Werner Aberer

Medical University of Graz, Gratz, Styria, Austria

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Publications (261)1074.04 Total impact

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    ABSTRACT: Lichen sclerosus (LS) is an inflammatory skin disease that usually involves the anogenital area. All patients with symptoms or signs suspicious of lichen sclerosus should be seen at least once initially by a physician with a special interest in the disease in order to avoid delay in diagnosis, as early treatment may cure the disease in some and reduce or prevent scarring. The diagnosis is made clinically in most cases. Biopsies should only be performed under certain circumstances. The gold standard for treatment remains potent to very potent topical steroids; however, mild and moderate disease in boys and men may be cured by circumcision. Certain triggers should be avoided. http://www.euroderm.org/images/stories/guidelines/2014/S3-Guideline-on-Lichen-sclerosus.pdf http://www.awmf.org/fachgesellschaften/mitgliedsgesellschaften/visitenkarte/fg/deutsche-gesellschaft-fuer-gynaekologie-und-geburtshilfe-dggg.html. © 2015 European Academy of Dermatology and Venereology.
    Journal of the European Academy of Dermatology and Venereology 07/2015; DOI:10.1111/jdv.13136
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    ABSTRACT: Considering the scarcity of dermatologic resources in many parts of the world, self-testing by patients is not only of interest for internal medicine but also for dermatology. In this open, nonrandomized, multicenter diagnostic trial involving subjects with suspected contact sensitization to nickel and/or a fragrance mix, we assessed the agreement of self-testing by subjects with readings made by dermatologists. The self-test product (Nixema(TM)) is based on Thin-Layer Rapid Use Epicutaneous Test (TRUE Test®) technology. One hundred and sixty-five subjects self-tested the ready-made patch-test product. The test was applied for 48 h and then read after 3 or 4 days. It was also evaluated independently by experienced dermatologists after 3 or 4 days. In the 162 evaluable subjects, the proportion of agreement for both allergens together was 89.5% [95% confidence interval (CI) 83.7-93.8], the sensitivity was 97.5 % (95% CI 86.8-99.9) and the specificity was 86.9% (95% CI 79.6-92.3). Cohen's kappa was also high at 0.749 (95% CI 0.637-0.862). Discrepancies between the subjects' readings and the dermatologists' readings were mainly due to the subjects interpreting reactions of 'irritant' or 'doubtful' as 'positive'. Apart from itching and burning sensations and tape irritation, no side effects were observed. In conclusion, this study showed a high rate of agreement between the self-reading of the upper arm and the readings made by the dermatologists. The upper arm proved to be an appropriate area for self-testing. Self-testing may improve the screening for contact sensitization for patients, particularly where dermatologic health resources are scarce. © 2015 S. Karger AG, Basel.
    Skin pharmacology and physiology 07/2015; 28(5):257-263. DOI:10.1159/000437017
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    ABSTRACT: Several unmet needs have been identified in allergic rhinitis: identification of the time of onset of the pollen season, optimal control of rhinitis and comorbidities, patient stratification, multidisciplinary team for integrated care pathways, innovation in clinical trials and above all patient empowerment. MASK-rhinitis (MACVIA-ARIA Sentinel NetworK for allergic rhinitis) is a simple system centred around the patient which was devised to fill many of these gaps using Information and Communications Technology (ICT) tools and a clinical decision support system (CDSS) based on the most widely used guideline in allergic rhinitis and its asthma co-morbidity (ARIA 2015 revision). It is one of the implementation systems of the Action Plan B3 of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA). Three tools are used for the electronic monitoring of allergic diseases: a cell phone-based daily visual analogue scale (VAS) assessment of disease control, CARAT (Control of Allergic Rhinitis and Asthma Test) and the e-Allergy screening (Premedical system of early diagnosis of allergy and asthma based on online tools). These tools are combined with a clinical decision support system (CDSS) and are available in many languages. An e-CRF and an e-learning tool complete MASK. MASK is flexible and other tools can be added. It appears to be an advanced, global and integrated ICT answer for many unmet needs in allergic diseases which will improve policies and standards. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    Allergy 07/2015; DOI:10.1111/all.12686
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    ABSTRACT: BACKGROUND: Icatibant, a selective bradykinin B2 receptor antagonist for the treatment of acute hereditary angio-oedema (HAE) attacks in adults, can be administered by health care professionals (HCPs) or self-administered. This analysis compared characteristics and outcomes of acute HAE attacks treated with self-administered and HCP-administered icatibant in a real-world setting. METHODS: The Icatibant Outcome Survey (Shire, Zug, Switzerland; NCT01034969) is an international observational study monitoring the safety and effectiveness of icatibant treatment. Descriptive retrospective analyses were performed (February 2008 to December 2012). RESULTS: Icatibant was used in 652 attacks in 170 patients with HAE type I/II. Most icatibant injections were self-administered (431/652, 68.5%). The proportion of self-treated attacks increased over time (40.3% in 2009 vs. 89.7% in 2012). The median time to administration was significantly shorter in self- versus HCP-treated attacks (1.5 vs. 2.4 h; p = 0.016). Earlier treatment (<2 h after onset) was significantly associated with a shorter median time to resolution (2.5 vs. 5.0 h; p = 0.032) and attack duration (3.0 vs. 14.0 h; p < 0.0001), regardless of administration method. Patients self-administered icatibant for attacks of all severities; overall, 34.7% of severe and 30.2% of very severe attacks were HCP treated. Logistic regression analysis did not find use of long-term prophylaxis, attack location or gender to be predictive for self-administration. CONCLUSIONS: The proportion of HAE attacks treated with self-administered icatibant increased over time. Patients successfully self-administered icatibant for a wide variety of HAE attacks, demonstrating that icatibant is generally well tolerated and effective for self-administration. Self-administration of icatibant provides a complementary option to HCP administration, enabling optimization of patient care.
    International Archives of Allergy and Immunology 06/2015; 167(1):21-8.
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    ABSTRACT: Icatibant, a selective bradykinin B2 receptor antagonist for the treatment of acute hereditary angio-oedema (HAE) attacks in adults, can be administered by health care professionals (HCPs) or self-administered. This analysis compared characteristics and outcomes of acute HAE attacks treated with self-administered and HCP-administered icatibant in a real-world setting. The Icatibant Outcome Survey (Shire, Zug, Switzerland; NCT01034969) is an international observational study monitoring the safety and effectiveness of icatibant treatment. Descriptive retrospective analyses were performed (February 2008 to December 2012). Icatibant was used in 652 attacks in 170 patients with HAE type I/II. Most icatibant injections were self-administered (431/652, 68.5%). The proportion of self-treated attacks increased over time (40.3% in 2009 vs. 89.7% in 2012). The median time to administration was significantly shorter in self- versus HCP-treated attacks (1.5 vs. 2.4 h; p = 0.016). Earlier treatment (<2 h after onset) was significantly associated with a shorter median time to resolution (2.5 vs. 5.0 h; p = 0.032) and attack duration (3.0 vs. 14.0 h; p < 0.0001), regardless of administration method. Patients self-administered icatibant for attacks of all severities; overall, 34.7% of severe and 30.2% of very severe attacks were HCP treated. Logistic regression analysis did not find use of long-term prophylaxis, attack location or gender to be predictive for self-administration. The proportion of HAE attacks treated with self-administered icatibant increased over time. Patients successfully self-administered icatibant for a wide variety of HAE attacks, demonstrating that icatibant is generally well tolerated and effective for self-administration. Self-administration of icatibant provides a complementary option to HCP administration, enabling optimization of patient care. © 2015 S. Karger AG, Basel.
    International Archives of Allergy and Immunology 06/2015; 167(1):21-28. DOI:10.1159/000430864
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    ABSTRACT: Drug hypersensitivity reactions are unpredictable adverse drug reactions. They manifest either within 1–6 h following drug intake (immediate reactions) with mild to life-threatening symptoms of anaphylaxis, or several hours to days later (delayed reactions), primarily as exanthematous eruptions. It is not always possible to detect involvement of the immune system (allergy). Waiving diagnostic tests can result in severe reactions on renewed exposure on the one hand, and to unjustified treatment restrictions on the other. With this guideline, experts from various specialist societies and institutions have formulated recommendations and an algorithm for the diagnosis of drug allergies. The key principles of diagnosing allergic/hypersensitivity drug reactions are presented. Where possible, the objective is to perform allergy diagnostics within 4 weeks–6 months following the reaction. A clinical classification of symptoms based on the morphology and time course of the reaction is required in order to plan a diagnostic work-up. In the case of typical symptoms of a drug hypersensitivity reaction and unequivocal findings from validated skin and/or laboratory tests, a reaction can be attributed to a trigger with sufficient confidence. However, skin and laboratory tests are often negative or insufficiently reliable. In such cases, controlled provocation testing is required to clarify drug reactions. This method is reliable and safe when attention is paid to indications and contraindications and performed under appropriate medical supervision. The results of the overall assessment are discussed with the patient and documented in an „allergy passport“ in order to ensure targeted avoidance in the future and allow the use of alternative drugs where possible.
    Allergo Journal International 05/2015; 24(3):94-105. DOI:10.1007/s40629-015-0052-6
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    ABSTRACT: Patients with elevated basal tryptase (sBT) >15μg/L and anaphylaxis may have an underlying mastocytosis. A monoclonal mast cell activation syndrome (MMAS) with aberrant mast cells (MC) at extracutaneous sites has been described in patients with severe hypotension or anaphylaxis. Since MC in patients with elevated sBT might be altered in the skin as well, we studied MCs in normal neck skin in anaphylaxis and urticaria patients with elevated sBT. A mean of 93.1 (SD 19.1) MC/mm² was counted in normal neck skin in 14 patients with anaphylaxis, 84.0 (SD 13.6) in 7 patients with urticaria, 142.0 (SD 24.0) in 2 patients with eczema, 124.4 (SD 43.2) in 5 patients with systemic mastocytosis (SM) in comparison to autopsy skin (39.1 MC/mm², SD 12.4). In 5/14 (35.7%) of the anaphylaxis and 3/5 (60%) SM patients more than 25% of MCs were spindle shaped and expressed CD 25 antigen. We could show for the first time that the normal skin can harbour clonal MC in anaphylaxis patients. Analogous to the criteria for mastocytosis, we suggest a skin score criteria including an elevated number of MC, spindle shape, CD 25 expression, c-Kit mutation and sBT values >20μg/L. In patients with anaphylaxis and elevated sBT skin should be biopsied and, as with the approach for mastocytosis diagnosis in the bone marrow, MC should be analysed for their number, clonality and c-Kit mutation. This approach should be confirmed in further studies. Patients with aberrant skin MC should be handled as mastocytosis patients. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    Allergy 04/2015; 70(7). DOI:10.1111/all.12634
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    ABSTRACT: Mastocytosis is a clonal disorder characterized by the proliferation and accumulation of mast cells (MC) in different tissues, with a preferential localization in skin and bone marrow (BM). The excess of MC in mastocytosis as well as the increased releasability of MC may lead to a higher frequency and severity of immediate hypersensitivity reactions. Mastocytosis in adults is associated with a history of anaphylaxis in 22-49%. Fatal anaphylaxis has been described particularly following hymenoptera stings, but also occasionally after intake of drugs such as non-steroidal antiinflammatory drugs, opioids and in the perioperative setting. However, data on the frequency of drug hypersensitivity in Mastocytosis and vice-versa are scarce and evidence for an association appears to be limited. Nevertheless, clonal MC disorders should be ruled out in cases of severe anaphylaxis: basal serum tryptase determination, physical examination for Cutaneous Mastocytosis lesions and clinical characteristics of anaphylactic reaction might be useful for differential diagnosis. In this position paper, the ENDA group performed a literature search on immediate drug hypersensitivity reactions in clonal MC disorders using MEDLINE EMBASE, and Cochrane Library, reviewed and evaluated the literature in five languages using the GRADE system for quality of evidence and strength of recommendation. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    Allergy 03/2015; 70(7). DOI:10.1111/all.12617
  • Journal of Allergy and Clinical Immunology 02/2015; 135(2):AB279. DOI:10.1016/j.jaci.2014.12.1850
  • Journal of Allergy and Clinical Immunology 02/2015; 135(2):AB194. DOI:10.1016/j.jaci.2014.12.1569
  • Journal of Allergy and Clinical Immunology 02/2015; 135(2):AB278. DOI:10.1016/j.jaci.2014.12.1847
  • Journal of Allergy and Clinical Immunology 02/2015; 135(2):AB194. DOI:10.1016/j.jaci.2014.12.1568
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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). DOI:10.1111/ddg.12537
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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). DOI:10.1111/ddg.12537_suppl
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  • Lukas Koch, Werner Aberer
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    ABSTRACT: A large variety of methods and a wide range of products from several manufacturers are available for IgE-based in vitro allergy testing. In the large majority of cases, the attending physician lacks information about the devices and products used in the laboratory performing the tests. To determine the comparability and reliability of different laboratories, we analyzed the findings of an international ring trial established in Austria 25 years ago.The results were satisfactory: 97.4 % of total IgE tests and 93.9 % of antigen-specific IgE tests were correct. Further analysis revealed more false-positive than false-negative antigen-specific IgE levels (17.1 vs. 5.2 %). The investigation of different allergen groups yielded excellent results for some allergens (97.8 % correct values for mites, or 99.6 % correct values for recombinant antigens), but quite unfavorable for others (21.4 % incorrect values for drugs). In view of this paucity of comparability and reliability, it would be appropriate to establish mandatory quality control in laboratories and manufacturing units.
    Wiener klinische Wochenschrift 09/2014; 126(19-20). DOI:10.1007/s00508-014-0594-5
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    ABSTRACT: PräliminarienZweck der LeitlinieDiese Leitlinie „Kontaktekzem“ ist als Orientierung für Ärzte aller Fachrichtungen gedacht, die Patienten mit Kontaktekzem betreuen. Sie soll auf der Basis des aktuellen Wissens über Kontaktekzeme die anerkannten diagnostischen, therapeutischen und interventionellen Maßnahmen darstellen.Für den Themenbereich Handekzem gibt es eine gesonderte Leitlinie [1].Verfahren zur Entwicklung und KonsensbildungDie Leitlinie wurde in formaler Konsensfindung einer Expertengruppe (s. Autoren) entwickelt, deren Zusammensetzung von den wissenschaftlichen Fachgesellschaften bestimmt wurde, die auf dem Gebiet Kontaktekzem in Deutschland aktiv sind. Es handelt sich dabei um die Deutsche Kontaktallergie-Gruppe (DKG) der Deutschen Dermatologischen Gesellschaft (Aberer, Kränke, Becker, Bircher, Brasch), den Informationsverbund Dermatologischer Kliniken (IVDK; Schnuch, Aberer, Brasch), die Deutsche Gesellschaft für Allergologie und klinische Immunologie (DGAKI; Przybilla, Biede ...
    Allergologie 06/2014; 37(08):309-324. DOI:10.5414/ALX01690
  • Journal of Allergy and Clinical Immunology 05/2014; 134(3). DOI:10.1016/j.jaci.2014.03.038
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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). DOI:10.1111/ddg.12348

Publication Stats

5k Citations
1,074.04 Total Impact Points

Institutions

  • 1998–2015
    • 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
    • King's College London
      Londinium, England, United Kingdom
  • 2009
    • University of Naples Federico II
      Napoli, Campania, Italy
  • 2005
    • Centre Hospitalier Universitaire de Nancy
      Nancy, Lorraine, France
  • 2004
    • Landeskrankenhaus Graz
      Gratz, Styria, Austria
  • 2003
    • Universität Witten/Herdecke
      • Chair of Dermatology
      Witten, North Rhine-Westphalia, Germany
  • 1993
    • University of Vienna
      Wien, Vienna, Austria