Peter Elsner

Universitätsklinikum Jena, Jena, Thuringia, Germany

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Publications (597)1124.85 Total impact

  • Journal der Deutschen Dermatologischen Gesellschaft 05/2015; 13(5). DOI:10.1111/ddg.12597_suppl · 1.40 Impact Factor
  • Journal der Deutschen Dermatologischen Gesellschaft 05/2015; 13(5). DOI:10.1111/ddg.12597 · 1.40 Impact Factor
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    ABSTRACT: Hand dermatitis is a socially significant health problem. This review provides a discussion on the clinical features and patterns as well as the differential diagnosis of hand dermatitis, because these are essential for proper diagnosis in clinical practice. The morphology, however, is poorly related to the etiology in chronic cases. In all cases of chronic hand dermatitis, a full diagnostic examination should be undertaken and the etiology should be clarified and addressed in the treatment concept, instead of just moving directly from a morphological diagnosis to therapy. Preventive measures should be included in the treatment concept according to etiology. A stepwise approach for escalating therapy is advised, including basic topical therapy, topical corticosteroids, calcineurin inhibitors, as well as phototherapy and systemic therapy with corticosteroids, alitretinoin, cyclosporine, methotrexate, azathioprine, and others.
    American Journal of Clinical Dermatology 04/2015; DOI:10.1007/s40257-015-0130-z · 2.52 Impact Factor
  • P Elsner, M Glitsch, H F Merk
    Der Hautarzt 04/2015; DOI:10.1007/s00105-015-3638-5 · 0.54 Impact Factor
  • P Elsner
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    ABSTRACT: Dermatologists from Germany are increasingly involved in international missions under tropical conditions. While civilian operations take place primarily in the context of international development cooperation, non-governmental organizations and private initiatives, dermatologists of the German Armed Forces have been engaged in numerous military missions and international disaster relief missions abroad. The specific requirements of these missions require a specialist qualification; however, the specialist training in "Skin and Venereal Diseases" under the medical care situation in Germany is generally insufficient. To be optimally prepared for dermatological missions in tropical regions, additional qualification in tropical medicine is recommended. Since this additional training is time consuming and can often not be put into practice, especially in the civilian sector, the acquisition of the certificate Tropical and Travel Dermatology (DDA) of the International Society for Dermatology in the Tropics in cooperation with the German Dermatological Academy (DDA)is recommended. In the future, training in tropical dermatology should be incorporated into the main curriculum of dermatology for those specialists planning to work on dermatological missions in the tropics.
    Der Hautarzt 04/2015; DOI:10.1007/s00105-015-3637-6 · 0.54 Impact Factor
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    ABSTRACT: With the revision of the German Ordinance on Occupational Diseases, skin cancer due to UV irradiation was amended as a new occupational disease to the list of occupational diseases in Germany. The new occupational disease BK 5103 has the following wording: "Squamous cell carcinoma or multiple actinic keratosis of the skin caused by natural UV irradiation". Actinic keratoses are to be considered as multiple according to this new occupational diseases if they occur as single lesions of more than five annually, or are confluent in an area > 4 cm(2) (field cancerization). It is estimated that more than 2.5 million employees are exposed to natural UV irradiation due to their work (outdoor workers) in Germany and therefore have an increased risk of skin cancer. In this article the medical and technical prerequisites which have to be fulfilled for this new occupational disease in Germany are introduced.
  • P. Elsner, S.M. John, Ch. Skudlik
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    ABSTRACT: Am 09.11.2014 wurde feierlich des Falls der Mauer in Berlin vor 25 Jahren gedacht. Nach dem Mauerfall überstürzten sich damals die Ereignisse, und zum 03.10.1990 wurde die deutsche Einheit vollzogen.Auch im deutschen Berufskrankheitenrecht vollzieht sich in diesen Tagen - mit Verspätung - die deutsche Einheit.In der ehemaligen DDR (und für einen Übergangszeitraum bis 01.01.1992 im Gebiet der neuen Bundesländer) galt die „Liste der Berufskrankheiten gemäß Anlage zur BK-Verordnung der ehemaligen DDR vom 6. Mai 1981“. Diese sah unter Nr. 90 die Anerkennung von „Bösartigen Neubildungen der Haut und zur Krebsbildung neigenden Hautveränderungen“ vor, wobei unter dieser Ziffer nicht nur Hautkrebserkrankungen „durch Ruß, Rohparaffin, Teer, Anthrazen, Pech oder ähnliche Stoffe“ (entsprechend der in der Bundesrepublik geltenden Ziffer 5102 der Anlage 1 der Berufskrankheitenverordnung) anerkannt wurden, sondern auch Fälle von Hautkrebs durch berufliche Exposition mit UV-Licht.Im „Vertrag zwischen ...
    Der Hautarzt 03/2015; 66(3):152-153. DOI:10.1007/s00105-015-3588-y · 0.54 Impact Factor
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    ABSTRACT: (18) F-fluorodeoxyglucose positron emission tomography (FDG-PET)/CT is commonly used to assess tumour recurrence in high-risk patients with malignant melanoma (MM). However, results can be ambiguous either because of the CT's insufficient soft-tissue contrast or non-specific FDG accumulation caused by inflammation. Ultrasound (US) can provide additional morphologic information that is superior to CT. For precisely combining PET and US findings, we used a real-time fusion technique based on navigated US (PET/US fusion). Here, we describe our results from patients where PET/US fusion proved helpful in differentiating unclear PET/CT findings. This fusion technique is likely to be helpful for decision making in MM patients and biopsy guidance. © 2015 The Royal Australian and New Zealand College of Radiologists.
    Journal of Medical Imaging and Radiation Oncology 03/2015; DOI:10.1111/1754-9485.12280 · 0.95 Impact Factor
  • P Elsner, S Schliemann
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    ABSTRACT: The different definitions of skin disease in medicine and in law are frequently confusing for dermatologists. While a skin disease may be defined medically referring to the definition of health by the WHO as a pathological condition of the skin leading to a disruption of the physical, mental and social well-being of the individual, legal definitions vary depending on the field of insurance law that is referred to. In the law of private health insurance, a skin disease is defined as an anomalous condition of the skin requiring medical treatment that exists independently of the subjective judgement of the insured person and needs to be objectively confirmed by a medical evaluation. In contrast, in the law of the social health insurance, the Federal Court of Social Justice defines disease as irregular physical or mental condition, deviating from the perception of a healthy human being that requires medical treatment or leads to inability to work. Substantial bodily disfigurement may be regarded as an irregular physical condition. In the law of the statutory accident insurance, occupational skin diseases are defined under clause 5101 of the occupational disease regulation as serious or repeatedly relapsing skin diseases that have forced a person to refrain from any work activities causal for the development, the aggravation or the recurrence of the disease. The Federal Court of Social Justice interprets the term "skin disease" from the protective purpose of the law, i.e. the protection against the economic and health consequences of the exposure to harmful agents and a thereby forced change of profession. This broad interpretation of the term "skin disease" leads to the recognition of diseases of the conjunctiva of the eye or diseases of the blood vessels of the skin due to cold damage as skin diseases according to clause 5101. For the correct treatment and possibly notification of occupational skin diseases in collaboration with various insurance carriers, dermatologists should be familiar not only with the medical definition, but also with these different legal definitions of skin disease.
  • J Lukács, S Schliemann, P Elsner
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    ABSTRACT: Scabies is an infectious skin disease caused by the human itch mite (Sarcoptes scabiei var. hominis). It is mainly transmitted by direct skin-to-skin contact. The spread of scabies can cause major difficulties in healthcare institutions, particularly in residential homes for the elderly. The disease is characterized by intense nocturnal itching, erythematous papules arranged in a linear order, and scratching resulting in excoriations. The diagnosis is confirmed by identification of the mite or by finding one or more mite tunnels in the skin. An individually occurring case does not need to be reported. If two or more cases occur in the same institution, the company physician and the appropriate public health department are to be informed in Germany. In case of a suspected scabies infection in medical personnel due to exposure in their work setting, medical notification to the statutory occupational accidents' insurance (Nr. 3101) is to be issued in accordance with § 202, Volume VII of the German Social Code. First line treatment is topical therapy with 5 % permethrin. If scabies control is required in an institution, systemic treatment with ivermectin may be considered. In the case of a scabies outbreak, all patients, contact persons, and staff must be treated simultaneously.
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    ABSTRACT: Tobacco smoking is known to influence various inflammatory skin diseases. A systematic review with a meta-analysis was conducted to analyse a possible association between the lifestyle factor tobacco smoking and hand dermatitis. We performed a systematic review using the MEDLINE, Embase and Cochrane Central Register databases. Our search was limited to English and German language, human-subject studies published between January 1, 1980 and December 31, 2013. A total of 43 articles were identified from the initial search, and after taking into account exclusion criteria, only three studies remained investigating the risk factors for hand eczema in the general and in high-risk populations (e.g. bakers, hairdressers, dental technicians). The extracted data were pooled and analysed by standard statistical methods. The studies meeting inclusion criteria consisted of one cohort study and two cross-sectional studies based on a total of 4.113 subjects with hand dermatitis and 34.875 subjects without hand dermatitis. While one of the studies had reported a significant association between hand dermatitis and smoking, the meta-analysis did not confirm this finding (OR 0.99; 95% CI 0.88–1.11). However, heterogeneity across studies was high (I2 = 72%). Our meta-analysis did not show tobacco smoking to be a risk factor for hand dermatitis. However, these results depend mainly on two large studies from one country. From present data, it cannot be excluded that smoking may influence the course of hand dermatitis. Even though smoking does not seem to be associated with hand dermatitis, it may still negatively influence the course of the disease.
    Journal of the European Academy of Dermatology and Venereology 02/2015; DOI:10.1111/jdv.12971 · 3.11 Impact Factor
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    ABSTRACT: Granuloma annulare (GA) is a benign inflammatory skin disease. Localized GA is likely to resolve spontaneously, while generalized GA (GGA) is rare and may persist for decades. GGA usually is resistant to a variety of therapeutic modalities and takes a chronic course. The objective of this study was to summarize all reported treatments of generalized granuloma annulare. This is a systematic review based on MEDLINE, Embase and Cochrane Central Register search of articles in English and German and a manual search, between 1980 and 2013, to summarize the treatment of generalized granuloma annulare. Most medical literature on treatment of GGA is limited to individual case reports and small series of patients treated without a control group. Randomized controlled clinical studies are missing. Multiple treatment modalities for GGA were reported including topical and systemic steroids, PUVA, isotretinoin, dapsone, pentoxifylline, hydroxychloroquine, cyclosporine, IFN-γ, potassium iodide, nicotinamide, niacinamide, salicylic acid, dipyridamole, PDT, fumaric acid ester, etanercept, infliximab, adalimumab. While there are numerous case reports of successful treatments in the literature including surgical, medical and phototherapy options, well-designed, randomized, controlled clinical trials are required for an evidence-based treatment of GGA.
    Journal of the European Academy of Dermatology and Venereology 02/2015; DOI:10.1111/jdv.12976 · 3.11 Impact Factor
  • Journal of the European Academy of Dermatology and Venereology 01/2015; DOI:10.1111/jdv.12880 · 3.11 Impact Factor
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    ABSTRACT: ZusammenfassungDie Leitlinie gibt evidenz- und konsensbasierte Empfehlungen zum Management von Handekzemen. Sie berücksichtigt einen systematischen Cochrane-Review „Intervention for hand eczema“, der auf einer systematischen Literatursuche (einschließlich Handsuche) basiert. Zusätzlich zu den evidenz- und konsensbasierten Empfehlungen zur Therapie von Handekzemen (HE) werden auch überwiegend konsensbasierte Empfehlungen zur Diagnostik und Prävention (primäre und sekundäre Prävention) gegeben. Die Therapieempfehlungen umfassen nichtmedikamentöse, topische, physikalische und systemische Behandlungsmöglichkeiten.Topische Glukokortikosteroide sind Therapie der ersten Wahl, jedoch wird eine Anwendung über einen Zeitraum länger als sechs Wochen nur in Ausnahmefällen und unter sorgfältiger ärztlicher Kontrolle empfohlen. Alitretinoin wird als Therapie der zweiten Wahl (nach topischen Glukokortikosteroiden) für Patienten mit schweren chronischen Handekzemen empfohlen. Für andere systemische Therapieverfahren fehlen derzeit randomisierte klinische Studien (RCTs). Ein direkter Therapievergleich der unterschiedlichen systemischen Medikamente in RCTs wird gefordert.Die Leitlinie wurde von einer Arbeitsgruppe der European Contact Dermatitis Society (ESCD) in einem öffentlichen Prozess mit dem Ziel entwickelt, aufgrund des derzeitigen Erkenntnistandes evidenz- und konsensbasierte Empfehlungen zu geben. Die Konsenskonferenzen wurden von einer professionellen Moderatorin der AWMF (Arbeitsgemeinschaft der medizinischen Wissenschaften) geleitet.Eine finanzielle Unterstützung durch die pharmazeutische Industrie erfolgte nicht. Die Leitlinie ist bis Dezember 2017 gültig.
    Journal der Deutschen Dermatologischen Gesellschaft 01/2015; 13(1). DOI:10.1111/ddg.12510_suppl · 1.40 Impact Factor
  • Journal der Deutschen Dermatologischen Gesellschaft 01/2015; 13(1). DOI:10.1111/ddg.12454 · 1.40 Impact Factor
  • Source
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    ABSTRACT: The guidelines aim to provide advice on the management of hand eczema (HE), using an evidence- and consensus-based approach. The guidelines consider a systematic Cochrane review on interventions for HE, which is based on a systematic search of the published literature (including hand-searching). In addition to the evidence- and consensus-based recommendation on the treatment of HE, the guidelines cover mainly consensus-based diagnostic aspects and preventive measures (primary and secondary prevention). Treatment recommendations include non-pharmacological interventions, topical, physical and systemic treatments. Topical corticosteroids are recommended as first line treatment in the management of HE, however continuous long-term treatment beyond six weeks only when necessary and under careful medical supervision. Alitretinoin is recommended as a second line treatment (relative to topical corticosteroids) for patients with severe chronic HE. Randomized control trials (RCT) are missing for other used systemic treatments and comparison of systemic drugs in “head-to-head” RCTs are needed.The guidelines development group is a working group of the European Society of Contact Dermatitis (ESCD) and has carefully tried to reconcile opposite views, define current optimal practice and provide specific recommendations, and meetings have been chaired by a professional moderator of the AWMF (Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften; Association of the Scientific Medical Societies in Germany).No financial support was given by any medical company. The guidelines are expected to be valid until December 2017 at the latest.
    Journal der Deutschen Dermatologischen Gesellschaft 01/2015; 13(1). DOI:10.1111/ddg.12510 · 1.40 Impact Factor
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    ABSTRACT: Antibacterial activity of dressings containing antimicrobials is mostly evaluated using in vitro tests. However, the various methods available differ significantly in their properties and results obtained are influenced by the method selected, micro-organisms used, and extraction method, the degree of solubility or the diffusability of the test-compounds. Here, results on antimicrobial activity of silver-containing dressings obtained by agar diffusion test (ADT), challenge tests (JIS L 1902, AATCC 100), and extraction-based methods (microplate laser nephelometry (MLN), luminescent quantification of bacterial ATP (LQbATP)) using Staphylococcus aureus and Pseudomonas aeruginosa were evaluated. Furthermore, the effect of the pH on antibacterial efficacy of these dressings was investigated. All silver-containing dressings exerted antimicrobial activity in all in vitro tests and results correlated considerably well. Differences were observed testing the agent-free basic materials. They did not exhibit any antimicrobial effects in the ADT, MLN or LQbATP, since these methods depend on diffusion/extraction of an active agent. However, they showed a strong antimicrobial effect in the challenge tests as they possess a high absorptive capacity, and are able to bind and sequester micro-organisms present. Therefore, it seems recommendable to choose several tests to distinguish whether a material conveys an active effect or a passive mechanism. In addition, it could be shown that release of silver and its antimicrobial efficacy is partially pH-dependent, and that dressings themselves affect the pH. It can further be speculated that dressings' effects on pH and release of silver ions act synergistically for antimicrobial efficacy.
    Journal of Materials Science Materials in Medicine 01/2015; 26(1):5343. DOI:10.1007/s10856-014-5343-9 · 2.38 Impact Factor
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    ABSTRACT: Wound infection plays an important role in compromised wound healing. A high bioburden impairs healing and leads to formation of a chronic wound. Distinctly higher pH values were observed in chronic wounds compared to acute wounds. However, there is only limited knowledge of pH dependency on the antibacterial efficacy of common antimicrobial substances. This study investigated the pH influence on the antimicrobial efficacy of povidone (PVP)-iodine, silver nitrate, chlorhexidine, octenidine and polihexanide against Staphylococcus aureus and Pseudomonas aeruginosa using the agar diffusion test and microplate laser nephelometry. The bactericidal activity of chlorhexidine and octenidine was mainly pH-independent in a pH range of 5.0-9.0. In contrast, polihexanide showed a significant efficacy increase at a higher pH. It was also found that the influence of the pH on antiseptics differs among species of bacteria. For instance, S. aureus exhibited an increasing sensitivity against silver nitrate with rising pH whereas the effect on P. aeruginosa was found to be distinctly decreased. The antimicrobial effect of PVP-iodine was strongly diminished with rising pH. The shift towards higher pH values in chronic wounds compared to acute wounds makes it imperative to know whether the antimicrobial efficacy of applied antimicrobial substances is altered by different pH levels. The results suggest that application of polihexanide might be advantageous for the management of wound infections, as both S. aureus and P. aeruginosa exhibited an increased susceptibility with rising pH. © 2015 S. Karger AG, Basel.
    Skin pharmacology and physiology 01/2015; 28(3):147-58. DOI:10.1159/000367632 · 1.96 Impact Factor
  • Journal der Deutschen Dermatologischen Gesellschaft 01/2015; 13(1). DOI:10.1111/ddg.12454_suppl · 1.40 Impact Factor
  • M Peckruhn, P Elsner
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    ABSTRACT: Vulvar diseases might cause problems in the differential diagnosis, because the clinical presentation of inflammatory, infectious and neoplastic disorders may be quite similar. Itching and pain as well as dysuria and dyspareunia are the most common symptoms of vulvar diseases. Inflammatory dermatoses like atopic and contact dermatitis, lichen planus, lichen sclerosus and atrophic vulvitis account for the majority of cases in specialized clinics. Furthermore, neoplastic conditions such as vulvar carcinoma, vulvar intraepithelial neoplasia (VIN) and vulvar Paget's disease have to be considered. Another frequent group are infections. Candida spp., herpes simplex viruses and human papilloma viruses are common pathogens. Additionally, vulvodynia is a typical problem that is sometimes difficult to treat. Because of the wide spectrum of clinical symptoms, cooperation with gynaecologists and psychosomatic specialists should be considered in difficult cases. The typical clinical presentations, their specific signs and symptoms, and pitfalls in the dermatological consultation are discussed.
    Der Hautarzt 12/2014; 66(1). DOI:10.1007/s00105-014-3552-2 · 0.54 Impact Factor

Publication Stats

6k Citations
1,124.85 Total Impact Points

Institutions

  • 2002–2015
    • Universitätsklinikum Jena
      • Klinik für Hautkrankheiten
      Jena, Thuringia, Germany
  • 1999–2014
    • Friedrich-Schiller-University Jena
      • • Clinic of Dermatology
      • • Institute of Medical Statistics, Computer Sciences and Documentation
      Jena, Thuringia, Germany
  • 2009–2012
    • Friedrich-Alexander Universität Erlangen-Nürnberg
      • Department of Medical Informatics, Biometry and Epidemiology
      Erlangen, Bavaria, Germany
  • 2005–2008
    • Procter & Gamble
      Cincinnati, Ohio, United States
  • 2007
    • Universität zu Lübeck
      Lübeck Hansestadt, Schleswig-Holstein, Germany
  • 2004
    • Northwestern University
      Evanston, Illinois, United States
    • Universität Ulm
      Ulm, Baden-Württemberg, Germany
  • 2003
    • University of Freiburg
      • Department of Pneumology
      Freiburg, Lower Saxony, Germany
  • 1994–1998
    • University of Zurich
      • Dermatologische Klinik und Poliklinik
      Zürich, Zurich, Switzerland
  • 1993–1998
    • Schulthess Klinik, Zürich
      Zürich, Zurich, Switzerland
  • 1996–1997
    • University Hospital Zürich
      Zürich, Zurich, Switzerland
  • 1990–1991
    • University of California, San Francisco
      • • Department of Dermatology
      • • Division of Hospital Medicine
      San Francisco, CA, United States
  • 1988–1991
    • University of Wuerzburg
      • Department of Dermatology, Venereology and Allergology
      Würzburg, Bavaria, Germany