W Aberer

Ludwig-Maximilian-University of Munich, München, Bavaria, Germany

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Publications (223)853.55 Total impact

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    ABSTRACT: ZusammenfassungIn Deutschland sind über 2,5 Millionen Arbeitnehmer aufgrund ihrer beruflichen Tätigkeit als Outdoor-Worker im besonderen Maße gegenüber natürlicher UV-Strahlung exponiert. Der Ärztliche Sachverständigenbeirat „Berufskrankheiten“ beim Bundesministerium für Arbeit und Soziales hat den Zusammenhang zwischen beruflicher UV-Strahlung und Hautkrebs geprüft und empfohlen, in die Anlage1 zur Berufskrankheiten-Verordnung folgende neue Berufskrankheit aufzunehmen: „Plattenepithelkarzinome oder multiple aktinische Keratosen der Haut durch natürliche UV-Strahlung“.Es wird aus Sicht der Arbeitsgemeinschaft für Berufs- und Umweltdermatologie (ABD) in der Deutschen Dermatologischen Gesellschaft (DDG) und der Deutschen Gesetzlichen Unfallversicherung (DGUV) dargestellt, welche Voraussetzungen für eine Meldung und Anerkennung einer beruflichen Hautkrebserkrankung durch natürliche UV-Strahlung erfüllt sein müssen.
    Journal der Deutschen Dermatologischen Gesellschaft 12/2014; 12(12). · 1.40 Impact Factor
  • 12/2014; 12(12):1102-6.
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    ABSTRACT: In Germany over 2.5 million employees have an increased risk of skin cancer due to their occupational exposure to natural UV-irradiation. The medical consultation board “Occupational diseases” of the Ministry of Labor and Social affairs has investigated the association between occupational UV-irradiation and skin cancer risk and recommends to add the following new occupational disease into the appendix1 of the German ordinance on occupational diseases: “Squamous cell carcinoma and multiple actinic keratosis due to natural UV-irradiation”.In this article we report in the view of the German Society of Occupational and Environmental Dermatology (ABD) and the German Statutory accident insurance (DGUV), whose criteria have to be fulfilled for the notification and recognition of an occupational skin cancer due to natural UV-irradiation.
    Journal der Deutschen Dermatologischen Gesellschaft 12/2014; 12(12). · 1.40 Impact Factor
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  • The Journal of allergy and clinical immunology. 05/2014;
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    ABSTRACT: ZusammenfassungHintergrundQualitätssicherung ist Aufgabe der Ärzteschaft, aber auch der gesetzlichen Unfallversicherung (GUV). Daten zur Qualität der Interaktion zwischen berufsdermatologisch tätigen Ärzten und Unfallversicherungsträgern stehen nur begrenzt zur Verfügung.Material und MethodikBei 854 Mitgliedern der Arbeitsgemeinschaft für Berufs- und Umweltdermatologie in Deutschland wurde im Oktober 2013 eine Online-Umfrage durchgeführt. Erfasst wurden demographische Daten, die Beurteilung der Zusammenarbeit mit den Trägern der GUV, eine betriebswirtschaftliche Beurteilung der Vergütung berufsdermatologischer Leistungen sowie prioritär zu optimierende Fragestellung(en) in der Zusammenarbeit.ErgebnisseDie Beteiligung an der Umfrage lag bei 182 Teilnehmern (21,3 % der Befragten). Die Zusammenarbeit mit den Unfallversicherungsträgern beurteilten 10,8 % als „sehr gut“, 56,7 % als „gut“, 24,2 % als „befriedigend“, 7,0 % als „ausreichend“ und nur 1,3 % als „mangelhaft“. 93,4 % äußerten sich zu Problemen bzw. Verbesserungspotenzial in der Zusammenarbeit Ihrer Praxis/Klinik mit der GUV. An vorderer Stelle stehen Abrechnungsfragen (44,7 %), gefolgt von Eingriffen in die Behandlungsfreiheit (36,5 %) und dem Behandlungsauftrag im Hautarztverfahren (29,4 %).SchlussfolgerungenOptimierungspotenziale für die Zusammenarbeit zwischen berufsdermatologisch tätigen Ärzten und GUV bestehen in der Vergütung der dermatologischen Leistungen bezüglich der „sprechenden Medizin“, in der Ermöglichung leitliniengerechter Diagnostik und Therapie und in zeitnaher Erteilung von Behandlungsaufträgen im Hautarztverfahren zur Nutzung des therapeutischen Fensters in der Prävention von Berufsdermatosen.SummaryBackground Quality assurance is a task of the medical profession, but it is also a duty of the occupational health insurance (OHI). Data on the interaction quality between physicians practicing occupational dermatology and the OHI are limited.Material and Methods An online survey was performed in 854 German members of the Working Group on Occupational and Environmental Dermatology in October 2013. Items included demographic data, a judgment on the cooperation between the dermatologists and OHI companies, an economic grading of the current compensation scheme, and priorization of optimization tasks.Results182 members (21.3 % of the invited population) participated in the survey. The cooperation with the OHI companies was judged as ìvery goodî by 10.8 %, as ìgoodî by 56.7 %, as ìsatisfactoryî by 24.2 %, as ìsufficientî by 7.0 % and as ìinsufficientî by 1.3 %. 93.4 % of the interviewed mentioned problems and improvement potentials in the cooperation of their practice or clinic with OHI companies. Main points of criticisms were reimbursement (44.7 %), followed by impairments of the treatment options (36.5 %) and the delay or scope of the treatment in the dermatologist's procedure (29.4 %).Conclusions While most physicians practicing occupational dermatology give a positive judgment of their cooperation with OHI companies, quality optimization potentials exist regarding the reimbursement of dermatological services, especially regarding time-intensive counselling in the prevention of occupational skin diseases, in the enablement of diagnostic and therapeutic procedures according to current guidelines and in a timely preventive intervention to use the therapeutic window before chronification of skin diseases may occur.
    Journal der Deutschen Dermatologischen Gesellschaft 05/2014; 12(5). · 1.40 Impact Factor
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    W. Aberer
    Allergy 05/2014; 69(5). · 5.88 Impact Factor
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    ABSTRACT: Background Quality assurance is a task of the medical profession, but it is also a duty of the occupational health insurance (OHI). Data on the interaction quality between physicians practicing occupational dermatology and the OHI are limited.Material and Methods An online survey was performed in 854 German members of the Working Group on Occupational and Environmental Dermatology in October 2013. Items included demographic data, a judgment on the cooperation between the dermatologists and OHI companies, an economic grading of the current compensation scheme, and prioritization of optimization tasks.Results182 members (21.3 % of the invited population) participated in the survey. The cooperation with the OHI companies was judged as “very good” by 10.8 %, as “good” by 56.7 %, as “satisfactory” by 24.2 %, as “sufficient” by 7.0 % and as “inadequate” by 1.3 %. 93.4 % of the interviewed mentioned problems and improvement potentials in the cooperation of their practice or clinic with OHI companies. Main points of criticisms were reimbursement (44.7 %), followed by impairments of the treatment options (36.5 %) and the delay or scope of the treatment in the dermatologist's procedure (29.4 %).Conclusions While most physicians practicing occupational dermatology give a positive judgment of their cooperation with OHI companies, quality optimization potentials exist regarding the reimbursement of dermatological services, especially regarding time-intensive counselling in the prevention of occupational skin diseases, in the enablement of diagnostic and therapeutic procedures according to current guidelines and in a timely preventive intervention to use the therapeutic window before chronification of skin diseases may occur.
    Journal der Deutschen Dermatologischen Gesellschaft 05/2014; 12(5). · 1.40 Impact Factor
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    ABSTRACT: This guideline is the result of a systematic literature review using the 'Grading of Recommendations Assessment, Development and Evaluation' (GRADE) methodology and a structured consensus conference held on 28 and 29 November 2012, in Berlin. It is a joint initiative of the Dermatology Section of the European Academy of Allergy and Clinical Immunology (EAACI), the EU-funded network of excellence, the Global Allergy and Asthma European Network (GA(2) LEN), the European Dermatology Forum (EDF), and the World Allergy Organization (WAO) with the participation of delegates of 21 national and international societies. Urticaria is a frequent, mast cell-driven disease, presenting with wheals, angioedema, or both. The life-time prevalence for acute urticaria is approximately 20%. Chronic spontaneous urticaria and other chronic forms of urticaria do not only cause a decrease in quality of life, but also affect performance at work and school and, as such, are members of the group of severe allergic diseases. This guideline covers the definition and classification of urticaria, taking into account the recent progress in identifying its causes, eliciting factors and pathomechanisms. In addition, it outlines evidence-based diagnostic and therapeutic approaches for the different subtypes of urticaria. This guideline was acknowledged and accepted by the European Union of Medical Specialists (UEMS).
    Allergy 04/2014; · 5.88 Impact Factor
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    ABSTRACT: Angioedema is defined as localized and self-limiting edema of the subcutaneous and submucosal tissue, due to a temporary increase in vascular permeability caused by the release of vasoactive mediator(s). When angioedema recurs without significant wheals, the patient should be diagnosed to have angioedema as a distinct disease. In the absence of accepted classification, different types of angioedema are not uniquely identified. For this reason, the European Academy of Allergy and Clinical Immunology gave its patronage to a consensus conference aimed at classifying angioedema. Four types of acquired and three types of hereditary angioedema were identified as separate forms from the analysis of the literature and were presented in detail at the meeting. Here, we summarize the analysis of the data and the resulting classification of angioedema.
    Allergy 03/2014; · 5.88 Impact Factor
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    ABSTRACT: Elevated serum tryptase levels can be a sign of mastocytosis, which is a rare disease associated with systemic and/or skin manifestations. To investigate patients with elevated tryptase levels in regard to their underlying diseases, and to determine whether increased tryptase can be used as a diagnostic marker for underlying mastocytosis. In a retrospective study the data of 96 patients with serum tryptase levels higher than 15 μg/L were systematically analysed. In 48 patients control investigations for baseline tryptase were performed. Fifty-three of the 96 patients had tryptase levels ≥20 μg/L. A mere 16% of the 96 patients suffered from mastocytosis and had the highest tryptase levels (P < 0.001). The remaining patients had anaphylaxis (36%), urticaria and angioedema (26%), local reactions to insect bites (4%), drug reactions (3%), or miscellaneous diagnoses (15%). Only 16 of these had acute symptoms at tryptase investigation. In all, 48 patients had a follow up; in 7/48 patients with acute symptoms normal tryptase levels were seen at control investigations, but 41/48 (85%) patients showed continuously elevated tryptase levels >15 μg/L and in 30 patients (62%) even values >20 μg/L; 11 of these patients had anaphylaxis, five urticaria, five other diagnoses and nine patients mastocytosis. More than 50% of patients with non-mastocytosis such as urticaria and angioedema, drug or anaphylactic reactions repeatedly had tryptase levels higher than 20 μg/L. Since baseline tryptase >20 μg/L is a minor criterion for mastocytosis, these patients should be inspected for skin lesions of mastocytosis and receive a diagnostic body work-up for systemic mastocytosis including a bone marrow biopsy.
    Australasian Journal of Dermatology 02/2014; · 0.97 Impact Factor
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    ABSTRACT: A 40-year-old man developed anaphylactic shock during surgical replacement of a prolapsed mitral valve during general anaesthesia and an attenuated reaction (Grade 2), three days later during a blood transfusion. Human serum albumin, a component of the fibrinogen concentrate used postoperatively with the erythrocyte concentrate, was identified as the trigger, confirmed by positive skin prick and intradermal tests. Any anaphylaxis during the peri-operative period should cause the clinician to perform allergy tests for identification of the culprit drug and, sometimes, culprit additive. Testing of human serum albumin, acting as hidden allergen, should be included, especially where there has been a blood transfusion.
    Anaesthesia 02/2014; 69(2):176-8. · 3.49 Impact Factor
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    ABSTRACT: Background: Anaphylaxis is the most severe manifestation of a mast cell–dependent immediate reaction and may be fatal. According to data from the Berlin region, its inci-dence is 2–3 cases per 100 000 persons per year.
    Deutsches Ärzteblatt International 01/2014; · 3.54 Impact Factor
  • Journal of the American Academy of Dermatology 01/2014; 70(1):e3-4. · 4.91 Impact Factor
  • Allergologie 01/2014; 37(08):309-324. · 0.34 Impact Factor
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    ABSTRACT: Sensitization to Hymenoptera venom without systemic sting reactions (SSRs) is commonly observed in the general population. Clinical relevance for a future sting has not yet been investigated. We aimed to evaluate the effect of these debatable sensitizations with deliberate sting challenges and to monitor serologic changes for up to 2 years. One hundred thirty-one challenges with bees and wasps were performed in 94 subjects with a hitherto irrelevant sensitization. The clinical outcome was recorded, and results of specific IgE (sIgE) determinations, skin tests, and basophil activation tests were correlated to the sting reaction. sIgE levels were monitored in reactors and nonreactors after 3 hours, 1 week, 4 weeks, and 1 year. Only 5 (5.3%) patients had SSRs, but 41 (43.6%) had large local reactions (LLRs) after the sting. Compared with the general population, there was a 9.5-fold higher risk for LLRs but not for SSRs. Three hours after the sting, sIgE levels slightly decreased, but none of the 94 subjects' results turned negative. After 1 week, sIgE levels already increased, increasing up to 3.5-fold (range, 0.2- to 34.0-fold) baseline levels after 4 weeks. To assess the clinical relevance of this increase, we randomly selected 18 patients for a re-sting. Again, 50% had an LLR, but none had an SSR. Although sensitization to Hymenoptera venoms was common, the risk of SSRs in sensitized subjects was low in our study. The sIgE level increase after the sting was not an indicator for conversion into symptomatic sensitization. Currently available tests were not able to distinguish between asymptomatic sensitization, LLRs, and SSRs.
    The Journal of allergy and clinical immunology 12/2013; · 12.05 Impact Factor
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    ABSTRACT: Toxocarosis is a parasitic infection caused by Toxocara canis or Toxocara cati. Their definite hosts are the domestic dog and cat, where their adult forms live within the lumen of the small intestine. In humans, infective larvae hatch after ingestion of eggs, but the juvenile stages fail to develop into mature adult worms. Instead, they migrate through the body with the potential to affect virtually every body site. DRESS syndrome (drug reaction with eosinophilia and systemic symptoms) is a serious cutaneous drug reaction, which also involves other organ systems.We report on a 45-year-old man who was admitted with fever up to 40 °C, skin rash and pruritus not responding to amoxicillin/clavulanic acid. Laboratory results showed a slightly elevated white blood cell count, with 62 % eosinophils. History revealed contact to roaming cats. Travel history was unremarkable. Extensive diagnostic workup was performed, and the patient was finally diagnosed with DRESS syndrome, responded to systemic corticosteroid therapy and was discharged. Serology for Toxocara came back positive a few days later. Stool was again sent for microscopy and was found positive for Giardia lamblia, which was treated with a 5-day course of metronidazole. The patient had again developed rash and eosinophilia (62 %). Total immunoglobulin (Ig)E was 1,689 U/l (normal limit: < 100 689 U/l). Follow-up serology showed a marked increase of Toxocara TES ELISA IgG (70 U, normal limit: < 20 U), confirming toxocarosis. Antiparasitic treatment with albendazole 400 mg bid for 5 days was initiated; eosinophilia resolved; and the patient had no further complaints.Although generalized exanthema due to Toxocara has not yet been described in literature, toxocarosis is known to cause a wide spectrum of cutaneous manifestations. Whether our patient had both, a drug reaction with eosinophilia and systemic symptoms and a parasitic infection, or whether a hypersensitivity reaction to Toxocara antigen was mimicking a DRESS syndrome remains unclear.
    Wiener klinische Wochenschrift 11/2013; · 0.81 Impact Factor
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    ABSTRACT: Historically, treatment for hereditary angioedema (HAE) attacks has been administered by healthcare professionals (HCPs). Patient self-administration could reduce delays between symptom onset and treatment, and attack burden. The primary objective was to assess the safety of self-administered icatibant in patients with HAE type I or II. Secondary objectives included patient convenience and clinical efficacy of self-administration. In this phase IIIb, open-label, multicenter study, adult patients were trained to self-administer a single 30-mg icatibant subcutaneous injection to treat their next attack. Icatibant-naïve patients were treated by an HCP prior to self-administration. Evaluations included adverse event (AE) reporting, a validated questionnaire for convenience, and visual analog scale for efficacy. A total of 151 patients were enrolled; 104 had an attack requiring treatment during the study, and 97 patients (19 naïve) were included in the self-administration cohort. Recurrence or worsening of HAE symptoms (22 of 97) was the most commonly reported AE; rescue medications including icatibant (N = 3) and C1-inhibitor concentrate (N = 6) were used in 13 cases. Overall, 89 of 97 patients used a single injection of icatibant. No serious AEs or hospitalizations were reported. Most patients (91.7%) found self-administration preferable to administration in the clinic. The median time to symptom relief (3.8 h) was comparable with results from controlled trials of icatibant. With appropriate training, patients were successfully able to recognize HAE attacks and decide when to self-administer icatibant. This, coupled with the patient-reported high degree of satisfaction, convenience and ease of use supports the adoption of icatibant self-administration in clinical practice.
    Allergy 11/2013; · 5.88 Impact Factor
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    ABSTRACT: New diagnostic tools such as the basophil activation test (BAT) and component-resolved diagnosis (CRD) are promising for hymenoptera venom or food allergy. A clear benefit for inhalant allergens has not yet been shown. Our aim was to compare new and established tests for grass pollen allergy. Forty-nine patients with grass pollen allergy and 47 controls were prospectively enrolled in the study. A symptom score was calculated for each patient. Conjunctival provocation tests (CPT), skin prick tests (SPT), BAT, and sIgE determination including CRD were performed. Sensitivity and specificity were compared and results were correlated with the symptom score. Single determination of sIgE to rPhl p 1 showed the best balance between sensitivity (98%) and specificity (92%). Use of additional components, such as rPhl p 2 and 5, did not increase sensitivity. Generally, sensitivity of tests was high: SPT 100%, ISAC-112 100%, sIgE to timothy grass 98%, BAT 98%, ISAC-103 84%, and CPT 83%. Specificity ranged from 79% (SPT) to 96% (CPT). All test results and calculated values (e.g. ratio sIgE/tIgE) did not correlate with symptom severity. Asymptomatic sensitization to timothy grass in controls was rare in the CAP (11%) and predominantly due to Phl p 1 sensitization. rPhl p 1 was sufficient to diagnose grass pollen allergy, and sIgE patterns were the same in symptomatically and asymptomatically sensitized subjects. The testing of multiple components was of minor importance, and no test correlated with symptom severity.
    Allergy 10/2013; · 5.88 Impact Factor

Publication Stats

3k Citations
853.55 Total Impact Points

Institutions

  • 2009–2013
    • Ludwig-Maximilian-University of Munich
      • Department of Dermatology and Allergology
      München, Bavaria, Germany
  • 1998–2013
    • Medical University of Graz
      • • Institute of Experimental and Clinical Pharmacology
      • • Universitätsklinik für Dermatologie und Venerologie
      Gratz, Styria, Austria
  • 1995–2013
    • Karl-Franzens-Universität Graz
      Gratz, Styria, Austria
  • 2012
    • Brighton and Sussex University Hospitals NHS Trust
      Brighton, England, United Kingdom
    • Paracelsus Medical University Salzburg
      Salzburg, Salzburg, Austria
    • King's College London
      Londinium, England, United Kingdom
  • 2005–2012
    • Friedrich-Alexander Universität Erlangen-Nürnberg
      Erlangen, Bavaria, Germany
    • Universitätsmedizin Göttingen
      Göttingen, Lower Saxony, Germany
    • Centre Hospitalier Universitaire de Nancy
      Nancy, Lorraine, France
  • 2011
    • George Washington University
      Washington, Washington, D.C., United States
  • 2007
    • Christian-Albrechts-Universität zu Kiel
      • Universitäts-Hautklinik Kiel
      Kiel, Schleswig-Holstein, Germany
    • Charité Universitätsmedizin Berlin
      • Department of Dermatology, Venerology and Allergology
      Berlin, Land Berlin, Germany
  • 2004
    • Bundesinstitut für Risikobewertung
      Berlín, Berlin, Germany
    • University Medical Center Schleswig-Holstein
      Kiel, Schleswig-Holstein, Germany
    • Landeskrankenhaus Graz
      Gratz, Styria, Austria
  • 2003
    • Universität Witten/Herdecke
      • Chair of Dermatology
      Witten, North Rhine-Westphalia, Germany
    • Hospital Regional Universitario Carlos Haya Málaga
      • Departamento de Medicina Interna
      Málaga, Andalusia, Spain
  • 2001
    • University of Innsbruck
      Innsbruck, Tyrol, Austria