Enno Christophers

• Professor emeritus, Dr. hc.c, FRCP
• Kiel University

Pustules are among the most common lesions produced in human skin. Infections by pathogens and drug‐induced reactions are frequent causes of pustule formation. In recent years immune‐mediated pustular diseases have drawn attention. It is proposed to classify pustular diseases according to the initiating events and sites: purely epidermal pustules,...

More often as compared to other barrier systems (gastrointestinal, urogenital, and respiratory linings) human skin over millions of years has been subject to fundamental changes in structure and function. When life on land started, the first changes consisted in the formation of a coherent impermeable stratum corneum. Two-legged locomotion was foll...

First studies have shown that juvenile psoriasis is associated with an increased prevalence of comorbidity. We carried out a data analysis to characterise the profiles of comorbidity in children with psoriasis and atopic eczema. Prevalence data were derived from the database of a German statutory health insurance company according to ICD-10 codes L...

Early-onset psoriasis (EOP) has been characterised by onset age < 40 years and accounts for more than 75% of psoriasis cases.(1) Late-onset psoriasis (LOP) by contrast occurs after 40 years of age.(1) Such a bi-modal age of onset has since been identified in several large studies.(2-4) However, little is known about the relative response of the two...

Psoriasis is a common inflammatory skin disease that presents with a variety of different subtypes and disease activities. There is evidence that various forms, including pustular psoriasis, represent different entities. Genome-wide association studies revealed more than 20 susceptibility loci on various chromosomes. These are mostly linked to immu...

Psoriasis is an immune-regulated skin disease with various clinical subtypes and disease activities. The majority of patients present with predominantly stable plaques. At the onset of new lesions plaque type psoriasis frequently demonstrates pin-sized and highly inflammatory papules sometimes with an inflammatory border. The histopathology of init...

To gain further insight into the genetic architecture of psoriasis, we conducted a meta-analysis of 3 genome-wide association studies (GWAS) and 2 independent data sets genotyped on the Immunochip, including 10,588 cases and 22,806 controls. We identified 15 new susceptibility loci, increasing to 36 the number associated with psoriasis in European...

Skin cancer, nonmelanoma skin cancer (NMSC) and cutaneous malignant melanoma (CMM), is the most frequent cancer worldwide. It is amenable to early detection, and screening for skin cancer has the potential to reduce mortality and morbidity. However, there are no recommendations for population-based skin cancer screening programmes due to the lack o...

Background: Efficacy of biologic therapies for psoriasis has been demonstrated in randomized trials, but effectiveness in real-world settings has yet to be fully determined. Objective: To compare clinical improvement and treatment satisfaction with biologic versus other therapies in patients with plaque psoriasis. Methods: European dermatologists r...

Interferone werden heute bei einer Vielzahl von Erkrankungen in der Monotherapie und auch Kombinationstherapie eingesetzt. In der Dermatologie werden Interferon α2a und Interferon α2b vor allem in der adjuvanten Therapie des malignen Melanoms mit einem hohen Metastasierungsrisiko verwendet. Darüber hinaus sind die Behandlung des Kaposi-Sarkoms und...

To gain further insight into the genetic architecture of psoriasis, we conducted a meta-analysis of 3 genome-wide association studies (GWAS) and 2 independent data sets genotyped on the Immunochip, including 10,588 cases and 22,806 controls. We identified 15 new susceptibility loci, increasing to 36 the number associated with psoriasis in European...

Psoriasis is not a uniform disorder but shows many clinically distinct forms of disease. The inflammatory skin changes show varying degrees of tissue neutrophilia that may affect clinical disease expression. Associated disorders include psoriatic arthritis, Crohn's disease and metabolic syndromeassociated risk factors. Gene-expression profiling is...

Schlüsselwörter • juvenile Psoriasis • Epidemiologie • klinisches Bild • Therapie Keywords • juvenile psoriasis • epidemiology • clinical picture • therapy Zusammenfassung Die Psoriasis in der Kindheit ist mit einer Jahresprävalenz von 0,71 % eine der häufigsten entzündlichen Hauterkrankungen dieses Lebensabschnittes. Kon-sequenzen für die körperli...

Psoriasis of childhood shows an annual prevalence of 0.71 % and accordingly has to be regarded as a frequent chronic inflammatory skin disorder of this age. The impact on the quality of life as well as development of the afflicted children and their parents is evident. On the other side, therapy is demanding with regard to the specific juvenile met...

The presence of eosinophils and/or eosinophil-derived products in the dermis is characteristic for involved skin of patients with atopic dermatitis and contributes to the observed tissue injury. CCL11 is a potent chemoattractant and activator of human eosinophils and interleukin (IL)-4 is a potent inducer of CCL11 expression in dermal fibroblasts....

Bei einer 67-jährigen Patientin, die aufgrund einer rheumatoiden Arthritis mit Etanercept behandelt wird, kam es unter der Etanercept-Therapie zum Auftreten eines afebrilen Erysipels. Nach Absetzen des Tumor-nekrosefaktor-alpha (TNF-α)-Fusionsproteins erfolgte der Temperaturanstieg. Das Erysipel wurde erfolgreich mit einem Kombinationspräparat, bes...

Psoriasis is a common disease affecting all age groups. In contrast to adult psoriasis, only few studies on the epidemiology of childhood psoriasis have been published. Assessment of prevalence and comorbidities of juvenile psoriasis in Germany based on health insurance data. Data were collected from a database of about 1.3 million nonselected indi...

Estimates of psoriatic arthritis (PsA) prevalence among psoriasis patients vary widely (5-40%). The time to development of PsA in patients with plaque psoriasis also remains unclear. To examine whether length of time since diagnosis of psoriasis affects risk of developing PsA, and to assess differences in quality of life (QoL), work-related issues,...

Psoriasis is a common immune mediated disorder that affects the skin, nails, and joints. To identify psoriasis susceptibility loci, we genotyped 438,670 SNPs in 1,409 European ancestry psoriasis cases and 1,436 controls. Twenty-one promising SNPs were followed-up in 5,048 psoriasis cases and 5,041 controls. Our results provide strong support for th...

Psoriasis is a common skin disorder with a prevalence of about 2% in Europe, presenting with inflammation and epidermal hyperproliferation.

Accumulation of neutrophils within the epidermis and formation of pustules represents a unique, however, ill-understood phenomenon in human skin. In this overview, we compare localized versus systemic pustular disorders. Localized pustules are mostly infectious and appear to be generated by the interaction of skin cells with Th17 cells and macropha...

Psoriasis is a common inflammatory and hyperproliferative skin disease with a multifactorial genetic basis. A recent study reported that psoriasis was associated with the IL12B haplotype rs3212227 (3′-untranslated region)–rs6887695 (60 kb, 5′) and the IL23R haplotype rs7530511 (L310P)–rs11209026 (Q381R). We examined these four single-nucleotide pol...

Psoriasis is a heterogeneous disorder with many different phenotypes. Further, different forms may alter their morphology and course of disease in that, for instance, plaque-type psoriasis may become pustular and vice versa. With advancing insight in immunopathology phenotype switching can now be explained by directional changes from T cell-mediate...

In addition to the function as a physical barrier human skin has been shown to be an important immune organ displaying various defense mechanisms, which can be divided into three major functional compartments: (i) Epithelial defense, which is characterized by antimicrobial peptides and proteins (AP) and which can be induced in inflammatory lesions...

The role of chronic inflammation causing metabolic and vascular disorders is increasingly recognized. It is hypothesized that proinflammatory cytokines contribute to atherogenesis, peripheral insulin resistance, and the development of hypertension and type II diabetes. Psoriasis as a chronic inflammatory skin disorder is characterized by a variety...

Epidemiological studies have shown that, in psoriasis patients, associated disorders may occur more frequently than expected. Such comorbidities include psoriatic arthritis, psoriatic pustular diseases, Crohn disease, and signs of metabolic syndrome, which leads to atherosclerosis with coronary heart disease. Although the disorders represent separa...

Epidemiologicial studies recently have shown that psoriasis patients may suffer from associated disorders more frequently than expected. Such comorbidities include psoriatic arthritis, psoriatic pustular diseases, Crohn's disease, and signs of metabolic syndrome which lead to atherosclerosis with coronary heart disease. Although the disorders repre...

AD, atopic dermatitis; FLG, filaggrin gene

Bei einem 11-jährigen Jungen mit einer Mevalonazidurie kam es nach systemischer Glukokortikosteroidtherapie zum Auftreten einer Rosazea. Unter topischer Therapie mit Metronidazol und Erythromycin sowie Reduktion der Steroiddosis zeigte sich eine deutliche Besserung des Hautbefundes.

For nearly 200 years it has been appreciated that plaque psoriasis consists of a number of distinct clinical phenotypes. However, a reliable and simple stratification of clinical presentation of psoriasis is lacking. In the era of immunogenetic association studies and an advanced understanding of the pathomechanisms of psoriasis it is important tha...

Evaluation of: Christensen TE, Callis CP, Papenfuss J et al. Observations of psoriasis in the absence of therapeutic intervention identifies two unappreciated morphologic variants, thin-plaque and thick-plaque psoriasis, and their associated phenotypes. J. Invest. Dermatol. 126, 2397–2403 (2006) 1. Christensen TE, Callis CP, Papenfuss J et al. Obse...

Endothelial cells are critically involved in the pathogenesis of inflammation, which is characterized by vasopermeability, plasma leakage, leukocyte recruitment, and neovascularization. Therefore, inhibitors of endothelial cell function could reduce inflammation. In this study, we evaluated the effects of the angiogenesis inhibitor vasostatin on in...

Summary

A reduction of symptoms of atopic dermatitis (AD) in small infants by the administration of Lactobacillus rhamnosus has been reported in a few studies. One study with older children and adolescents failed to show any effect. We conducted a prospective study to reassess the efficacy of orally administered L. rhamnosus strain GG (LGG) in infants with...

Psoriasis is a common inflammatory skin disease. Epidemiological data demonstrate an association with a number of distinct disorders of the joints (psoriatic arthritis), the intestine (Crohn's disease), and skin (pustular disorders), as well as increased risk of cardiovascular disease. Systemic risk factors include obesity, hypertension, dyslipidae...

Conventional systemic therapies and phototherapy for psoriasis are limited by safety concerns that may preclude long-term treatment with these agents. To estimate the unmet need for safe and effective treatments for psoriasis. A survey was conducted at three psoriasis outpatient clinics in Europe. Male and female patients of any age with psoriasis...

Leiomyomatosis cutis is a rare disease involving large areas of the body surface with painful leiomyomas. Only a small panel of drugs has provided limited effects in the management of paroxysmal pain attacks associated with these tumours. Two patients with multiple, otherwise therapy-refractors cutaneous leiomyomas predominantly on the extremities...

Previous studies have narrowed the interval containing PSORS1, the psoriasis-susceptibility locus in the major histocompatibility complex (MHC), to an approximately 300-kb region containing HLA-C and at least 10 other genes. In an effort to identify the PSORS1 gene, we cloned and completely sequenced this region from both chromosomes of five indivi...

Atopic dermatitis (AD) is a chronic inflammatory skin disease commonly associated with respiratory allergies such as rhinitis and asthma, and a high serum level of IgE. In contrast to the 'classic' IgE-mediated allergic (extrinsic) form of AD, approximately 20% of the patients are reported to show normal IgE levels, lack of sensitizations towards e...

Psoriasis has a strong genetic component in the development of the disease as indicated by familial occurrence and a high concordance rate among monozygotic twins. In genome-wide scans for psoriasis several susceptibility loci have been detected, but the disease-causing genes have not yet been identified. A recent scan, performed on psoriatic arthr...

A previous study identified two peaks of allelic association between psoriasis and single nucleotide polymorphisms (SNPs) mapping to distal chromosome 17q, including a disease associated SNP that leads to loss of a RUNX1 transcription factor binding site, and additional SNPs in the third intron of the RAPTOR gene. Another study found an association...

Many patients with moderate to severe chronic plaque psoriasis fail to respond to or are not appropriate candidates for conventional systemic therapies and/or phototherapy. To assess the efficacy, quality of life and safety of alefacept among the proportion of patients who participated in the phase III studies and who were not suitable candidates f...

FBAT, family-based association test; GD, Graves disease; GRR, genotype relative risk; GRR1, genotype relative risk for carriers of one copy of the test allele; GRR2, genotype relative risk for carriers of two copies of the test allele; PDT, pedigree disequilibrium test; RA, rheumatoid arthritis; SLE, systemic lupus erythematosus; SNP, single nucleo...

Halo dermatitis (Meyerson's nevus) is an inflammatory, sometimes itchy, eczematous eruption usually encircling a preexisting melanocytic nevus that can be mistaken for malignant melanoma or Sutton's nevus. Unlike the latter, it mostly resolves spontaneously within weeks and never causes regression of the central lesion. Sutton's nevi, however, are...

To access publisher full text version of this article. Please click on the hyperlink in Additional Links field Human leukocyte antigen (HLA)-Cw6 has long been associated with psoriasis, and PSORS1 (psoriasis susceptibility 1), a major gene for psoriasis susceptibility, has been mapped to its vicinity. A previous analysis identified multiple risk ha...

Psoriasis is a common, immunologically-mediated, inflammatory and hyperproliferative disease of the skin and joints. Available evidence indicates that a major psoriasis gene (PSORS1) resides in the major histocompatibility complex (MHC), and that several additional psoriasis susceptibility genes reside elsewhere. Identification of the PSORS1 gene h...

Human healthy skin is continuously exposed to bacteria, but is particularly resistant to the common gut bacterium Escherichia coli. We show here that keratinocytes secrete, as the main E. coli-killing compound, the S100 protein psoriasin in vitro and in vivo in a site-dependent way. In vivo treatment of human skin with antibodies to psoriasin inhib...

Actinic keratoses (AKs) are epidermal lesions that occur in areas of long-term sun exposure. These AK lesions have been identified as an early clinical manifestation in the disease continuum of squamous cell carcinoma (SCC). The risk for AK lesions to develop into SCC has been reported to be as high as 6% to 10%,1 with an even greater percentage of...

Psoriasis is a chronic, immune-mediated disorder that usually requires long-term treatment for control. Approximately 25% of patients have moderate to severe disease and require phototherapy, systemic therapy or both. Despite the availability of numerous therapeutic options, the long-term management of psoriasis can be complicated by treatment-rela...

Psoriasis represents a chronic inflammatory disorder which shows an abundance of pro-inflammatory mediators. These include cytokines, chemokines, complement split products and antimicrobial peptides present within the scale material of lesional surfaces. Some of these provide evidence for participation of innate immune mechanisms. Recent data demon...

In an effort to confirm previously reported linkages to psoriasis, we analyzed 942 affected sibling pairs ( ASPs) from 710 pedigrees for 53 polymorphic microsatellites spanning 14 psoriasis candidate regions at an intermarker spacing of similar to5 cM. Maximum LOD score (MLS) analysis of ASPs yielded allele sharing of 60% for markers within the maj...

Alefacept, human lymphocyte function-associated antigen 3/immunoglobulin 1 fusion protein, binds to CD2 molecules on the surface of activated T cells, selectively targeting memory-effector (CD45RO+) T cells, which comprise more than 75% of T cells in psoriatic plaques. To examine the efficacy and tolerability of intramuscular alefacept. Internation...