TY  - JOUR
A1  - Rak, Katrin
A1  - Hamm, Henning
A1  - Kerstan, Andreas
A1  - Kolb-Mäurer, Annette
A1  - Goebeler, Matthias
T1  - Severe and prolonged liver damage in pityriasis rubra pilaris treated with acitretin: a case report
JF  - SN Comprehensive Clinical Medicine
N2  - Acitretin is a systemic retinoid that is used in dermatology for treatment of various inflammatory and especially hyperkeratotic diseases. Elevation of liver enzymes may occur occasionally but normally resolves spontaneously, at the latest after termination of acitretin. However, it can very rarely develop into a life-threatening adverse event including drug-induced liver injury (DILI). A 45-year-old man with classical pityriasis rubra pilaris, a frequently severe, inflammatory skin disease, was started on acitretin. After a seemingly harmless elevation of transaminases, a few weeks after initiation of acitretin, the patient experienced a dramatic course of liver injury with hepatic jaundice though acitretin was stopped immediately. Eventually, laboratory values recovered upon high-dose oral prednisolone therapy. Prescribing physicians should keep in mind that acitretin might induce severe liver injury. Even after termination of acitretin laboratory values should be monitored for a while in order to recognize symptomless but harmful drug-induced liver injury in time.
KW  - acitretin
KW  - pityriasis rubra pilaris
KW  - drug-induced liver injury (DILI)
KW  - adverse event
Y1  - 2022
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-323982
VL  - 4
IS  - 1
ER  - 
TY  - JOUR
A1  - Strobel, Katharina
A1  - Sickenberger, Christina
A1  - Schoen, Christoph
A1  - Kneitz, Hermann
A1  - Kolb-Mäurer, Annette
A1  - Goebeler, Matthias
T1  - Diagnosis and therapy of Mycobacterium marinum: a single-center 21-year retrospective analysis
JF  - Journal der Deutschen Dermatologischen Gesellschaft
N2  - Background and Objectives
In Europe, infections with Mycobacterium (M.) marinum are rare. We conducted a retrospective single-center study to assess the clinical spectrum of M. marinum infection and its diagnosis, treatment and outcome under real-world conditions.
Patients and Methods
Eighteen patients presenting with M. marinum infections between 1998 and 2018 were identified in the data warehouse of the University Hospital Würzburg and considered for detailed analysis.
Results
Twelve patients reported aquatic exposure. In 16/18 cases the upper extremities were affected. No invasive infections were detected. Mean time to diagnosis was 15 weeks. Histology revealed granulomatous inflammation in 14 patients while mycobacterial cultures were positive for M. marinum in 16 cases. Most patients received antibiotic monotherapy (14/18) while combination therapy was administered in four cases. Treatment (with a median duration of 10 weeks) was successful in 13 patients. Five patients were lost to follow-up.
Conclusions
Our retrospective analysis of M. marinum infections at a German tertiary referral center revealed a considerable diagnostic delay and the relevance of microbiological culture, PCR and histology for diagnosis. Monotherapy with clarithromycin (rather than doxycycline) appeared as a reasonable treatment option while immunosuppressed or -compromised patients and those with extended disease received combination therapy.
KW  - Mycobacterium marinum
KW  - diagnosis
KW  - therapy
Y1  - 2022
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-318428
VL  - 20
IS  - 9
SP  - 1211
EP  - 1218
ER  -