Constantin Orfanos

• Professor Emeritus at Freie Universität Berlin

Unter dem Druck der postmodernen Zivilgesellschaft, der ökonomischen Zwänge und der aufgelegten diversen Regularien entwickelt sich der Arztberuf in ein „marktgerechtes“ Gewerbe. Bereits heute werfen Ökonomisierung und drohende Kommerzialisierung der Medizin ihren Schatten voraus, die Patienten vermissen oft und nachdrücklich den Heilkundigen und d...

In der Körperkultur der griechischen Antike spielte die nackte Haut eine wichtige Rolle, sie hatte kulturellen Symbolcharakter, denn der gesunde Körper wurde über eine gesunde Haut als solcher wahrgenommen. Früh wusste man gut damit umzugehen, sie zu reinigen und zu pflegen, man konnte Wunden fachgerecht verbinden und behandeln, wobei auch Frauen s...

Since retinol became available in the mid 1940s, at least 2500 different retinoids, structurally related to retinol, were synthesized. Dermatologists have played a leading role in developing this new class of drugs. Topical retinoic acid was first successfully used for treatment of keratoses in 1962 [76]. In the beginning of the 1970s, the first sy...

Während der zweiten Hälfte des vergangenen Jahrhunderts wurde die experimentelle Forschung in die deutsche Dermatologie eingeführt und hat dem Fach ein neues Gesicht gegeben. Die Gründung der „Arbeitsgemeinschaft Dermatologische Forschung” (ADF) vor 40 Jahren hat substanziell dazu beigetragen, aus dem traditionell morphologischen Fach eine naturwis...

Die Ärzteschaft, einschl. der Dermatologen, wird heute durch die Möglichkeiten der medizinischen Hochtechnologie und die Ökonomisierung des medizinischen Berufs herausgefordert; sie ist vielfach überfordert. Die Krankenhäuser wandeln sich in Industriebetriebe um, die mit Profit arbeiten sollen, und der Arzt findet sich manchmal zwischen Budget und...

Vital polymorphonuclears of healthy person and of patients with psoriasis before and after therapy with oral rettnoid (Ro 10–9359) were observed in vitro under standradized conditions. In this model normal pllymorphonuclears showed well-defined changes entering (A) a stage of resting and accommondation, (B) a state of Movement in loco, and finally,...

Hippocrates was the first to introduce the concept of ‘physis’ and to transform hieratic or theocratic medicine into rational medicine. The overall construction of the Asclepieion on Kos clearly indicates that he and his school followed a holistic concept, combining scientific thought with drug therapy, diet schedules, and physical and mental exerc...

Skin colonization with Staphylococcus aureus (S. aureus) was examined in 30 patients with atopic dermatitis (AD), in 25 patients with nonatopic eczema (NAE) and in 30 individuals as healthy controls (HC). Bacteria growth was examined in aerobic cultures and the population densities per dish were estimated; S. aureus colonization was found in the ec...

The relationship between cutaneous malignant melanoma (MM) and possible risk factors was assessed in a case-controlled study. Two hundred patients and 200 non-melanoma controls of German origin matched for age and sex were interviewed and examined for pigmented moles and pigmentation characteristics. In patients with MM significantly more melanocyt...

Cutaneous melanoma is a tumor with high metastatic potential, but the mechanisms leading to progression are still not fully understood. To provide further molecular basis for understanding the progression of melanoma, the aim of this study was to examine the expression pattern of cell cycle modulators (p21, p27, p53 and Rb) and proapoptotic multido...

During periods of smoking, patients with Behçet's disease have less oral aphthae than in abstinence. To elucidate this observation, human keratinocytes and dermal microvascular endothelial cells (HMEC-1) were incubated with serum of 20 patients with Behçet's disease and 20 healthy controls for 4 hours. Maximum non-toxic concentrations were determin...

Ein Epizentrum der HIV-Infektion in Afrika liegt in der Subsahara, und zwar im Süd-Südosten des Kontinents über Südafrika, Swaziland, Lesotho, Botswana, Zimbabwe, Malawi und den angrenzenden Ländern vor. Es ist bis heute nicht überzeugend geklärt, wann und auf welchem Wege sich die HIV-Infektion dort etabliert und dermaßen schnell ausgebreitet hat,...

Es werden zwei Kranke mit Eumyzetom in Ostafrika beschrieben, die den langjährigen Verlauf und die damit verbundenen Komplikationen dieser Infektion mit Madurella mycetomatis und anderen Bodensaprophyten demonstrieren sollen. Kennzeichnend für beide war der harmlose Beginn mit indolenten Papeln an den Füßen, sowie der lange Verlauf bis zum Auftrete...

The molecular and cellular pathogenesis of pemphigus remains unclear. However, the integrity of intraepidermal and dermoepidermal adhesion appears to be of special importance, and the presence of antibodies directed against desmosomal plaque proteins can provoke pemphigus-like pathologies. Antibodies reactive with various tissue antigens have been...

A case report of recurrent angiolymphoid hyperplasia with eosinophilia (ALHE) in an otherwise healthy 20-year-old female with manifestation of the disease limited to the left arm and hand is presented together with brief evaluation of the literature as well as the features distinguishing ALHE and Kimura's disease. Immunohistochemical investigations...

Obwohl seit der Antike bekannt, ist die Lepra heute in manchen Ländern Asiens, Südamerikas und Afrikas noch endemisch, dort mit einer Prävalenz von >1 : 10 000. Bereits vor 15 Jahren hat die WHO die Elimination dieser alten Infektionskrankheit zum Ende des 20.Jahrhunderts angekündigt, doch bis einschließlich 2005 wurde das angestrebte Ziel nicht er...

Dermatologische Einrichtungen sind in Ostafrika rar, die dermatologische Versorgung ist in Tansania und den angrenzenden Ländern für eine Bevölkerung von insgesamt über 100 Millionen Menschen ausgesprochen mangelhaft. Im Norden Tansanias, in der Provinz um den Kilimandscharo nahe an der Grenze zu Kenia, ist das „Kilimanjaro Christian Medical Center...

Cidofovir is an acyclic nucleoside phosphonate with broad-spectrum activity against DNA viruses, including human papilloma virus (HPV). However, data on the efficacy of cidofovir in an immunosuppressive setting remain contradictory. We report for the first time on the promotion of the healing of recalcitrant warts in a patient with myelodysplastic...

Apoptosis is a form of programmed cell death with typical morphological signs. It has an important role in physiological conditions during the embryonic period for supporting the cell homeostasis. Apoptosis is regulated by many genes and gene products which are in complicated interrelations. In malignant melanoma, there is a disturbed cell control...

Background: In the chinese literature several reports indicate that localized scleroderma (LS) may be successfully treated with herbs of the traditional chinese medicine (TCM). In this study we aimed to investigate the effectiveness of a TCM schedule in European patients. Patients and methods: In a prospective randomized pilot-study 24 patients (7...

Therapy resistance is crucial for the high mortality of melanoma. The death ligand tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) bears high potential as a new anticancer agent, as binding to the death receptors TRAIL receptor 1/death receptor 4 (TRAIL-R1/DR4) or TRAIL receptor 2/death receptor 5 (TRAIL-R2/DR5) triggers apoptosis i...

In this study 77 patients with histologically confirmed Kaposi's sarcoma (KS) were seen at the Regional Dermatology Training Centre (RDTC) in Moshi, Tanzania. Sixty six patients (85.7%) were HIV-seropositive KS-patients (40 males, 26 females; male: female ratio 1.5:1), whereas another 11 (14.3%) KS-patients, all males, were found HIV-seronegative,...

For a long time, the mantra of acne pathogenesis debates has been that acne vulgaris lesions develop when (supposedly largely androgen-mediated) increased sebum production, ductal hypercornification, and propionibacteria come together with local inflammatory process in the unlucky affected individual. And yet, the exact sequence, precise interdepen...

For a long time, the mantra of acne pathogenesis debates has been that acne vulgaris lesions develop when (supposedly largely androgen-mediated) increased sebum production, ductal hypercornification, and propionibacteria come together with local inflammatory process in the unlucky affected individual. And yet, the exact sequence, precise interdepen...

Induction of apoptosis has been demonstrated previously by overexpression of CD95 ligand (CD95L) in cultured human melanoma cells. For in vivo approaches based on CD95L, however, targeted expression is a prerequisite and tyrosinase promoters have been considered for selection. Luciferase reporter gene assays performed for a representative panel of...

The lymph nodes are generally the first extracutaneous manifestation in patients with cutaneous T-cell lymphoma (CTCL); however, their early involvement is difficult to assess. The aim of our study was to define the diagnostic and prognostic value of T-cell clonality analysis for a more precise assessment of lymph node involvement in CTCL. T-cell c...

Scleredema adultorum Buschke is a very rare connective tissue disorder. The etiology of the disease is unknown although increased deposition of collagen and mucin is observed. The propeptide of type I collagen is increased in suction blister fluid aspirates obtained from scleredematous skin as cornpaired to normal control skin. The subunits of proc...

Systemic lupus erythematosus (SLE) is one of the most frequently seen autoimmune disorders.Prevalence rates vary between 14 and 50 per 100,000 population (Hochberg 1997). Cutaneous LE (CLE) presumably occurs two to three times more frequently than SLE. However, exact population-based epidemiologic data are not available. In selected groups of patie...

Mycosis fungoides (MF) and Sezary syndrome (SS) are the most common clinical variants of cutaneous T cell lymphoma. Although thought to be closely related to mature T helper cells, the relation between the neoplastic cells in MF and SS is still not fully clarified. This report describes a patient with complete remission of SS under treatment with e...

The initial steps of melanocytic dysfunction in vitiligo are hitherto not well understood. The aim of the present study was to examine the sequence of early events that occur in melanocytes after autologous minigrafting in patients with vitiligo, depending on their clinical response. Six patients with non-segmental widespread vitiligo were included...

Cutaneous melanoma is one of the highly malignant human tumours, due to its tendency to generate early metastases and its resistance to classical chemotherapy. We recently demonstrated that pamidronate, a nitrogen-containing bisphosphonate, has an antiproliferative and proapoptotic effect on different melanoma cell lines. In the present study, we c...

Exponential proliferation of human melanoma cells has been associated with low levels of protein kinase C (PKC)-alpha. The aim of the present study was to investigate the functional relationship between PKC-alpha and melanoma cell proliferation. Treatment of human melanoma cells with the selective PKC inhibitor Ro-31-8220 resulted in a significant...

Ten patients with malignant melanoma and phototoxic reactions under dacarbazine or 5-(3,3-dimethyl-1-triazeno) imidazole-4-carboxamide (DTIC) chemotherapy were investigated. All patients available for testing showed increased ultraviolet A-sensitivity (n = 5); patch testing revealed no type IV allergies (n = 6). In 5 patients intravenous DTIC was r...

Composite lymphomas are defined as two unrelated, morphologically and genetically distinct lymphomas occurring at the same point in time within the same tissue or organ. Since their original definition, several composite lymphomas have been reported exclusively based on morphological grounds. However, with the application of immunohistological and...

Verrucous carcinoma, a variant of squamous cell carcinoma, is distinct from squamous cell carcinoma in morphology and behavior. It preferentially occurs on the oropharyngeal mucosa, the urogenital mucosa, and the soles. In contrast to its malignant clinical picture, the tumor grows locally invasive but is histologically benign and metastasizes rare...

A woman developed widespread contact dermatitis after temporary tattooing with henna, caused by paraphenylenediamine (PPD) which had been added to the henna as an enhancer. The patient recovered after treatment; a week later an acute generalized rebound occurred after she wore dark clothing (black chador). Patch tests revealed type-IV allergy to PP...

The significance of CD95/Fas ligand expression by melanoma cells has remained a controversial matter in recent years. On the other hand, CD95 activation may represent a powerful tool for eliminating tumor cells. Here, we demonstrate expression of CD95 in 15/17 human melanoma cell lines analysed, but complete lack of CD95 ligand (CD95L). Overexpress...

Histiocytoses are diseases caused by proliferation of either dendritic cells/Langerhans cells or of monocytes/macrophages. Generalized eruptive histiocytosis belongs to the cutaneous non-Langerhans cell histiocytoses and is a rare monocyte-macrophage proliferative disorder that usually follows a benign clinical course. We present the case of a 59-y...

The Bcl-2-related proteins Bcl-X(L) and Bcl-X(S) represent alternative splice products and exert opposite activities in the control of apoptosis, but their significance for melanoma is not yet clear. Applying the tetracycline-inducible expression system Tet-On, we found overexpression of Bcl-X(S) by itself sufficient to induce apoptosis in vitro in...

The initial steps of melanocytic dysfunction in vitiligo are hitherto not well understood. The aim of the present study was to examine the sequence of early events that occur in melanocytes after autologous minigrafting in patients with vitiligo, depending on their clinical response. Six patients with non-segmental widespread vitiligo were included...

The leukotrienes, a family of highly potent biological substances derived from arachidonic acid, are suggested to play an important role in the development of tissue inflammation.1 Leukotriene B4 (LTB4) is a major player whose synthesis is mainly controlled by 5-lipoxygenase. Among several diseases, hyperkeratotic inflammatory skin diseases and esp...

An unusual course was observed in a patient with indolent T-prolymphocytic leukaemia (T-PLL) who subsequently developed mycosis fungoides (Mf), lymphomatoid papulosis (LyP) and cutaneous CD30+ anaplastic large cell lymphoma (ALCL). Polymerase chain reaction analysis demonstrated identical monoclonal T-cell receptor-beta and -gamma gene rearrangemen...

Increased cell volume, accumulation of lipid droplets in the cytoplasm, and nuclear degeneration are phenomena indicating terminal differentiation of human sebocytes followed by holocrine secretion and cell death. The molecular pathways of natural and induced sebocyte elimination are still unknown, however. In this study, SZ95 sebocytes were found...

Although several immunological abnormalities have been demonstrated in Behçet's disease (BD), the exact mechanism of the inflammatory changes occurring is still unknown. Antigen-presenting cells, such as mononuclear phagocytes, play a major role in the regulation of immune-mediated as well as of non-specific inflammation. To investigate the serum a...

Psoriasis is one of the most common skin diseases. A variety of molecular alterations has been identified in the active, lesional epidermis and dermis of psoriasis, but the pathogenesis still remains unexplained. Therefore, all antipsoriatic therapeutic regimens are symptomatic. Although there is no cure for psoriasis, a variety of therapeutic moda...

Aquagenic urticaria is a rare disorder characterized by the occurrence of pruritus and wheals after temporary contact with water. The familial occurrence of aquagenic urticaria over 3 generations is reported here in association with familial lactose intolerance, a condition in which the enzyme lactase encoded on chromosome 2, is deficient. In two p...

Normal human melanocytes respond to endothelin-1 with induced proliferation and differentiation. Whereas in cultured melanoma cells the predominant endothelin receptor, ET(B)-R, is consistently downregulated, ET(B)-R upregulation was recently reported for melanoma tumors. Contrary to the pro-survival activity described for endothelin in vascular ce...

During the last decades dermatology has been profoundly transformed from its descriptive origin into an important part of modern medicine and biosciences. Areas of interest and expertise in the future will likely be focused on major topics on clinical dermatology (psoriasis, atopic dermatitis, skin infections including those sexually transmitted),...

The importance of apoptosis in hair follicle cycling is still not clearly understood, however, its regulation in follicular keratinocytes (FK) during bulb regression (catagen) may be essential for hair regrowth. So far, the control of FK apoptosis remains unknown. In this study, the anti-inflammatory cytokine IL-4 was found to induce apoptosis dose...

The proapoptotic potential of tumor necrosis factor-alpha (TNF-alpha) has been demonstrated for various cell types, whereas nuclear factor-kappaB (NF-kappaB) is known to support the transcription of prosurvival genes. In the present study, investigation of normal human melanocytes revealed induction of apoptosis after TNF-alpha treatment (100 U/ml)...

Nuclear factor-kappaB (NFkappaB) is a pleiotropic transcriptional activator, which is a sensitive transcriptional factor for free radicals and activates multiple target genes. UVA is very efficient in inducing free radicals in human skin cells. L-ascorbic acid is regarded as a scavenger of UVA-induced free radicals in human keratinocytes. In epider...

This study was performed to detect circulating melanoma cells in peripheral blood using a novel method based on magnetic-activated cell separation (MACS) followed by a nested reverse transcriptase-polymerase chain reaction (RT-PCR) for tyrosinase and MART-1 mRNA. Samples to be tested were enriched for tumour cells either by isolating melanoma cells...

During the last decades dermatology has been profoundly transformed from its descriptive origin into an important part of modern medicine and biosciences. Areas of interest and expertise in the future will likely be focused on major topics on clinical dermatology (psoriasis, atopic dermatitis, skin infections including those sexually transmitted),...

Nuclear factor-κB (NFκB) is a pleiotropic transcriptional activator, which is a sensitive transcriptional factor for free radicals and activates multiple target genes. UVA is very efficient in inducing free radicals in human skin cells. L-ascorbic acid is regarded as a scavenger of UVA-induced free radicals in human keratinocytes. In epidermis, mel...

Pamidronate belongs to the class of nitrogen-containing bisphosphonates that are potent inhibitors of bone resorption frequently used for the treatment of osteoporosis and cancer-induced osteolysis. The inhibition of osteoclasts’ growth has been suggested as the main mechanism of the inhibitory effect of pamidronate on bone metastases. Recent findi...

13-cis Retinoic acid is rapidly absorbed into cells and exerts its anti-proliferative effect on human sebocytes by specific isomerization to high levels of all-trans retinoic acid and binding the retinoic acid receptors. In this study, we have shown that bovine serum albumin, an extracellular binding protein for 13-cis retinoic acid, plays an impor...

Control of translation initiation was recognised as a critical checkpoint for cell proliferation and tumorigenesis. In human melanoma cells, we have previously reported consistent overexpression of translation initiation factor eIF-4A1. Here, we investigated by transfection of antisense constructs its significance for the control of melanoma cell g...

Nitric oxide is a gaseous messenger involved in the regulation of several physiologic processes in various cell types, including skin cells. Three different nitric oxide synthases (neuronal nitric oxide synthase, endothelial nitric oxide synthase, inducible nitric oxide synthase) have been identified in human cells. For inducible nitric oxide synth...

Sebaceous glands may be involved in a pathway conceptually similar to that of the hypothalamic-pituitary-adrenal (HPA) axis. Such a pathway has been described and may occur in human skin and lately in the sebaceous glands because they express neuropeptide receptors. Corticotropin-releasing hormone (CRH) is the most proximal element of the HPA axis,...