}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-189689}, pages = {770-778}, year = {2016}, abstract = {Common birthmarks can be an indicator of underlying genetic disease but are often overlooked. Mongolian blue spots (dermal melanocytosis) are usually localized and transient, but they can be extensive, permanent, and associated with extracutaneous abnormalities. Co-occurrence with vascular birthmarks defines a subtype of phakomatosis pigmentovascularis, a group of syndromes associated with neurovascular, ophthalmological, overgrowth, and malignant complications. Here, we discover that extensive dermal melanocytosis and phakomatosis pigmentovascularis are associated with activating mutations in GNA11 and GNAQ, genes that encode Ga subunits of heterotrimeric G proteins. The mutations were detected at very low levels in affected tissues but were undetectable in the blood, indicating that these conditions are postzygotic mosaic disorders. In vitro expression of mutant GNA11\(^R183C\) and GNA11\(^Q209L\) in human cell lines demonstrated activation of the downstream p38 MAPK signaling pathway and the p38, JNK, and ERK pathways, respectively. Transgenic mosaic zebrafish models expressing mutant GNA11\(^R183C\) under promoter mitfa developed extensive dermal melanocytosis recapitulating the human phenotype. Phakomatosis pigmentovascularis and extensive dermal melanocytosis are therefore diagnoses in the group of mosaic heterotrimeric G-protein disorders, joining McCune-Albright and Sturge-Weber syndromes. These findings will allow accurate clinical and molecular diagnosis of this subset of common birthmarks, thereby identifying infants at risk for serious complications, and provide novel therapeutic opportunities.}, language = {en} } @article{NothhaftKlepperKneitzetal.2019, author = {Nothhaft, Matthias and Klepper, Joerg and Kneitz, Hermann and Meyer, Thomas and Hamm, Henning and Morbach, Henner}, title = {Hemorrhagic bullous Henoch-Sch{\"o}nlein Purpura: case report and review of the literature}, series = {Frontiers in Pediatrics}, volume = {6}, journal = {Frontiers in Pediatrics}, doi = {10.3389/fped.2018.00413}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-201435}, pages = {413}, year = {2019}, abstract = {Henoch-Sch{\"o}nlein Purpura (HSP) or IgA vasculitis is the most common systemic vasculitis of childhood and may affect skin, joints, gastrointestinal tract, and kidneys. Skin manifestations of HSP are characteristic and include a non-thrombocytopenic palpable purpura of the lower extremities and buttocks. Rarely, HSP may initially present as or evolve into hemorrhagic vesicles and bullae. We present an otherwise healthy 5-year-old boy with an acute papulovesicular rash of both legs and intermittent abdominal pain. After a few days the skin lesions rapidly evolved into palpable purpura and hemorrhagic bullous lesions of variable size and severe hemorrhagic HSP was suspected. A histological examination of a skin biopsy showed signs of a small vessel leukocytoclastic vasculitis limited to the upper dermis and direct immunofluorescence analysis revealed IgA deposits in vessel walls, compatible with HSP. To further characterize the clinical picture and treatment options of bullous HSP we performed an extensive literature research and identified 41 additional pediatric patients with bullous HSP. Two thirds of the reported patients were treated with systemic corticosteroids, however, up to 25\% of the reported patients developed skin sequelae such as hyperpigmentation and/or scarring. The early use of systemic corticosteroids has been discussed controversially and suggested in some case series to be beneficial by reducing the extent of lesions and minimizing sequelae of disease. Our patient was treated with systemic corticosteroids tapered over 5 weeks. Fading of inflammation resulted in healing of most erosions, however, a deep necrosis developing from a large blister at the dorsum of the right foot persisted so that autologous skin transplantation was performed. Re-examination 11 months after disease onset showed complete clinical remission with re-epithelialization but also scarring of some affected areas.}, language = {en} } @article{SchaeferBauerDonhauseretal.2017, author = {Sch{\"a}fer, Kristina and Bauer, Boris and Donhauser, Julian and Kerstan, Andreas and Hamm, Henning}, title = {Becker Naevus Syndrome of the Lower Body: A New Case and Review of the Literature}, series = {Acta Dermato-Venereologica}, volume = {97}, journal = {Acta Dermato-Venereologica}, number = {4}, doi = {10.2340/00015555-2589}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-171057}, pages = {499-504}, year = {2017}, abstract = {Becker naevus syndrome is a rare epidermal naevus syndrome defined by the co-occurrence of a Becker naevus with various cutaneous, muscular and skeletal anomalies. In the majority of cases, abnormalities exclusively consist of ipsilateral hypoplasia of the breast, areola and/or nipple in addition to the naevus. Here, we report on a 42-year-old woman with an extensive Becker naevus reaching from the left buttock to the left calf verified on histological examination. In addition, there was marked hypoplasia of the fatty tissue of the left thigh confirmed by magnetic resonance imaging in contrast to hyperplasia of the fatty tissue of the left gluteal area. Underlying muscles and bones were not affected. There was no difference in leg lengths. In addition, we review and discuss the features of Becker naevus syndrome with emphasis on 10 reported cases with involvement of the lower body.}, language = {en} } @phdthesis{Jung2022, author = {Jung, Lisa}, title = {Nachweis von Autoantik{\"o}rpern bei Patienten mit prurigin{\"o}sen Hauterkrankungen}, doi = {10.25972/OPUS-26525}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-265254}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2022}, abstract = {Pruritus tritt verst{\"a}rkt bei {\"a}lteren Menschen auf und ist mit vielen verschiedenen Dermatosen unterschiedlichen Ursprungs vergesellschaftet. Pruritus und ein fortgeschrittenes Lebensalter sind auch charakteristisch f{\"u}r die h{\"a}ufigste blasenbildende Autoimmundermatose, das bull{\"o}se Pemphigoid. Im pr{\"a}monitorischen Stadium treten h{\"a}ufig nur Juckreiz und unspezifische Hautver{\"a}nderungen auf. Das Prodromalstadium eines bull{\"o}sen Pemphigoids dauert wenige Wochen bis zu mehreren Jahren. Ziel dieser Arbeit war es, die prurigin{\"o}sen Erkrankungen Prurigo simplex subacuta [L28.2], Prurigo nodularis [L28.1], eosinophilenreiche Dermatitis [L30.8] und Prurigoform eines atopischen Ekzems [L20.0] im Hinblick auf das klinische, laborchemische und histologische Bild bei der Erstdiagnose der Erkrankungen auszuwerten. Insbesondere sollte {\"u}berpr{\"u}ft werden, ob bei der Erstdiagnose typische Autoantik{\"o}rper einer subepidermalen blasenbildenden Autoimmundermatose (BP180, BP230) nachgewiesen werden konnten und trotz des letzendlich ungew{\"o}hnlichen Erscheinungsbildes letztlich ein bull{\"o}ses Pemphigoid vorgelegen haben k{\"o}nnte. Es erfolgte eine retrospektive Auswertung der oben genannten prurigin{\"o}sen Erkrankungen, die {\"u}ber einen Zeitraum von {\"u}ber 10 Jahren in der Klinik f{\"u}r Dermatologie, Venerologie und Allergologie des Universit{\"a}tsklinikums W{\"u}rzburg behandelt wurden. Die Patienten wurden gem{\"a}ß ICD-Kodierung in die vier oben genannten Gruppen unterteilt. Nebst Patientencharakteristika wurden die Parameter direkte Immunfluoreszenz (DIF), indirekte Immunfluoreszenz (IIF), ELISA-Testverfahren, Immunoblot, eosinophile Granulozyten, Gesamt-IgE, histologische Untersuchung, Dermographismus und Blasenbildung ausgewertet. Es konnten insgesamt 325 Patienten in die Studie eingeschlossen werden, bei denen bei der Erstdiagnose einer prurigin{\"o}sen Erkankung eine IIF auf der humanen Spalthaut und/oder auf dem Affen{\"o}sophagus als Substrat veranlasst wurde. Es konnten bei insgesamt 54 (16,7\%) Patienten Autoantik{\"o}rper gegen IgG oder IgA mittels IIF nachgewiesen werden. Bei 42 (76,4\%) Patienten wurde eine weiterf{\"u}hrende Diagnostik mittels DIF durchgef{\"u}hrt, die bei 37 (88,1\%) Personen als negativ befundet wurde. Bei f{\"u}nf (11,9\%) Patienten konnten Autoantik{\"o}rper gegen IgG, IgA und IgM nachgewiesen werden. Alle stammten aus der Gruppe mit einer Prurigo simplex subacuta [L28.2]. Bei diesen f{\"u}nf Patienten wurde zus{\"a}tzlich noch ein ELISA-Test durchgef{\"u}hrt. Nur bei einem Patienten konnten Autoantik{\"o}rper gegen BP180 und Desmoglein 1 nachgewiesen werden. 66 Mit dieser Studie konnte aufgezeigt werden, dass bei Patienten mit den Erkrankungen Prurigo simplex subacuta [L28.2], Prurigo nodularis [L28.1], eosinophilenreiche Dermatitis [L30.8] und Prurigoform eines atopischen Ekzems [L20.0] keine erh{\"o}hte Bildung von Autoantik{\"o}rpern gegen die dermoepidermale Junktionszone stattfindet. Dennoch sollte bei Patienten mit prurigin{\"o}sen Erkrankungen eine serologische Untersuchung mittels IIF - und im Falle einer Positivit{\"a}t mittels ELISA und ggf. DIF durchgef{\"u}hrt werden, vor allem bei {\"a}lteren Patienten, bei welchen der Pruritus als f{\"u}hrendes Symptom beschrieben wird, um die Diagnose einer bull{\"o}sen Autoimmundermatose sicher ausschließen zu k{\"o}nnen. Zudem sollte eine Verlaufskontrolle {\"u}ber mehrere Jahre erfolgen, um die Auswirkung des Pruritus als Trigger auf die Bildung von Autoantik{\"o}rpern einer bull{\"o}sen Autoimmundermatose zu verfolgen.}, subject = {Autoantik{\"o}rper}, language = {de} } @phdthesis{Weiss2021, author = {Weiß, Neele}, title = {Bedeutung des MEK5/ERK5-Signalwegs in der zielgerichteten Melanomtherapie}, doi = {10.25972/OPUS-21907}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-219073}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2021}, abstract = {In dieser Dissertation wird der MEK5/ERK5- Signalweg als m{\"o}glicher Angriffspunkt in der zielgerichteten Melanomtherapie identifiziert. Die Adressierung von ERK5 bietet eine Alternative, um einer Resistenzentwicklung gegen{\"u}ber Inhibitoren des MAPK- Signalwegs entgegenzuwirken. Das maligne Melanom ist ein hochaggressiver Tumor mit steigender Inzidenz. Zunehmende Sonnenstunden im Rahmen des Klimawandels mit erh{\"o}hter Belastung der Haut durch UV-Strahlung werden die Problematik des malignen Melanoms f{\"u}r den Menschen in den n{\"a}chsten Jahren weiter zunehmen lassen. Die Aktivierung des MEK5/ERK5- Signalwegs scheint eine Reaktion von Tumorzellen auf Therapiestress zu sein. Diese Aktivierung liefert den Melanomzellen einen {\"U}berlebensvorteil und verhindert ein langfristiges Therapieansprechen. ERK5 beeinflusst den Zellzyklus von Melanomzellen und ist somit m{\"o}glicherweise von wichtiger Bedeutung in der Tumorgenese des malignen Melanoms. Patienten mit NRAS- Mutation profitieren auffallend weniger von einer gezielten MEKi-Therapie als solche mit BRAF Mutation. F{\"u}r ersteres Patientenkollektiv steht aktuell lediglich die Immuntherapie zur Verf{\"u}gung, wodurch oft nur ein kurzes, progressionsfreies Intervall erreicht werden kann und die Patienten h{\"a}ufig unter schweren Nebenwirkungen leiden. Grund f{\"u}r die problematische Behandlung k{\"o}nnte das h{\"a}ufige Auftreten einer basalen ERK5- Aktivierung in NRAS- mutierten Melanomen sein. Diese Arbeit liefert eine positive Prognose {\"u}ber den Nutzen einer ERK5- Inhibition als Erweiterung des Therapieschemas. Diese These gilt auch f{\"u}r Melanompatienten mit einer BRAF- Mutation. Patienten, die an einem malignen Melanom erkrankt sind, weisen zu 80\% eine Mutation in einem dieser beschriebenen Onkogene auf. Die Arbeit l{\"a}sst darauf schließen, dass eine ERK5- Inhibition in der Therapie von beiden Gruppen erfolgreich sein k{\"o}nnte und somit das Leben nahezu aller Melanompatienten betrifft.}, subject = {Melanom}, language = {de} } @article{HoubenEbertHesbacheretal., author = {Houben, Roland and Ebert, Marlies and Hesbacher, Sonja and Kervarrec, Thibault and Schrama, David}, title = {Merkel Cell Polyomavirus Large T Antigen is Dispensable in G2 and M-Phase to Promote Proliferation of Merkel Cell Carcinoma Cells}, series = {Viruses}, volume = {12}, journal = {Viruses}, number = {10}, issn = {1999-4915}, doi = {10.3390/v12101162}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-218171}, abstract = {Merkel cell carcinoma (MCC) is an aggressive skin cancer frequently caused by the Merkel cell polyomavirus (MCPyV), and proliferation of MCPyV-positive MCC tumor cells depends on the expression of a virus-encoded truncated Large T antigen (LT) oncoprotein. Here, we asked in which phases of the cell cycle LT activity is required for MCC cell proliferation. Hence, we generated fusion-proteins of MCPyV-LT and parts of geminin (GMMN) or chromatin licensing and DNA replication factor1 (CDT1). This allowed us to ectopically express an LT, which is degraded either in the G1 or G2 phase of the cell cycle, respectively, in MCC cells with inducible T antigen knockdown. We demonstrate that LT expressed only in G1 is capable of rescuing LT knockdown-induced growth suppression while LT expressed in S and G2/M phases fails to support proliferation of MCC cells. These results suggest that the crucial function of LT, which has been demonstrated to be inactivation of the cellular Retinoblastoma protein 1 (RB1) is only required to initiate S phase entry.}, language = {en} } @article{GlutschKneitzGesierichetal.2021, author = {Glutsch, Valerie and Kneitz, Hermann and Gesierich, Anja and Goebeler, Matthias and Haferkamp, Sebastian and Becker, J{\"u}rgen C. and Ugurel, Selma and Schilling, Bastian}, title = {Activity of ipilimumab plus nivolumab in avelumab-refractory Merkel cell carcinoma}, series = {Cancer Immunology, Immunotherapy}, volume = {70}, journal = {Cancer Immunology, Immunotherapy}, number = {7}, issn = {14320851}, doi = {10.1007/s00262-020-02832-0}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-265635}, pages = {2087-2093}, year = {2021}, abstract = {Background Merkel cell carcinoma (MCC) is a rare and aggressive neuroendocrine cutaneous malignancy with poor prognosis. In Europe, approved systemic therapies are limited to the PD-L1 inhibitor avelumab. For avelumab-refractory patients, efficient and safe treatment options are lacking. Methods At three different sites in Germany, clinical and molecular data of patients with metastatic MCC being refractory to the PD-L1 inhibitor avelumab and who were later on treated with combined IPI/NIVO were retrospectively collected and evaluated. Results Five patients treated at three different academic sites in Germany were enrolled. Three out of five patients investigated for this report responded to combined IPI/NIVO according to RECIST 1.1. Combined immunotherapy was well tolerated without any grade II or III immune-related adverse events. Two out of three responders to IPI/NIVO received platinum-based chemotherapy in between avelumab and combined immunotherapy. Conclusion In this small retrospective study, we observed a high response rate and durable responses to subsequent combined immunotherapy with IPI/NIVO in avelumab-refractory metastatic MCC patients. In conclusion, our data suggest a promising activity of second- or third-line PD-1- plus CTLA-4-blockade in patients with anti-PD-L1-refractory MCC.}, language = {en} } @article{MarquardtSolimandoKerscheretal.2021, author = {Marquardt, Andr{\´e} and Solimando, Antonio Giovanni and Kerscher, Alexander and Bittrich, Max and Kalogirou, Charis and K{\"u}bler, Hubert and Rosenwald, Andreas and Bargou, Ralf and Kollmannsberger, Philip and Schilling, Bastian and Meierjohann, Svenja and Krebs, Markus}, title = {Subgroup-Independent Mapping of Renal Cell Carcinoma — Machine Learning Reveals Prognostic Mitochondrial Gene Signature Beyond Histopathologic Boundaries}, series = {Frontiers in Oncology}, volume = {11}, journal = {Frontiers in Oncology}, issn = {2234-943X}, doi = {10.3389/fonc.2021.621278}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-232107}, year = {2021}, abstract = {Background: Renal cell carcinoma (RCC) is divided into three major histopathologic groups—clear cell (ccRCC), papillary (pRCC) and chromophobe RCC (chRCC). We performed a comprehensive re-analysis of publicly available RCC datasets from the TCGA (The Cancer Genome Atlas) database, thereby combining samples from all three subgroups, for an exploratory transcriptome profiling of RCC subgroups. Materials and Methods: We used FPKM (fragments per kilobase per million) files derived from the ccRCC, pRCC and chRCC cohorts of the TCGA database, representing transcriptomic data of 891 patients. Using principal component analysis, we visualized datasets as t-SNE plot for cluster detection. Clusters were characterized by machine learning, resulting gene signatures were validated by correlation analyses in the TCGA dataset and three external datasets (ICGC RECA-EU, CPTAC-3-Kidney, and GSE157256). Results: Many RCC samples co-clustered according to histopathology. However, a substantial number of samples clustered independently from histopathologic origin (mixed subgroup)—demonstrating divergence between histopathology and transcriptomic data. Further analyses of mixed subgroup via machine learning revealed a predominant mitochondrial gene signature—a trait previously known for chRCC—across all histopathologic subgroups. Additionally, ccRCC samples from mixed subgroup presented an inverse correlation of mitochondrial and angiogenesis-related genes in the TCGA and in three external validation cohorts. Moreover, mixed subgroup affiliation was associated with a highly significant shorter overall survival for patients with ccRCC—and a highly significant longer overall survival for chRCC patients. Conclusions: Pan-RCC clustering according to RNA-sequencing data revealed a distinct histology-independent subgroup characterized by strengthened mitochondrial and weakened angiogenesis-related gene signatures. Moreover, affiliation to mixed subgroup went along with a significantly shorter overall survival for ccRCC and a longer overall survival for chRCC patients. Further research could offer a therapy stratification by specifically addressing the mitochondrial metabolism of such tumors and its microenvironment.}, language = {en} } @article{StolzeTrautmannGoebeleretal.2016, author = {Stolze, Ina and Trautmann, Axel and Goebeler, Matthias and Stoevesandt, Johanna}, title = {Dangerous Leg Cramps: Severe Pustular Exanthema Caused by an Over-the-Counter Drug}, series = {Acta Dermato-Venereologica}, volume = {96}, journal = {Acta Dermato-Venereologica}, doi = {10.2340/00015555-2324}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-171285}, pages = {703-704}, year = {2016}, abstract = {Abstract is missing}, language = {en} } @article{SchmidtSticherlingSardyetal.2020, author = {Schmidt, Enno and Sticherling, Michael and S{\´a}rdy, Mikl{\´o}s and Eming, R{\"u}diger and Goebeler, Matthias and Hertl, Michael and Hofmann, Silke C. and Hunzelmann, Nicolas and Kern, Johannes S. and Kramer, Harald and Nast, Alexander and Orzechowski, Hans-Dieter and Pfeiffer, Christiane and Schuster, Volker and Sitaru, Cassian and Zidane, Miriam and Zillikens, Detlef and Worm, Margitta}, title = {S2k guidelines for the treatment of pemphigus vulgaris/foliaceus and bullous pemphigoid: 2019 update}, series = {JDDG: Journal der Deutschen Dermatologischen Gesellschaft}, volume = {18}, journal = {JDDG: Journal der Deutschen Dermatologischen Gesellschaft}, number = {5}, doi = {10.1111/ddg.14097}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-217806}, pages = {516 -- 526}, year = {2020}, language = {en} } @phdthesis{Rehlinghaus2024, author = {Rehlinghaus, Christine}, title = {Retrospektive Evaluation der intraven{\"o}sen Dexamethason- bzw. Methylprednisolon-Pulstherapie bei ausgepr{\"a}gter Alopecia areata}, doi = {10.25972/OPUS-36071}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-360711}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2024}, abstract = {Hintergrund: Bei der Entscheidung f{\"u}r eine intraven{\"o}se Kortikosteroid-Pulstherapie bei schweren Formen der AA ist die Abw{\"a}gung von Therapieaufwand, Nebenwirkungen und Risiken einerseits und der Erfolgsaussicht andererseits von zentraler Bedeutung. Ziel: Ziel dieser retrospektiven Analyse war es daher, die Wirksamkeit und Sicherheit der intraven{\"o}sen Kortikosteroid-Pulstherapie bei Patient:innen mit ausgepr{\"a}gter AA klinikintern als qualit{\"a}tssichernde Maßnahme zu untersuchen, prognostisch bedeutsame Faktoren f{\"u}r den Therapieeffekt zu ermitteln und hierdurch die beste Indikation herauszuarbeiten. Methode: 126 Patient:innen (13 Kinder und Jugendliche) erhielten Dexamethason 100 mg (122 Patienten) oder Methylprednisolon 20-30 mg/kg/KG (max. 1000 mg, 4 Patienten) an drei aufeinanderfolgenden Tagen f{\"u}r ein bis drei Zyklen. Ergebnisse: Patienten mit einer AA partialis bzw. diffusa zeigten im Hinblick auf ein vollst{\"a}ndiges oder kosmetisch akzeptables Wiederwachstum die besten Ansprechraten (44,3\%, n=43). Unter den Ophiasis-Patienten und den Patienten mit AA totalis/universalis sprach nur etwa ein Viertel auf die Therapie an (Ophiasis 23,8\%, n=5; AA totalis/universalis: 25\%, n=2). Schwerwiegende unerw{\"u}nschte Nebenwirkungen wurden nicht beobachtet. Schlussfolgerung: In der vorliegenden Untersuchung ließen sich eine l{\"a}ngere Bestandsdauer der Erkrankung und Erkrankungsepisode ({\"u}ber 6 Monate), ein schwerer Auspr{\"a}gungsgrad (Ophiasis, AA totalis/universalis) und krankheitstypische Nagelver{\"a}nderungen als wichtige ung{\"u}nstige prognostische Faktoren nachweisen. Dagegen wirkten sich die untersuchten Kriterien Alter, Geschlecht, atopisches Ekzem und andere Erkrankungen des atopischen Formenkreises, Schilddr{\"u}sen- und Autoimmunerkrankungen in der Eigenanamnese sowie AA in der Familienanamnese nicht negativ auf den Behandlungserfolg aus. Patienten mit AA partialis und einer Bestandsdauer der AA von maximal 6 Monaten haben die besten Erfolgsaussichten.}, subject = {Alopecia areata}, language = {de} } @article{KervarrecSamimiGuyetantetal.2019, author = {Kervarrec, Thibault and Samimi, Mahtab and Guy{\´e}tant, Serge and Sarma, Bhavishya and Ch{\´e}ret, J{\´e}r{\´e}my and Blanchard, Emmanuelle and Berthon, Patricia and Schrama, David and Houben, Roland and Touz{\´e}, Antoine}, title = {Histogenesis of Merkel Cell Carcinoma: A Comprehensive Review}, series = {Frontiers in Oncology}, volume = {9}, journal = {Frontiers in Oncology}, doi = {10.3389/fonc.2019.00451}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-325733}, year = {2019}, abstract = {Merkel cell carcinoma (MCC) is a primary neuroendocrine carcinoma of the skin. This neoplasia features aggressive behavior, resulting in a 5-year overall survival rate of 40\%. In 2008, Feng et al. identified Merkel cell polyomavirus (MCPyV) integration into the host genome as the main event leading to MCC oncogenesis. However, despite identification of this crucial viral oncogenic trigger, the nature of the cell in which MCC oncogenesis occurs is actually unknown. In fact, several hypotheses have been proposed. Despite the large similarity in phenotype features between MCC tumor cells and physiological Merkel cells (MCs), a specialized subpopulation of the epidermis acting as mechanoreceptor of the skin, several points argue against the hypothesis that MCC derives directly from MCs. Alternatively, MCPyV integration could occur in another cell type and induce acquisition of an MC-like phenotype. Accordingly, an epithelial as well as a fibroblastic or B-cell origin of MCC has been proposed mainly based on phenotype similarities shared by MCC and these potential ancestries. The aim of this present review is to provide a comprehensive review of the current knowledge of the histogenesis of MCC.}, language = {en} } @article{BrinkerHeklerHauschildetal.2019, author = {Brinker, Titus J. and Hekler, Achim and Hauschild, Axel and Berking, Carola and Schilling, Bastian and Enk, Alexander H. and Haferkamp, Sebastian and Karoglan, Ante and von Kalle, Christof and Weichenthal, Michael and Sattler, Elke and Schadendorf, Dirk and Gaiser, Maria R. and Klode, Joachim and Utikal, Jochen S.}, title = {Comparing artificial intelligence algorithms to 157 German dermatologists: the melanoma classification benchmark}, series = {European Journal of Cancer}, volume = {111}, journal = {European Journal of Cancer}, doi = {10.1016/j.ejca.2018.12.016}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-220569}, pages = {30-37}, year = {2019}, abstract = {Background Several recent publications have demonstrated the use of convolutional neural networks to classify images of melanoma at par with board-certified dermatologists. However, the non-availability of a public human benchmark restricts the comparability of the performance of these algorithms and thereby the technical progress in this field. Methods An electronic questionnaire was sent to dermatologists at 12 German university hospitals. Each questionnaire comprised 100 dermoscopic and 100 clinical images (80 nevi images and 20 biopsy-verified melanoma images, each), all open-source. The questionnaire recorded factors such as the years of experience in dermatology, performed skin checks, age, sex and the rank within the university hospital or the status as resident physician. For each image, the dermatologists were asked to provide a management decision (treat/biopsy lesion or reassure the patient). Main outcome measures were sensitivity, specificity and the receiver operating characteristics (ROC). Results Total 157 dermatologists assessed all 100 dermoscopic images with an overall sensitivity of 74.1\%, specificity of 60.0\% and an ROC of 0.67 (range = 0.538-0.769); 145 dermatologists assessed all 100 clinical images with an overall sensitivity of 89.4\%, specificity of 64.4\% and an ROC of 0.769 (range = 0.613-0.9). Results between test-sets were significantly different (P < 0.05) confirming the need for a standardised benchmark. Conclusions We present the first public melanoma classification benchmark for both non-dermoscopic and dermoscopic images for comparing artificial intelligence algorithms with diagnostic performance of 145 or 157 dermatologists. Melanoma Classification Benchmark should be considered as a reference standard for white-skinned Western populations in the field of binary algorithmic melanoma classification.}, language = {en} } @article{BrinkerHeklerEnketal.2019, author = {Brinker, Titus J. and Hekler, Achim and Enk, Alexander H. and Berking, Carola and Haferkamp, Sebastian and Hauschild, Axel and Weichenthal, Michael and Klode, Joachim and Schadendorf, Dirk and Holland-Letz, Tim and von Kalle, Christof and Fr{\"o}hling, Stefan and Schilling, Bastian and Utikal, Jochen S.}, title = {Deep neural networks are superior to dermatologists in melanoma image classification}, series = {European Journal of Cancer}, volume = {119}, journal = {European Journal of Cancer}, doi = {10.1016/j.ejca.2019.05.023}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-220539}, pages = {11-17}, year = {2019}, abstract = {Background Melanoma is the most dangerous type of skin cancer but is curable if detected early. Recent publications demonstrated that artificial intelligence is capable in classifying images of benign nevi and melanoma with dermatologist-level precision. However, a statistically significant improvement compared with dermatologist classification has not been reported to date. Methods For this comparative study, 4204 biopsy-proven images of melanoma and nevi (1:1) were used for the training of a convolutional neural network (CNN). New techniques of deep learning were integrated. For the experiment, an additional 804 biopsy-proven dermoscopic images of melanoma and nevi (1:1) were randomly presented to dermatologists of nine German university hospitals, who evaluated the quality of each image and stated their recommended treatment (19,296 recommendations in total). Three McNemar's tests comparing the results of the CNN's test runs in terms of sensitivity, specificity and overall correctness were predefined as the main outcomes. Findings The respective sensitivity and specificity of lesion classification by the dermatologists were 67.2\% (95\% confidence interval [CI]: 62.6\%-71.7\%) and 62.2\% (95\% CI: 57.6\%-66.9\%). In comparison, the trained CNN achieved a higher sensitivity of 82.3\% (95\% CI: 78.3\%-85.7\%) and a higher specificity of 77.9\% (95\% CI: 73.8\%-81.8\%). The three McNemar's tests in 2 × 2 tables all reached a significance level of p < 0.001. This significance level was sustained for both subgroups. Interpretation For the first time, automated dermoscopic melanoma image classification was shown to be significantly superior to both junior and board-certified dermatologists (p < 0.001).}, language = {en} } @article{ScholzCosgareaSuesskindetal.2018, author = {Scholz, S. L. and Cosgarea, I. and S{\"u}ßkind, D. and Murali, R. and M{\"o}ller, I. and Reis, H. and Leonardelli, S. and Schilling, B. and Schimming, T. and Hadaschik, E. and Franklin, C. and Paschen, A. and Sucker, A. and Steuhl, K. P. and Schadendorf, D. and Westekemper, H. and Griewank, K. G.}, title = {NF1 mutations in conjunctival melanoma}, series = {British Journal of Cancer}, volume = {118}, journal = {British Journal of Cancer}, doi = {10.1038/s41416-018-0046-5}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-233329}, pages = {1243-1247}, year = {2018}, abstract = {Background Conjunctival melanoma is a potentially deadly eye tumour. Despite effective local therapies, tumour recurrence and metastasis remain frequent. The genetics of conjunctival melanomas remain incompletely understood. Methods A large cohort of 63 conjunctival melanomas was screened for gene mutations known to be important in other melanoma subtypes by targeted next-generation sequencing. Mutation status was correlated with patient prognosis. Results Frequent mutations in genes activating the MAP kinase pathway were identified. NF1 mutations were most frequent (n = 21, 33\%). Recurrent activating mutations were also identified in BRAF (n = 16, 25\%) and RAS genes (n = 12, 19\%; 11 NRAS and 1 KRAS). Conclusions Similar to cutaneous melanomas, conjunctival melanomas can be grouped genetically into four groups: BRAF-mutated, RAS-mutated, NF1-mutated and triple wild-type melanomas. This genetic classification may be useful for assessment of therapeutic options for patients with metastatic conjunctival melanoma}, language = {en} } @article{SondermannUtikalEnketal.2019, author = {Sondermann, Wiebke and Utikal, Jochen Sven and Enk, Alexander H. and Schadendorf, Dirk and Klode, Joachim and Hauschild, Axel and Weichenthal, Michael and French, Lars E. and Berking, Carola and Schilling, Bastian and Haferkamp, Sebastian and Fr{\"o}hling, Stefan and von Kalle, Christof and Brinker, Titus J.}, title = {Prediction of melanoma evolution in melanocytic nevi via artificial intelligence: A call for prospective data}, series = {European Journal of Cancer}, volume = {119}, journal = {European Journal of Cancer}, doi = {10.1016/j.ejca.2019.07.009}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-239263}, pages = {30-34}, year = {2019}, abstract = {Recent research revealed the superiority of artificial intelligence over dermatologists to diagnose melanoma from images. However, 30-50\% of all melanomas and more than half of those in young patients evolve from initially benign lesions. Despite its high relevance for melanoma screening, neither clinicians nor computers are yet able to reliably predict a nevus' oncologic transformation. The cause of this lies in the static nature of lesion presentation in the current standard of care, both for clinicians and algorithms. The status quo makes it difficult to train algorithms (and clinicians) to precisely assess the likelihood of a benign skin lesion to transform into melanoma. In addition, it inhibits the precision of current algorithms since 'evolution' image features may not be part of their decision. The current literature reveals certain types of melanocytic nevi (i.e. 'spitzoid' or 'dysplastic' nevi) and criteria (i.e. visible vasculature) that, in general, appear to have a higher chance to transform into melanoma. However, owing to the cumulative nature of oncogenic mutations in melanoma, a more fine-grained early morphologic footprint is likely to be detectable by an algorithm. In this perspective article, the concept of melanoma prediction is further explored by the discussion of the evolution of melanoma, the concept for training of such a nevi classifier and the implications of early melanoma prediction for clinical practice. In conclusion, the authors believe that artificial intelligence trained on prospective image data could be transformative for skin cancer diagnostics by (a) predicting melanoma before it occurs (i.e. pre-in situ) and (b) further enhancing the accuracy of current melanoma classifiers. Necessary prospective images for this research are obtained via free mole-monitoring mobile apps.}, language = {en} } @article{TappenbeckSchroederNiebergallRothetal.2019, author = {Tappenbeck, Nils and Schr{\"o}der, Hannes M. and Niebergall-Roth, Elke and Hassinger, Fathema and Dehio, Ulf and Dieter, Kathrin and Kraft, Korinna and Kerstan, Andreas and Esterlechner, Jasmina and Frank, Natasha Y. and Scharffetter-Kochanek, Karin and Murphy, George F. and Orgill, Dennis P. and Beck, Joachim and Frank, Markus H. and Ganss, Christoph and Kluth, Mark A.}, title = {In vivo safety profile and biodistribution of GMP-manufactured human skin-derived ABCB5-positive mesenchymal stromal cells for use in clinical trials}, series = {Cytotherapy}, volume = {21}, journal = {Cytotherapy}, doi = {10.1016/j.jcyt.2018.12.005}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-240456}, pages = {546-560}, year = {2019}, abstract = {Background aims Human dermal ABCB5-expressing mesenchymal stromal cells (ABCB5+ MSCs) represent a promising candidate for stem cell-based therapy of various currently uncurable diseases in several fields of regenerative medicine. We have developed and validated a method to isolate, from human skin samples, and expand ABCB5+ MSCs that meet the guideline criteria of the International Society for Cellular Therapy. We are able to process these cells into a Good Manufacturing Practice-conforming, MSC-based advanced-therapy medicinal product. Methods To support the development of ABCB5+ MSCs for potential therapeutic topical, intramuscular and intravenous administration, we have tested our product in a series of Good Laboratory Practice-compliant nonclinical in-vivo studies addressing all relevant aspects of biosafety, including potential long-term persistence and proliferation, distribution to nontarget tissues, differentiation into undesired cell types, ectopic tissue formation, tumor formation and local tissue reaction. Results (i) Subcutaneous application of 1 × 107 ABCB5+ MSCs/animal and intravenous application of 2 × 106 ABCB5+ MSCs/animal, respectively, to immunocompromised mice did not result in safety-relevant biodistribution, persistence or proliferation of the cells; (ii) three monthly subcutaneous injections of ABCB5+ MSCs at doses ranging from 1 × 105 to 1 × 107 cells/animal and three biweekly intravenous injections of 2 × 106 ABCB5+ MSCs/animal, respectively, to immunocompromised mice were nontoxic and revealed no tumorigenic potential; and (iii) intramuscular injection of 5 × 106 ABCB5+ MSCs/animal to immunocompromised mice was locally well tolerated. Discussion The present preclinical in vivo data demonstrate the local and systemic safety and tolerability of a novel advanced-therapy medicinal product based on human skin-derived ABCB5+ MSCs.}, language = {en} }