Holger A Haenssle

Universitätsklinikum Freiburg, Freiburg an der Elbe, Lower Saxony, Germany

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Publications (74)156.68 Total impact

  • A Blum, J Kreusch, W Stolz, H Haenssle
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    ABSTRACT: Based on the skin cancer screening model of Germany a critical statement is presented about skin cancer epidemiology, the total body examination and time intervals. The number of skin cancer cases will increase and the number of dermatologists will probably decrease; thus a fundamental and pragmatic strategy is required for further education and planning to comply with the increased dermato-oncological demand of an aging population. Hereby dermoscopy should be a basic diagnostic tool for the early recognition of skin cancer and precursors as well as to avoid unnecessary excisions of benign skin lesions. The excision ratio between malignant and benign skin tumours should be optimized.
    Der Hautarzt 04/2015; DOI:10.1007/s00105-015-3613-1 · 0.54 Impact Factor
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    ABSTRACT: ZusammenfassungHintergrundBestimmte Subtypen des Melanoms haben eine schlechtere Prognose als andere. Unser Ziel war es, patientenbezogene Faktoren zu identifizieren, die mit spezifischen Subtypen des Melanoms vergesellschaftet sind.Patienten und MethodenMonozentrische Studie an 347 Melanompatienten, bei denen prospektiv 22 patientenbezogene Variablen erhoben wurden, woraus eine Datenbank mit mehr als 7600 Merkmalen erstellt wurde.ErgebnisseMelanome wurden histologisch als superfiziell-spreitend (SSM, 70,6 %), nodulär (NM; 12,7 %), akrolentiginös (ALM; 4,0 %), Lentigo maligna (LMM; 3,8 %) oder nicht klassifiziertes Melanom (UCM; 8,9 %) klassifiziert. Bekannte Risikofaktoren (i. e. zahlreiche atypische Nävi, Sommersprossen, Z. n., Melanom) waren signifikant mit den Subtypen SSM und LMM assoziiert. NM und ALM-Patienten wiesen signifikant weniger gewöhnliche oder atypische Nävi auf. NM waren zumeist vom Patienten selbst oder einem Verwandten entdeckt worden, wohingegen SSM, LMM und ALM zumeist vom Dermatologen entdeckt wurden. NM und UCM waren präferentiell an schlecht beobachtbaren Körperstellen lokalisiert, SSM an der unteren Extremität, ALM im Plantarbereich und LMM an Kopf und Hals. ALM und LMM-Patienten waren signifikant älter als die anderen Patienten. Wir entwickelten ein multinomiales logistisches Modell zur Vorhersage eines Melanomsubtyps (Gesamtgenauigkeit 81 %), welches geeignet sein könnte, um die Aufmerksamkeit klinisch tätiger Ärzte entsprechend zu fokussieren oder in vollautomatisierte Diagnosealgorithmen eingeschlossen zu werden.SchlussfolgerungenMelanomsubtypen zeigen signifikante Unterschiede hinsichtlich patientenbezogener Faktoren.
    Journal der Deutschen Dermatologischen Gesellschaft 01/2015; 13(1). DOI:10.1111/ddg.12561_suppl · 1.40 Impact Factor
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    ABSTRACT: Background Certain melanoma histotypes carry a worse prognosis than others. We aimed to identify patient related factors associated with specific melanoma histotypes.Patients and methodsSingle center study including 347 melanoma patients, prospectively assessed for 22 variables leading to a database of more than 7 600 features.ResultsMelanomas were histologically categorized as superficial spreading (SSM, 70.6 %), nodular (NM; 12.7 %), acrolentiginous (ALM; 4.0 %), lentigo maligna (LMM; 3.8 %), or unclassified melanoma (UCM; 8.9 %). Well recognized melanoma risk indicators (i. e. many atypical nevi, freckles, previous melanoma), were significantly associated with SSM and LMM histotypes. NM and ALM patients carried significantly less common and/or atypical nevi. NM were mostly self-detected or detected by relatives. In contrast, SSM, LMM, and ALM were most frequently detected by dermatologists. NM and UCM were preferentially located on poorly observable sites, SSM on the lower limbs, ALM on plantar sites, and LMM on the head and neck. ALM and LMM patients were significantly older than other patients. A multinomial logistic model was designed to predict a certain melanoma histotype (overall accuracy 81 %), which could be helpful to focus the attention of clinicians or may be integrated into fully automated diagnostic algorithms.Conclusions Melanoma histotypes show significant differences regarding patients’ characteristics.
    Journal der Deutschen Dermatologischen Gesellschaft 01/2015; 13(1). DOI:10.1111/ddg.12561 · 1.40 Impact Factor
  • Journal der Deutschen Dermatologischen Gesellschaft 12/2014; 12(12):1135-7. DOI:10.1111/ddg.12503 · 1.40 Impact Factor
  • Journal der Deutschen Dermatologischen Gesellschaft 12/2014; 12(12). DOI:10.1111/ddg.12503_suppl · 1.40 Impact Factor
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    ABSTRACT: The nucleotide excision repair (NER) pathway repairs UV-induced DNA lesions in an accurate fashion and prevents UV-irradiated areas of the skin from tumour formation. The XPA protein plays a major role in DNA damage demarcation as well as stabilization of other NER factors and was found to be defective in xeroderma pigmentosum (XP) complementation group A patients.
    Journal of the European Academy of Dermatology and Venereology 11/2014; DOI:10.1111/jdv.12841 · 3.11 Impact Factor
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    ABSTRACT: Pigmented and non-pigmented nail alterations are a frequent challenge for dermatologists. A profound knowledge of clinical and dermatoscopic features of nail disorders is crucial because a range of differential diagnoses and even potentially life-threatening diseases are possible underlying causes. Nail matrix melanocytes of unaffected individuals are in a dormant state, and, therefore, fingernails and toenails physiologically are non-pigmented. The formation of continuous, longitudinal pigmented streaks (longitudinal melanonychia) may either be caused by a benign activation of matrix melanocytes (e.g., as a result of trauma, inflammation, or adverse drug reactions) or by a true melanocytic proliferation (e.g., in a nevus or melanoma). In general, non-continuous nail alterations, affecting only limited parts of the nail apparatus, are most frequently of non-melanocytic origin. Important and common differential diagnoses in these cases are subungual hemorrhage or onychomycosis. In addition, foreign bodies, bacterial infections, traumatic injuries, or artificial discolorations of the nail unit may less frequently cause non-continuous nail alterations. Many systemic diseases that may also show involvement of the nails (e.g., psoriasis, atopic dermatitis, lichen planus, alopecia areata) tend to induce alterations in numerous if not all nails of the hands and feet. A similar extensive and generalized alteration of nails has been reported after treatment with a number of systemic drugs, especially antibiotics and cytostatics. Benign or malignant neoplasms that may also affect the nail unit include glomus tumor, Bowen's disease, squamous cell carcinoma, and rare collision tumors. This review aims to assist clinicians in correctly evaluating and diagnosing nail disorders with the help of dermatoscopy.
    10/2014; 4(4):11-20. DOI:10.5826/dpc.0404a02
  • Journal der Deutschen Dermatologischen Gesellschaft 08/2014; 12(8). DOI:10.1111/ddg.12322_suppl · 1.40 Impact Factor
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    Journal der Deutschen Dermatologischen Gesellschaft 05/2014; 12(5). DOI:10.1111/ddg.12281_suppl · 1.40 Impact Factor
  • Journal der Deutschen Dermatologischen Gesellschaft 05/2014; 12(8). DOI:10.1111/ddg.12322 · 1.40 Impact Factor
  • 04/2014; 150(7). DOI:10.1001/jamadermatol.2013.8635
  • Journal der Deutschen Dermatologischen Gesellschaft 04/2014; 12(4). DOI:10.1111/ddg.12235_suppl · 1.40 Impact Factor
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    ABSTRACT: Pigmented and nonpigmented nail abnormalities often represent a challenge for clinicians because many, and sometimes potentially life-threatening differential diagnoses must be taken into consideration. Although many details of nail diseases can already be assessed with the naked eye, dermoscopy opens up a second microscopic level of inspection, which can be very useful for the diagnostic process. In the last 20 years dermoscopy has made rapid progress in the further development of criteria for the early recognition of melanoma. In addition, the use of dermoscopy has been extended to the examination of cutaneous adnexa, such as hairs (trichoscopy) and nails (onychoscopy). Many, sometimes highly specific criteria for the dermoscopic assessment of nail diseases have been described in a series of recently published articles. This review article provides important diagnostic aids for a well-founded dermoscopic assessment of nail diseases.
    Der Hautarzt 03/2014; DOI:10.1007/s00105-013-2707-x · 0.54 Impact Factor
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    ABSTRACT: Cold atmospheric plasma (CAP, i.e. ionized air) is an innovating promising tool in reducing bacteria. We conducted the first clinical trial with the novel PlasmaDerm(®) VU-2010 device to assess safety and, as secondary endpoints, efficacy and applicability of 45 s/cm(2) cold atmospheric plasma as add-on therapy against chronic venous leg ulcers. From April 2011 to April 2012, 14 patients were randomized to receive standardized modern wound care (n = 7) or plasma in addition to standard care (n = 7) 3× per week for 8 weeks. The ulcer size was determined weekly (Visitrak(®) , photodocumentation). Bacterial load (bacterial swabs, contact agar plates) and pain during and between treatments (visual analogue scales) were assessed. Patients and doctors rated the applicability of plasma (questionnaires). The plasma treatment was safe with 2 SAEs and 77 AEs approximately equally distributed among both groups (P = 0.77 and P = 1.0, Fisher's exact test). Two AEs probably related to plasma. Plasma treatment resulted in a significant reduction in lesional bacterial load (P = 0.04, Wilcoxon signed-rank test). A more than 50% ulcer size reduction was noted in 5/7 and 4/7 patients in the standard and plasma groups, respectively, and a greater size reduction occurred in the plasma group (plasma -5.3 cm(2) , standard: -3.4 cm(2) ) (non-significant, P = 0.42, log-rank test). The only ulcer that closed after 7 weeks received plasma. Patients in the plasma group quoted less pain compared to the control group. The plasma applicability was not rated inferior to standard wound care (P = 0.94, Wilcoxon-Mann-Whitney test). Physicians would recommend (P = 0.06, Wilcoxon-Mann-Whitney test) or repeat (P = 0.08, Wilcoxon-Mann-Whitney test) plasma treatment by trend. Cold atmospheric plasma displays favourable antibacterial effects. We demonstrated that plasma treatment with the PlasmaDerm(®) VU-2010 device is safe and effective in patients with chronic venous leg ulcers. Thus, larger controlled trials and the development of devices with larger application surfaces are warranted.
    Journal of the European Academy of Dermatology and Venereology 03/2014; 29(1). DOI:10.1111/jdv.12490 · 3.11 Impact Factor
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    ABSTRACT: Background Factors associated with early vs. late diagnosis of cutaneous melanoma remain poorly understood.Objective To identify factors with a significant impact on melanoma thickness.Methods Patients with previous melanoma (n = 347, median age at diagnosis: 56.5 years, 44.7% female, 55.3% male) were recruited for this monocentre, non-randomized, observational study between April 2012 and March 2013. All patients were assessed by means of a structured interview and systematic clinical and dermoscopic full-body examination. Melanoma thickness in association with patients’ characteristics, risk indicators and patterns of diagnosis was submitted to statistical analyses.ResultsUnivariate analyses revealed associations between a statistically significant lower Breslow thickness and participation in specialized dermoscopic screening programs, personal history of more than one previous melanoma, diagnostic examination with a dermatoscope, diagnostic examination by board certified dermatologist, high number of common and/or atypical nevi, younger age at time of diagnosis, higher level of education, or superficial spreading or lentigo maligna melanoma subtype (all P ≤ 0.01). In a multivariate regression analysis only three of these criteria: (i) participation in specialized screening programs (P < 0.0001); (ii) melanoma subtype (P < 0.0001); and (iii) diagnostic examination with a dermatoscope (P = 0.040) and one interaction term (‘younger age’ x ‘female sex’, P < 0.0001) showed an independent influence on a significantly lower melanoma thickness.Conclusions The screening of patients in specialized surveillance programs resulted in melanoma detection at significantly earlier stages. The use of dermoscopy, SSM or LMM histotype and younger age in connection with female sex were also characteristics that were independently associated with significantly thinner melanomas in multivariate analyses.
    Journal of the European Academy of Dermatology and Venereology 03/2014; DOI:10.1111/jdv.12471 · 3.11 Impact Factor
  • Journal der Deutschen Dermatologischen Gesellschaft 02/2014; 12(5). DOI:10.1111/ddg.12281 · 1.40 Impact Factor
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    ABSTRACT: Optimized delivery of antigens combined with sustainable maturation of dendritic cells (DCs) is crucial for generation of effective antitumoral immune responses. Multiple approaches for ex vivo antigen loading and improvement in immunogenicity have been described. We have recently established a single-step protocol consisting of a fusion peptide (a sequence of the melanoma antigen Melan-A and a cationic cell-penetrating HIV TAT domain) bound in complexes with a toll-like receptor agonist. As the exact cellular uptake mechanisms of TAT-coupled antigens have been a matter of considerable debate and significantly depend on cell type, cargo and concentrations, we evaluated internalization routes into human immature DCs in comparison with non-phagocytic cell lines. We found that Melan-A-TAT fusion peptide uptake by DCs is mainly energy dependent, superior compared with polylysine-coupled Melan-A and significantly higher in DCs as compared with Jurkat cells or HUVECs. Furthermore, we could track the uptake of the fusion peptide exclusively through early endosomes to lysosome compartments after 90 min by fluorescence microscopy and immunoelectron microscopy. Specific endocytosis inhibitors revealed major internalization of the fusion peptide by DCs via clathrin-mediated endocytosis, whereas uptake by non-phagocytic HUVECs differed significantly, involving macropinocytosis as well as clathrin-mediated endocytosis. As our understanding of the processes involved in internalization of TAT-coupled cargos by human DCs broadens, and DC activation becomes available by single-step procedures as described, further development of simultaneous DC maturation and intra-cellular peptide targeting is warranted.
    Experimental Dermatology 01/2014; 23(1):20-6. DOI:10.1111/exd.12285 · 4.12 Impact Factor
  • Steffen Emmert, Michael P Schön, Holger A Haenssle
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    ABSTRACT: The prevalent keratinocyte-derived neoplasms of the skin are basal cell carcinoma and squamous cell carcinoma. Both so called nonmelanoma skin cancers comprise the most common cancers in humans by far. Common risk factors for both tumor entities include sun-exposure, DNA repair deficiencies leading to chromosomal instability, or immunosuppression. Yet, fundamental differences in the development of the two different entities have been and are currently unveiled. The constitutive activation of the sonic hedgehog signaling pathway by acquired mutations in the PTCH and SMO genes appears to represent the early basal cell carcinoma developmental determinant. Although other signaling pathways are also affected, small hedgehog inhibitory molecules evolve as the most promising basal cell carcinoma treatment options systemically as well as topically in current clinical trials. For squamous cell carcinoma development mutations in the p53 gene, especially UV-induced mutations, have been identified as early events. Yet, other signaling pathways including epidermal growth factor receptor, RAS, Fyn, or p16INK4a signaling may play significant roles in squamous cell carcinoma development. The improved understanding of the molecular events leading to different tumor entities by de-differentiation of the same cell type have begun to pave the way for modulating new molecular targets therapeutically with small molecules.
    Advances in Experimental Medicine and Biology 01/2014; 810:234-52. · 2.01 Impact Factor

Publication Stats

454 Citations
156.68 Total Impact Points


  • 2014
    • Universitätsklinikum Freiburg
      Freiburg an der Elbe, Lower Saxony, Germany
  • 2009–2014
    • Universitätsmedizin Göttingen
      • Department of Dermatology, Venereology and Allergology
      Göttingen, Lower Saxony, Germany
  • 2002–2014
    • Georg-August-Universität Göttingen
      Göttingen, Lower Saxony, Germany
  • 2008
    • Universität Heidelberg
      • Department of Dermatology
      Heidelburg, Baden-Württemberg, Germany
  • 2003
    • Philipps University of Marburg
      Marburg, Hesse, Germany
    • Gesellschaft für wissenschaftliche Datenverarbeitung mbH Göttingen
      Göttingen, Lower Saxony, Germany