TY - JOUR A1 - Hamm, Henning A1 - Höger, Peter H T1 - Skin Tumors in Childhood JF - Deutsches Ärzteblatt International N2 - Background: Dermatologists, paediatricians, and general practitioners are often consulted by worried parents for the evaluation of a cutaneous tumor. Methods: Selective literature review. Results: Only 1-2% of skin tumors excised in children turn out to be malignant when examined histologically. Warning signs of malignancy include rapid growth, firm consistency, diameter exceeding 3 cm, ulceration, a non-movable mass, and presence in the neonatal period. The more common malignant skin tumors in adults-basal cell carcinoma, cutaneous squamous cell carcinoma, and melanoma-are very rare in childhood. Congenital melanocytic nevi and sebaceous nevi bear a lower malignant potential than previously believed; nevertheless, their excision is often indicated. A Spitz nevus can mimic a melanoma both clinically and histologically. Some benign skin tumors of childhood tend to regress spontaneously within a few years but may cause complications at particular locations and when multiple. For infantile hemangiomas requiring systemic treatment because of imminent obstruction or ulceration, propranolol seems to have a far more favorable risk-benefit ratio than corticosteroids. Conclusion: Physicians need specialized knowledge in order to decide whether a skin tumor in a child should be excised, non-surgically treated, or further evaluated, or whether it can be safely left untreated because of the likelihood of spontaneous remission. KW - congenital melanocytic nevi KW - mastocytosis KW - diagnosis KW - melanoma KW - children KW - lumps Y1 - 2011 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-142402 VL - 108 IS - 20 ER - TY - JOUR A1 - Williams, Tatjana A1 - Machann, Wolfram A1 - Kühler, Leif A1 - Hamm, Henning A1 - Müller-Höcker, Josef A1 - Zimmer, Michael A1 - Ertl, Georg A1 - Ritter, Oliver A1 - Beer, Meinrad A1 - Schönberger, Jost T1 - Novel desmoplakin mutation: juvenile biventricular cardiomyopathy with left ventricular non-compaction and acantholytic palmoplantar keratoderma JF - Clinical Research in Cardiology N2 - Two sons of a consanguineous marriage developed biventricular cardiomyopathy. One boy died of severe heart failure at the age of 6 years, the other was transplanted because of severe heart failure at the age of 10 years. In addition, focal palmoplantar keratoderma and woolly hair were apparent in both boys. As similar phenotypes have been described in Naxos disease and Carvajal syndrome, respectively, the genes for plakoglobin (JUP) and desmoplakin (DSP) were screened for mutations using direct genomic sequencing. A novel homozygous 2 bp deletion was identified in an alternatively spliced region of DSP. The deletion 5208_5209delAG led to a frameshift downstream of amino acid 1,736 with a premature truncation of the predominant cardiac isoform DSP-1. This novel homozygous truncating mutation in the isoform-1 specific region of the DSP C-terminus caused Carvajal syndrome comprising severe early-onset heart failure with features of non-compaction cardiomyopathy, woolly hair and an acantholytic form of palmoplantar keratoderma in our patient. Congenital hair abnormality and manifestation of the cutaneous phenotype in toddler age can help to identify children at risk for cardiac death. KW - Desmoplakin KW - Juvenile biventricular cardiomyopathy KW - Palmoplantar keratoderma Y1 - 2011 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-141198 VL - 100 IS - 12 ER - TY - THES A1 - Storim, Julian T1 - Dynamic mapping of the immunological synapse in T cell homeostasis and activation T1 - Dynamische Untersuchung der immunologischen Synapse während T-Zellhomöostase und -aktivierung N2 - Polarity and migration are essential for T cell activation, homeostasis, recirculation and effector function. To address how T cells coordinate polarization and migration when interacting with dendritic cells (DC) during homeostatic and activating conditions, a low density collagen model was used for confocal live-cell imaging and high-resolution 3D reconstruction of fixed samples. During short-lived (5 to 15 min) and migratory homeostatic interactions, recently activated T cells simultaneously maintained their amoeboid polarization and polarized towards the DC. The resulting fully dynamic and asymmetrical interaction plane comprised all compartments of the migrating T cell: the actin-rich leading edge drove migration but displayed only moderate signaling activity; the mid-zone mediated TCR/MHC induced signals associated with homeostatic proliferation; and the rear uropod mediated predominantly MHC independent signals possibly connected to contact-dependent T cell survival. This “dynamic immunological synapse” with distinct signaling sectors enables moving T cells to serially sample antigen-presenting cells and resident tissue cells and thus to collect information along the way. In contrast to homeostatic contacts, recognition of the cognate antigen led to long-lasting T cell/DC interaction with T cell rounding, disintegration of the uropod, T cell polarization towards the DC, and the formation of a symmetrical contact plane. However, the polarity of the continuously migrating DC remained intact and T cells aggregated within the DC uropod, an interesting cellular compartment potentially involved in T cell activation and regulation of the immune response. Taken together, 3D collagen facilitates high resolution morphological studies of T cell function under realistic, in vivo-like conditions. N2 - Zellpolarität und Migration sind essentielle Voraussetzungen für T Zellaktivierung und homöostase sowie für Rezirkulation, und Effektorfunktionen. Um unter homöostatischen bzw. aktivierenden Bedingungen die Koordi¬nation von Polarisation und Migration von T Lymphozyten, die mit dendritischen Zellen (DC) interagieren, zu untersuchen, wurde ein Kollagenmatrix-Model mit niedriger Kollagendichte für konfokale Zeitraffermikro¬skopie und die hochaufgelöste Rekonstruktion fixierter Proben genutzt. Bei kurzen (5-15 min), migratorischen homöostatischen Kontakten behielten voraktivierte T-Zel¬len ihr amöboide Polarisation bei, während sie sich gleichzeitig Richtung DC polarisierten. Die hieraus resultie¬rende, dynamische und asymmetrische Kontaktflä¬che bestand aus allen Kompartimenten der migrierenden T-Zelle: Der F-Aktin-reiche vordere Zellpol („leading edge“) sorgte für Vor¬schub, hatte aber nur einen geringen Anteil an der Singaltransduktion; im mittleren Bereich („mid-zone“) waren MHC/TCR-abhängige Signale mit homöostatischer Proliferation assozi¬iert; und im als Uropod bezeichneten hintere Zellpol fanden sich vor allem MHC-unabhän¬gige Signale, die möglicherweise im Zusammenhang mit kontaktabhängigem Überleben stehen. Diese „dynamische immuno¬logische Synapse“ mit ihren Signaltransduktionsbereichen versetzt wan¬dernde T-Zellen in die Lage, nacheinander Kontakt zu mehreren antigenpräsen¬tierenden oder gewebsspezifischen Zellen aufzunehmen und so Informationen „im Vorbeigehen“ zu sammeln. Im Gegensatz zu homöostatischen Kontakten führte die Bindung des spezifischen Antigens zu langlebigen T Zellen/DC Kontakten, die mit der Abrundung der T Zelle und der Pola¬risation Richtung DC, der Auflösung ihres Uropods sowie der Ausbildung einer symmetri¬schen Kontaktfläche einher gin¬gen. Die Polarität der währenddessen fortge¬setzt migrierenden DC blieb dem gegenüber erhal¬ten und T-Zellen akkumulierten im DC-Uropod, einem interes¬santen Zellkompartiment, dass an T Zell-aktivierung und der Regu¬lation der Immunantwort beteiligt sein könnte. Zusammenge¬fasst ermöglicht das 3D Kollagenmatrix-Modell die hoch aufgelöste morphologische Untersu¬chung von T-Zell¬funk¬tionen unter realistischen, in vivo-artigen Bedingungen. KW - T-Lymphozyt KW - Dendritische Zelle KW - Zellmigration KW - Immunologische Synapse KW - T-Zellaktivierung KW - T-Zellhomöostase KW - Kollagen KW - T lymphocyte KW - dendritic cell KW - immunological synapse KW - migration Y1 - 2011 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-70114 ER - TY - JOUR A1 - Wobser, Marion A1 - Gaigl, Zeno A1 - Trautmann, Axel T1 - The concept of "compartment allergy": prilocaine injected into different skin layers N2 - We herein present a patient with delayed-type allergic hypersensitivity against prilocaine leading to spreading eczematous dermatitis after subcutaneous injections for local anesthesia with prilocaine. Prilocaine allergy was proven by positive skin testing and subcutaneous provocation, whereas the evaluation of other local anesthetics - among them lidocaine, articaine and mepivacaine - did not exhibit any evidence for cross-reactivity. Interestingly, our patient repeatedly tolerated strictly deep subcutaneous injection of prilocaine in provocation testing while patch and superficial subcutaneous application mounted strong allergic responses. We hypothesize, that lower DC density in deeper cutaneous compartments and/or different DC subsets exhibiting distinct functional immunomodulatory properties in the various layers of the skin may confer to the observed absence of clinical reactivity against prilocaine after deep subcutaneous injection. The term compartment allergy indicates that the route of allergen administration together with the targeted immunologic environment orchestrates on the immunologic outcome: overt T-cell mediated allergy or clinical tolerance. KW - Medizin Y1 - 2011 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-68679 ER - TY - JOUR A1 - Houben, Roland A1 - Hesbacher, Sonja A1 - Schmid, Corinna P. A1 - Kauczok, Claudia S. A1 - Flohr, Ulrike A1 - Haferkamp, Sebastian A1 - Müller, Cornelia S. L. A1 - Schrama, David A1 - Wischhusen, Jörg A1 - Becker, Jürgen C. T1 - High-Level Expression of Wild-Type p53 in Melanoma Cells is Frequently Associated with Inactivity in p53 Reporter Gene Assays N2 - Background: Inactivation of the p53 pathway that controls cell cycle progression, apoptosis and senescence, has been proposed to occur in virtually all human tumors and p53 is the protein most frequently mutated in human cancer. However, the mutational status of p53 in melanoma is still controversial; to clarify this notion we analysed the largest series of melanoma samples reported to date. Methodology/Principal Findings: Immunohistochemical analysis of more than 180 melanoma specimens demonstrated that high levels of p53 are expressed in the vast majority of cases. Subsequent sequencing of the p53 exons 5–8, however, revealed only in one case the presence of a mutation. Nevertheless, by means of two different p53 reporter constructs we demonstrate transcriptional inactivity of wild type p53 in 6 out of 10 melanoma cell lines; the 4 other p53 wild type melanoma cell lines exhibit p53 reporter gene activity, which can be blocked by shRNA knock down of p53. Conclusions/Significance: In melanomas expressing high levels of wild type p53 this tumor suppressor is frequently inactivated at transcriptional level. KW - Krebs KW - Hautkrebs Y1 - 2011 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-69012 ER - TY - JOUR A1 - Baptistella Florence, Michelle Etienne A1 - Massuda, Juliana Yumi A1 - Bröcker, Eva-Bettina A1 - Metze, Konradin A1 - Cintra, Maria Leticia A1 - de Souza, Elemir Macedo T1 - Angiogenesis in the progression of cutaneous squamous cell carcinoma: an immunohistochemical study of endothelial markers JF - CLINICS N2 - OBJECTIVE: To demonstrate the role of angiogenesis in the progression of cutaneous squamous cell carcinoma. INTRODUCTION: Angiogenesis is a pivotal phenomenon in carcinogenesis. Its time course in cutaneous squamous cell carcinoma has not yet been fully established. METHODS: We studied the vascular bed in 29 solar keratoses, 30 superficially invasive squamous cell carcinomas and 30 invasive squamous cell carcinomas. The Chalkley method was used to quantify the microvascular area by comparing panendothelial (CD34) with neoangiogenesis (CD105) immunohistochemical markers. The vascular bed from non-neoplastic adjacent skin was evaluated in 8 solar keratoses, 10 superficially invasive squamous cell carcinomas and 10 invasive squamous cell carcinomas. RESULTS: The microvascular area in CD105-stained specimens significantly increased in parallel with cutaneous squamous cell carcinoma progression. However, no differences between groups were found in CD34 sections. Solar keratosis, superficially invasive squamous cell carcinoma and invasive squamous cell carcinoma samples showed significant increases in microvascular area for both CD34- and CD105-stained specimens compared with the respective adjacent skin. DISCUSSION: The angiogenic switch occurs early in the development of cutaneous squamous cell carcinoma, and the rate of neovascularization is parallel to tumor progression. In contrast to panendothelial markers, CD105 use allows a dynamic evaluation of tumor angiogenesis. CONCLUSION: This study demonstrated the dependence of skin carcinogenesis on angiogenesis. KW - Pathologic neovascularization KW - CD105 antigen KW - human KW - CD34 antigen KW - skin neoplasms KW - keratosis Y1 - 2011 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-133650 VL - 66 IS - 3 ER -