Kjell M Kaune

Klinikum Bremen-Mitte, Bremen, Bremen, Germany

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Publications (30)96.16 Total impact

  • K M Kaune · M Kasperkiewicz · D Tams · M Bergmann · M Zutt ·
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    ABSTRACT: A 87-year-old woman presented with a three-year history of partially erosive, partially bullous skin and mucosal lesions, symblepharon of both eyelids as well as dysphagia. To date, multiple excisions of the skin lesions, which had been described as "skin tumors" by surgeons, had been performed. The synopsis of histology, direct and indirect immunofluorescence established the diagnosis of anti-p200/anti-laminin γ1 pemphigoid and BP180 NC16A/4575- positive mucous membrane pemphigoid with an unusual "epitope-spreading" phenomenon. Due to the late initiation of therapy, the disease-related loss of vision unfortunately was irreversible.
    Der Hautarzt 10/2014; 66(1). DOI:10.1007/s00105-014-3529-1 · 0.56 Impact Factor
  • M Zutt · F Mazur · M Bergmann · A J Lemke · K M Kaune ·
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    ABSTRACT: A 71-year-old man presented with giant basal cell carcinoma on the abdomen which had metastasized. He was treated with oral vismodegib. Both the primary ulcerated tumor on the abdomen and the metastases responded. Vismodegib was well tolerated without significant side effects. The tumor recurred promptly after vismodegib was discontinued, and then was resistant to therapy when vismodegib was re-administered.
    Der Hautarzt 09/2014; 65(11). DOI:10.1007/s00105-014-3503-y · 0.56 Impact Factor
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    ABSTRACT: ZusammenfassungHintergrundInfantile Hämangiome (IH) können zu schwerwiegenden Komplikationen wie Obstruktion, Ulzeration oder Herzinsuffizienz fhren. Daher ist bei bestimmten Problemlokalisationen oder bei ausbleibender Regression eine rechtzeitige und suffiziente Therapie notwendig. Da systemische Therapien wie der β-Blocker Propranolol oder orale Kortikosteroide in seltenen Fällen ernstzunehmende Nebenwirkungen haben können, sind gut wirksame und verträgliche Lokaltherapien als Ergänzung oder Alternative wnschenswert.Patienten und MethodikIm Rahmen einer interdisziplinären retrospektiven Studie wurden 38 Kinder mit insgesamt 77 IH mit dem gepulsten Farbstofflaser (PDL) (595 nm) und Nd:YAG-Laser (1 064 nm) behandelt. Der Therapieerfolg und die Nebenwirkungen wurden sowohl anhand objektiver Parameter wie sonographisch bestimmter Tiefenausdehnung als auch subjektiv von den Eltern der Kinder bewertet.ErgebnisseAlle 77 behandelten IH sprachen auf die Therapie an, wobei 52,8% nach Therapieabschluss abgeheilt waren und 47,2% nur noch eine minimale Restgröfle aufwiesen. Der Behandlungserfolg wurde von den Eltern in 92,6% als sehr gut oder gut bewertet. Als Hauptnebenwirkung trat in 45,9% eine transiente Blasenbildung auf.SchlussfolgerungenDie Kombinationsbehandlung mit PDL und Nd:YAG-Laser ist eine wirksame und nebenwirkungsarme lokale Therapie gegen IH.
    Journal der Deutschen Dermatologischen Gesellschaft 06/2014; 12(6). DOI:10.1111/ddg.12354_suppl · 2.05 Impact Factor
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    ABSTRACT: Background Infantile hemangiomas (IH) can cause severe complications such as obstruction, ulceration or heart failure. Therefore, in certain difficult-to-treat areas, or when there is no sign of involution, early and effective therapy is required. In rare instances, systemic treatments, like the beta-blocker propranolol and oral corticosteroids, can cause serious side effects. Effective and well-tolerated local treatment options are thus desirable as additive or alternative methods.Patients and Methods In this retrospective interdisciplinary study, 38 children with 77 IH were treated with pulsed dye laser (PDL) (595 nm) and Nd:YAG laser (1,064 nm). The treatment success and side effects were evaluated according to objective and subjective parameters, including hemangioma thickness measured by ultrasound and the parents’ evaluation of treatment.ResultsAll 77 treated IH responded to the therapy, of which 52.8 % healed after the end of treatment and 47.2 % had only minimum residual components. The success of treatment was assessed by the parents in 92.6 % as very good or good. Transient blistering occurred as the main side effect in 45.9 %.Conclusions Combination therapy with PDL and Nd:YAG laser represents an effective local method for IH with minimal side effects.
    Journal der Deutschen Dermatologischen Gesellschaft 05/2014; 12(6). DOI:10.1111/ddg.12354 · 2.05 Impact Factor
  • M Zutt · S Ischebeck · K.M. Kaune ·
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    ABSTRACT: A 68-year-old woman presented with an enormous exophytic tumor on her forehead extending to the scalp. After complete resection of the tumor, the resulting defect was closed successfully using a bovine dermal substitute followed by a split-thickness skin graft.
    Der Hautarzt 12/2013; 64(12):923-926. DOI:10.1007/s00105-013-2672-4 · 0.56 Impact Factor
  • M. Zutt · S. Ischebeck · K.M. Kaune ·
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    ABSTRACT: Wir berichten über eine 68-jährige Patientin, die sich mit einem gigantischen, exophytischen Tumor an der Stirn und der behaarten Kopfhaut frontal vorstellte. Nach kompletter Entfernung des Tumors konnte der sehr ausgedehnte Skalpdefekt mit einem bovinen Dermisersatzpräparat und einer anschließenden Spalthauttransplantation erfolgreich verschlossen werden.
    Der Hautarzt 12/2013; 64(12). · 0.56 Impact Factor
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    ABSTRACT: Abstract is missing (Short).
    Acta Dermato-Venereologica 09/2013; 94(3). DOI:10.2340/00015555-1698 · 3.03 Impact Factor
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    ABSTRACT: Background: Concepts of reconstruction of intraoral structures may often include the transfer of flaps composed of external skin with hairs. Given that intraoral hair growth following myocutaneous flaps can cause discomfort, there is a need for effective treatments to relieve cancer patients of these symptoms. Objective: To describe the successful epilation of hairy intraoral flaps using Nd:YAG laser emitting a wavelength of 1,064 nm. Methods: We performed an interdisciplinary prospective clinical study with 9 patients suffering from intraoral hair growth after plastic reconstruction of a hairy donor site due to cancer. Eight male and one female patients were treated with 1-4 sessions of Nd:YAG laser at 5-15-week intervals. Results: Laser treatment resulted in effective hair reduction in 8/9 patients regardless of flap type. In 5/9 patients a hair clearance of >90% could be achieved, whereas laser treatment was ineffective in one male with white hair. Patients were very satisfied with the outcome and no side effects could be observed. Conclusion: Nd:YAG laser therapy appears to be a successful therapeutic option for patients suffering from growth of dark hair in the oral cavity after plastic reconstruction using a hairy donor site.
    Dermatology 07/2013; 226(4). DOI:10.1159/000350685 · 1.57 Impact Factor

  • British Journal of Dermatology 03/2012; 167(4):944-6. DOI:10.1111/j.1365-2133.2012.10966.x · 4.28 Impact Factor
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    ABSTRACT: Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare entity characterized by a CD4+/CD56+/CD123+ immunophenotype and a fatal clinical course. The average survival of 12-14 months may be prolonged by allogeneic bone marrow transplantation (BMT). We report about a male patient who suffered from BPDCN with a typical histology and co-expression of CD4/CD123 and a CD56 expression by 80% of the tumour cells. The cutaneous tumour relapse after chemotherapy and allogeneic BMT was completely negative for CD56. We performed interphase fluorescence in situ hybridization (FISH) analysis of tumour tissue, asserved before and after BMT, using specific probes for chromosome 11, which encompass the CD56 gene region. The tumour cells revealed a partial loss of 11q as well as a monosomy of chromosome 11. This case demonstrates for the first time that loss of CD56 expression can also occur as a secondary event after chemotherapy and BMT. In our case, DNA loss of 11q23 could be responsible for the negativity of 20% of tumour cells as observed before chemotherapy. However, the complete loss of CD56 expression in the relapsed tumour cannot be explained by the loss of 11q23 alone. Additional factors such as chemotherapy-induced mutations might also have contributed.
    Journal of the European Academy of Dermatology and Venereology 10/2011; 25(10):1225-9. DOI:10.1111/j.1468-3083.2010.03922.x · 2.83 Impact Factor
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    ABSTRACT: Sequential digital dermatoscopy identifies dynamic changes in melanocytic lesions. However, no algorithm exists that systematically weights dynamic changes regarding their association with melanoma. We sought to identify relevant dynamic changes and to integrate these into a novel diagnostic algorithm. During follow-up (mean 44.28 months) of 688 patients at high risk, 675 pigmented lesions with prospectively documented dynamic changes were excised. The association between specific changes and melanoma was assessed. We detected 61 melanomas (38 invasive, median thickness 0.42 mm) with dynamic changes. Multivariate logistic regression analyses revealed a significant association between the diagnosis of melanoma and 5 dynamic criteria. According to the observed odds ratios we defined two dynamic major criteria (2 points each: asymmetric-multifocal enlargement and architectural change) and 3 dynamic minor criteria (1 point each: focal increase in pigmentation, focal decrease in pigmentation, and overall decrease in pigmentation when not accompanied by a lighter pigmentation of the adjacent skin). The DynaMel score was generated by addition of dynamic and 7-point checklist scores with a threshold for excision of 3 or more points. Including information about dynamic changes increased the sensitivity of the 7-point checklist from 47.5% (29 of 61 melanomas detected) to 77.1% (47 of 61 melanomas detected). The specificity slightly decreased from 99.0% to 98.1%. Before broad application the DynaMel algorithm needs to be validated using data from a different prospective study. The DynaMel algorithm integrates a scoring system for dynamic dermatoscopic changes into the 7-point checklist for dermatoscopy and thereby increased the sensitivity of melanoma detection.
    Journal of the American Academy of Dermatology 06/2011; 66(1):27-36. DOI:10.1016/j.jaad.2010.09.731 · 4.45 Impact Factor
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    ABSTRACT: The cyclin-dependent kinase inhibitor 2A (CDKN2A) gene on chromosome 9p21 encodes p16 (INK4A), the inhibitor of the CDK4/retinoblastoma (Rb) cell proliferation pathway, as well as p14 (ARF), which controls p53-dependent pathways. Inactivation of p16 has previously been associated with the prognostically unfavourable primary cutaneous diffuse large B-cell lymphoma, leg type (PCLBCL, LT). In this work, we analysed 22 tumors [nine primary cutaneous follicle centre lymphomas (PCFCL), seven primary cutaneous marginal zone lymphomas (PCMZL) and six PCLBCL, LT] not only for alterations of the p16 gene but also for p14, p53 and Rb by fluorescence in situ hybridization (FISH) and immunohistochemistry. In most PCLBCL, LT (4/6) alterations of CDKN2A (two biallelic deletions, one monoallelic deletion and one trisomy 9) and in addition the highest frequency of deletions of p53 (3/6) and Rb (3/6) were detected. p16 was not expressed but very high levels of phosphorylated Rb, indicating a functional effect of genomic CDKN2A alterations on the protein level in PCLBCL, LT. Regarding the p14/p53 axis, PCLBCL, LT showed a variable expression. Neither PCFCL nor PCMZL showed alterations of CDKN2A and also deletions of p53 or Rb were extremely rare in these subtypes. Exclusively in PCMZL, p53 protein was consistently lacking. In conclusion, only PCLBCL, LT is characterized by a high frequency of aberrations of the CDKN2A network components in both important tumor suppressor pathways regulated by the CDKN2A gene. Moreover, PCLBCL, LT appears to be distinguishable from PCMZL not only by its level of p53 expression but also by its stage of Rb phosphorylation. The latter may also apply to a subgroup of PCFCL.
    Experimental Dermatology 04/2011; 20(4):331-5. DOI:10.1111/j.1600-0625.2010.01226.x · 3.76 Impact Factor
  • Angela Goppold · Kjell M Kaune · Timo Buhl · Michael P Schön · Markus Zutt ·

    European journal of dermatology: EJD 03/2011; 21(2):262-3. DOI:10.1684/ejd.2010.1230 · 1.99 Impact Factor

  • The Journal of allergy and clinical immunology 01/2011; 127(1):284-5. DOI:10.1016/j.jaci.2010.10.044 · 11.48 Impact Factor
  • Kjell M Kaune · Ellen Haas · Timo Buhl · Michael P Schön · Markus Zutt ·

    European journal of dermatology: EJD 07/2010; 20(4):510-1. DOI:10.1684/ejd.2010.0956 · 1.99 Impact Factor
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    ABSTRACT: The retrospectively developed 7-point checklist is one of the most applicable dermatoscopic algorithms for clinical use. However, until today no prospective data on the diagnostic performance of this algorithm were reported. Our aim was to assess the sensitivity, specificity, and diagnostic accuracy of the 7-point checklist in the setting of a prospective long-term study. Patients at increased melanoma risk (n = 688) were screened at regular intervals by naked-eye examination, the dermatoscopic 7-point checklist, and digital dermatoscopy follow-up (10-year study interval). We detected 127 melanomas including 50 melanomas in situ. The mean Breslow thickness of invasive melanomas was 0.57 mm. A total of 79 melanomas displayed the 7-point checklist melanoma threshold of 3 or more points (62% sensitivity, compared with 78%-95% in retrospective settings). In all, 48 melanomas scored fewer than 3 points and were excised because of complementary information (eg, lesional history, dynamic changes detected by digital dermatoscopy). The specificity of the 7-point checklist was 97% (compared with 65%-87% in retrospective settings). Regression patterns, atypical vascular patterns, and radial streaming were associated with the highest relative risk for melanoma (odds ratio 3.26, 95% confidence interval 2.05-5.16; odds ratio 3.04, 95% confidence interval 1.70-5.46; odds ratio 2.91, 95% confidence interval 1.64-5.15; P < .0003, respectively). Melanomas thicker than 0.5 mm exhibited significantly more regression patterns and atypical vascular patterns (P < .02). The malignant versus benign ratio for all excised lesions was 1:8.6 (127 melanomas, 1092 nonmelanomas). Calculation of the specificity was a limitation. True negative lesions were defined by a score less than 3 points and either the histopathological diagnosis of nonmelanoma or the absence of dynamic changes during digital dermatoscopy follow-up (nonexcised, nonsuspicious, no change). The 7-point checklist for dermatoscopy was less sensitive but highly specific in this prospective clinical setting. Complementary information clearly increased the sensitivity. Regression patterns or radial streaming in nevi of patients at high risk should raise a higher melanoma suspicion than might be concluded from retrospective studies.
    Journal of the American Academy of Dermatology 03/2010; 62(5):785-93. DOI:10.1016/j.jaad.2009.08.049 · 4.45 Impact Factor
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    ABSTRACT: To identify patients at increased melanoma risk who benefit from long-term surveillance with digital dermoscopy. Prospective, nonrandomized, observational study. University-based surveillance program. Six hundred eighty-eight patients prospectively categorized into defined melanoma risk groups and followed up (mean, 44.3 months) by clinical examinations, dermoscopy, and, for atypical nevi, sequential digital dermoscopy. Association between patient risk factors and detection of melanomas. Odds ratios from a multivariate logistic regression analysis indicated a highly increased melanoma risk for patients with familial atypical mole and multiple melanoma (FAMMM) syndrome, atypical mole syndrome (AMS), or previous melanoma. Each digitally documented atypical lesion (range, 1-17 lesions per patient) denoted a significant 10% increase in melanoma risk. Patients with higher melanoma risk (1) showed a higher percentage of melanomas detected by digital dermoscopy (FAMMM syndrome group, 50%; AMS group, 22%), (2) more often developed multiple melanomas within shorter intervals, and (3) showed a ratio of melanoma to benign results for lesions excised because of dynamic changes of 1:15 (AMS group) or 1:4 (FAMMM syndrome group). Melanomas detected by digital dermoscopy were significantly thinner (0.41 mm in mean Breslow thickness) compared with melanomas detected by other means (0.62 mm; P = .04). We suggest an individualized surveillance plan, with digital dermoscopy performed at follow-up intervals of 3 months for patients with FAMMM syndrome and 6 to 12 months (depending on additional risk factors) for those with AMS. Patients with multiple common nevi and no additional risk factors had no benefit from sequential digital dermoscopy.
    Archives of dermatology 03/2010; 146(3):257-64. DOI:10.1001/archdermatol.2009.370 · 4.79 Impact Factor
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    ABSTRACT: Mycosis fungoides is the most common subtype of mature T-cell lymphoma that primarily arises in the skin. The tumor manifests as patches, plaques, tumors, or erythroderma and can secondarily involve lymph nodes, peripheral blood, and visceral organs. In advanced tumor stage, chemotherapy is a second-line approach, which is generally not considered curative. Initially, most patients profit from this treatment, but observed remissions usually do not exceed several months. Because of possible immunosuppressive effects in vulnerable patients, the overall benefit of chemotherapy itself is not unequivocal in cutaneous T-cell lymphoma. We report 3 patients whose tumor-stage mycosis fungoides was not sufficiently controlled by several preceding systemic therapies, including liposome-encapsulated doxorubicin. All patients experienced excellent improvement with 250 mg/m2 gemcitabine weekly, a low-dose regimen that is predicted to be less toxic compared with standard-dose gemcitabine.
    Clinical Lymphoma & Myeloma 10/2009; 9(5):E21-4. DOI:10.3816/CLM.2009.n.079 · 1.13 Impact Factor
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    Archives of dermatology 09/2009; 145(8):955-8. DOI:10.1001/archdermatol.2009.166 · 4.79 Impact Factor
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    ABSTRACT: Blastic plasmacytoid dendritic cell (BPDC) neoplasm, formerly called blastic natural killer cell lymphoma or CD4+/CD56+ hematodermic neoplasm, is a rare tumor entity, now regarded to be derived from the plasmacytoid dendritic cell (PDC) lineage. Because over 90% of patients present with skin lesions usually early in their disease, dermatologists have to be familiar with the specific diagnostic features and the clinical course of this devastating disease. We present a woman with a long standing solitary skin tumor of BPDC neoplasm, who experienced a deleterious clinical course, which is typical for this disease. Phenotypic and karyotypic characteristics distinguishing this tumor from myelomonocytic leukemia with skin involvement are presented.
    The American Journal of dermatopathology 09/2009; 31(7):695-701. DOI:10.1097/DAD.0b013e3181a5e13d · 1.39 Impact Factor

Publication Stats

256 Citations
96.16 Total Impact Points


  • 2013-2014
    • Klinikum Bremen-Mitte
      Bremen, Bremen, Germany
  • 2008-2014
    • Universitätsmedizin Göttingen
      • Department of Dermatology, Venereology and Allergology
      Göttingen, Lower Saxony, Germany
  • 2007-2013
    • Georg-August-Universität Göttingen
      Göttingen, Lower Saxony, Germany
  • 2004
    • University of Florence
      Florens, Tuscany, Italy