S Roos

Klinikum Hanau GmbH, Hanau, Hesse, Germany

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Publications (14)22.4 Total impact

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    ABSTRACT: Prurigo nodularis (PN) is a chronic inflammatory skin disease with nodular itching lesions. UV therapy--both PUVA and NUVB--are known to clear up PN temporarily due to the antipruritic effect of UV light. However, relapse after treatment is common in PN, which means that either long-term therapy is necessary or the treatment protocols have to be optimized to minimize side-effects. The aim of this study was to evaluate the effect that combining bath PUVA and targeted UVB 308 nm excimer radiation has on recalcitrant nodular prurigo. In a prospective trial, 22 patients with PN were treated with either PUVA alone or with a combination of PUVA and excimer UVB. The end point was complete or almost complete remission of PN. Adding a 308-nm excimer UVB to the treatment of the pruritic nodules sped up the healing process; 30% less PUVA radiation was needed. The combination of PUVA and excimer UVB in PN appears to be very efficacious. Reducing psoralen UVA doses by 30% offered long-term benefits in phototherapy of chronic recalcitrant diseases like PN.
    Journal of the European Academy of Dermatology and Venereology 10/2010; 25(7):799-803. · 2.69 Impact Factor
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    ABSTRACT: Artificial balneophototherapy is an imitation of the natural balneophototherapy (Dead Sea climatotherapy; DSC) using highly concentrated salt solutions (25%) and UVB radiation. In 2008 the artificial balneophototherapy was included in the German healthcare system as an effective, evidence-based therapy for patients with moderate-severe psoriasis. In contrast, natural DSC is still considered a "non-standard and off-label therapy". Therefore we analyzed all studies published in the past two decades on both artificial and natural balneophototherapy comparing them in effectiveness, length of remission and practicability. Evidence-based studies on DSC showed good clinical results and long remission periods in psoriatic patients; the two methods seem comparable in effectiveness. Patients with chronic, therapy-resistant psoriasis should have access to DSC if they fail routine measures.
    Der Hautarzt 08/2010; 61(8):683-90. · 0.50 Impact Factor
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    ABSTRACT: Die Balneophototherapie mit Starksole [künstliche Photosoletherapie (kPST)] ist in Deutschland als effektive, evidenzbasierte Therapie anerkannt und seit dem 01.07.2008 in den Leistungskatalog der gesetzlichen Krankenkassen aufgenommen worden. Die Behandlung mit natürlicher Photosoletherapie am Toten Meer (nPST) hingegen gilt weiterhin nicht als Standardmethode und wird den Patienten häufig nur mit großem Aufwand bewilligt. Ziel vorliegender Arbeit war es, erstmals für diese beiden Formen der Photosoletherapie die Studienlage auf therapeutische Wirksamkeit, Remissionszeiten und Praktikabilität zu vergleichen. Es zeigt sich, dass inzwischen auch gute evidenzbasierte Studienergebnisse für die Effektivität der natürlichen Photosoletherapie vorliegen und beide Therapieformen vergleichbar sind. Dem Patient mit schwerer, therapieresistenter Psoriasis sollte es nach Ausschöpfung der Therapiemöglichkeiten im Inland leichter möglich sein, eine entsprechende Therapie am Toten Meer zu erlangen. Artificial balneophototherapy is an imitation of the natural balneophototherapy (Dead Sea climatotherapy; DSC) using highly concentrated salt solutions (25%) and UVB radiation. In 2008 the artificial balneophototherapy was included in the German healthcare system as an effective, evidence-based therapy for patients with moderate-severe psoriasis. In contrast, natural DSC is still considered a “non-standard and off-label therapy”. Therefore we analyzed all studies published in the past two decades on both artificial and natural balneophototherapy comparing them in effectiveness, length of remission and practicability. Evidence-based studies on DSC showed good clinical results and long remission periods in psoriatic patients; the two methods seem comparable in effectiveness. Patients with chronic, therapy-resistant psoriasis should have access to DSC if they fail routine measures. SchlüsselwörterBalneophototherapie-Naturklimatherapie-Photosoletherapie-Psoriasis-Totes Meer KeywordsBalneophototherapy-Climatotherapy-Psoriasis-Dead Sea
    Der Hautarzt 01/2010; 61(8):683-690. · 0.50 Impact Factor
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    ABSTRACT: Darier disease is often associated with pruritus and an unpleasant odor, causing medical and emotional problems. Ablative laser therapy has proven effective in ameliorating these symptoms. Side effects of this approach include permanent hypopigmentation and a risk of scarring. We present two cases where non-ablative therapy with pulsed dye lasers proved a safe and effective way to manage the intertriginous lesions. Although the mechanism of action is unclear, our success indicates that pulsed dye laser therapy is an option in Darier disease. Larger numbers of patients, ideally in multicenter studies, must be treated in this way to confirm our results.
    Der Hautarzt 05/2009; 60(12):995-8. · 0.50 Impact Factor
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    ABSTRACT: The authors have indicated no significant interest with commercial supporters.
    Dermatologic Surgery 05/2009; 35(7):1139-40. · 1.87 Impact Factor
  • Archives of dermatology 09/2008; 144(8):1073-5. · 4.76 Impact Factor
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    ABSTRACT: Pulsed dye (PDL) 595- and 1,064-nm Nd:YAG lasers are used for the treatment of vascular lesions. PDL-heated blood exhibits increased absorption of radiation at 1,064 nm, suggesting that the use of combined sequential dual wavelengths may offer benefits over single-wavelength treatments. This study compares the treatment efficacy of combined sequential dual-wavelength versus single delivery of 595-nm PDL or 1,064-nm Nd:YAG wavelengths in facial telangiectasia in a split face study design using subpurpuric parameters. Twenty patients were studied using the sequential delivery of PDL and Nd:YAG wavelengths on one side of the nose. The other side received either PDL or Nd:YAG treatment. Vessels (<0.6 mm in diameter) were treated with a 7-mm spot size at 10 J/cm(2), 10 ms with the PDL, followed by the Nd:YAG at 70 J/cm(2), 15 ms with a multiplex interpulse delay of 100 ms. Subjects received a single treatment, and results were evaluated after 4-week follow-up. Improvement was determined by blinded assessment of photographs taken before and after final evaluation. The efficacy of the dual-wavelength laser treatment when compared to Nd:YAG or PDL laser alone was significantly more evident than either single-wavelength treatment (p<.05). There was no statistically significant difference in efficacy between the single-wavelength treatment groups. The sequential delivery of 595- and 1,064-nm-wavelength radiation with an interpulse delay suggests that the synergistic approach to laser therapy for facial telangiectasia is a superior method compared to standard single wavelength therapy.
    Dermatologic Surgery 06/2008; 34(5):702-8. · 1.87 Impact Factor
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    ABSTRACT: Tattooing has been around since the early beginnings of modern civilization. The discovery of selective photothermolysis at last has made it possible to remove tattoos without leaving a scar. Q-switched neodymium: yttrium-aluminum-garnet, alexandrite, and ruby lasers with pulse durations in the nanosecond domain fulfill this need. Argon or cw-CO(2) lasers as well as intense pulsed light sources should not be used since they often produce significant scarring. This article provides an overview of current laser systems. Developments leading to new tattoo inks, feedback systems to detect the absorbance characteristics of tattoo inks, dermal clearing agents, and perhaps even lasers with shorter pulse-durations might improve the results in the future.
    Journal der Deutschen Dermatologischen Gesellschaft 11/2007; 5(10):889-97. · 1.40 Impact Factor
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    ABSTRACT: The use of cold air cooling (CAC) and cryogen spray cooling during dye laser treatment of port-wine stains (PWS) has become a standard in recent years. Still unsolved is the question of which fluences are necessary in combination with CAC in order to achieve an optimum clearance and the lowest possible rate of side-effects. In a prospective study, we treated 11 patients with PWS with pulsed dye laser (Photogenica V, Cynosure, lambda = 585 nm, iota(p) = 0.5 ms, spot size = 7 mm). Each PWS was partitioned into three areas: (area 1) 6 J/cm(2) without CAC, (area 2) 6 J/cm(2) with CAC (level 4), (area 3) 9 J/cm(2) with CAC (level 4). Area 3 (mean, 59%) showed a slightly better clearance than area 1 (mean, 57%); in area 2, we observed a reduced clearance (mean, 45%). Compared with area 1, we achieved a reduction of pain through CAC in areas 2 and 3. The healing periods as well as the rate of side-effects were comparable in all areas. We observed a slight but not statistically relevant increase in clearance with the use of higher fluences and CAC compared with lower fluences without CAC. Because pain is lowered significantly when using CAC, and because this makes the treatment more comfortable for the patients, we tend to recommend the use of higher fluences (9 J/cm(2)) with simultaneous CAC for treating PWS.
    Journal of the European Academy of Dermatology and Venereology 11/2007; 21(9):1229-33. · 2.69 Impact Factor
  • Journal der Deutschen Dermatologischen Gesellschaft 09/2007; 5(10). · 1.40 Impact Factor
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    ABSTRACT: In dermatology, the pulsed dye laser (PDL) is the therapeutic instrument of choice for treating most superficial cutaneous vascular lesions. In addition, clinical experience over the last decade allowed us to treat patients with an ever increasing number of non-vascular indications. The purpose of this report is to summarize and critically appraise the scientific evidence that support the role of PDL in treating non-vascular skin lesions. A literature-based study has been conducted, including the review of publications over the period January 1995 to December 2006, using the Medline Database. We also included our own experience in managing non-vascular lesions with the PDL. Four sets of preoperative and postoperative photos are presented. For viral skin lesions, PDL proved to be an alternative to other therapy options. This applies particularly to periungual warts and mollusca contagiosa. The mechanism of PDL with inflammatory dermatoses has not yet been elucidated. The effect seems to be better if there is a vascular component to the disease. With most of these indications (such as psoriasis and acne), PDL currently plays a rather minor or complementary role. Regarding collagen remodelling (hypertrophic scars, keloids, stretch marks, and skin rejuvenation), the question of whether a therapy makes sense or not has to be decided from case to case. With PDL, it is possible to achieve good results with numerous, partly less well-known indications (i.e. lupus erythematosus). With other diseases, PDL has so far been considered to be a complementary therapy method or to be in an experimental state.
    Journal of the European Academy of Dermatology and Venereology 09/2007; 21(7):877-90. · 2.69 Impact Factor
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    ABSTRACT: Venous lakes of the lip are a cosmetic problem for many patients due to their exposed location, nodularity, fragility and blue color. We sought an effective and well tolerated therapy method. Over one year, we treated 20 patients with a combination of diode laser (910 nm) and radiofrequency. In all cases, there was complete regression of the venous lake (average: 1.4 treatment sessions). Side effects were transient pain that was assessed as mild by the patients, and transient swelling. Scarring or hypo-/hyperpigmentation did not occur. This combined approach is a recommended option at least equivalent to other therapy methods (argon laser, CO(2) laser, pulsed-dye-laser, and others), or even superior to them due to the low rates of side effects and low number of treatment sessions.
    Der Hautarzt 09/2007; 58(8):679-83. · 0.50 Impact Factor
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    ABSTRACT: Lippenrandangiome stellen aufgrund ihrer exponierten Lage, knotigen Struktur, leichten Verletzlichkeit und der blauen Farbe für viele Patienten ein kosmetisches Problem dar. Ziel war es, eine effektive und gut verträgliche Therapiemethode zu finden.Wir behandelten 20 Patienten innerhalb eines Jahres mit einer Kombination aus Diodenlaser (910 nm) und Radiofrequenztherapie.In allen Fällen kam es zu einer vollständigen Rückbildung (Durchschnitt: 1,4 Sitzungen). Als Begleitreaktionen traten ein kurz anhaltender, von den Patienten als gering eingestufter Schmerz und eine vorübergehende Schwellung auf. Zu Narben oder Hypo-/Hyperpigmentierungen kam es nicht.Die dargestellte Therapieform ist eine empfehlenswerte Behandlungsmöglichkeit, die anderen bisher eingesetzten Therapiemethoden (Argonlaser, CO2-Laser, Farbstofflaser etc.) zumindest gleichwertig und aufgrund geringer Nebenwirkungsraten und geringer Anzahl der Behandlungssitzungen teilweise überlegen ist.
    Der Hautarzt 07/2007; 58(8):679-683. · 0.50 Impact Factor
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    ABSTRACT: Der M.Darier stellt für die Patienten nicht zuletzt aufgrund von Juckreiz und des fötiden Geruchs ein medizinisches und psychisches Problem dar. Es konnte bereits gezeigt werden, dass durch ablative Lasersysteme eine Beschwerdefreiheit der Patienten erreicht werden kann. Problematisch hierbei ist v.a. die höhere Rate an Nebenwirkungen wie dauerhafte Hypopigmentierungen und eine Gefahr der Narbenbildung. Mit dem nichtablativen Farbstofflaser konnten in den beiden vorliegenden Fällen die flachen, intertriginösen Effloreszenzen sicher und effizient therapiert werden. Obwohl der Wirkmechanismus letztlich nicht vollständig geklärt ist, rechtfertigt der Erfolg in Einzelfällen den Einsatz des Farbstofflasers beim M.Darier. Ob sich dieses Ergebnis jedoch an größeren Fallzahlen bestätigen lässt, müssen kontrollierte und ggf. multizentrische klinische Studien erst noch klären. Darier disease is often associated with pruritus and an unpleasant odor, causing medical and emotional problems. Ablative laser therapy has proven effective in ameliorating these symptoms. Side effects of this approach include permanent hypopigmentation and a risk of scarring. We present two cases where non-ablative therapy with pulsed dye lasers proved a safe and effective way to manage the intertriginous lesions. Although the mechanism of action is unclear, our success indicates that pulsed dye laser therapy is an option in Darier disease. Larger numbers of patients, ideally in multicenter studies, must be treated in this way to confirm our results.
    Der Hautarzt 60(12):995-998. · 0.50 Impact Factor