R M Szeimies

Knappschaftskrankenhaus Recklinghausen, Recklinghausen, North Rhine-Westphalia, Germany

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Publications (146)318.97 Total impact

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    ABSTRACT: Amyloid and amyloidosis describes a heterogenous group of diseases which are characterized by the pathological extracellular deposition of autologous proteins. Basically, amyloidoses can be divided into systemic or organ-limited (e.g. cutaneous) forms and can be acquired or hereditary in nature. The subclassification discriminates between primary amyloidosis (in the absence of an obvious predisposing disease) and secondary amyloidosis (if caused by a certain underlying disease). The subclassification of amyloidoses is based on the main protein constituent and therefore on the chemical composition of the amyloid fibrils. However, the exact etiopathogenesis of amyloid formation remains unclear. In addition to the clinical presentation, histology, electron microscopy and biochemical-immunological differentiation are also decisive for a proper diagnosis. In cutaneous amyloidosis the deposition of amyloid either occurs along reticulin fibers and the basal membrane (perireticulary amyloidoses) or along collagen fibers (pericollagenous amyloidosis). The purpose of this article is to provide an up-to-date overview on the different kinds of cutaneous amyloidoses.
    Full-text · Article · May 2009 · Der Pathologe
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    S Schreml · J Schroeder · F Eder · R M Szeimies · M Landthaler · P Babilas
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    ABSTRACT: Amyloid and amyloidosis describes a heterogeneous group of diseases which are characterized by the pathological extracellular deposition of autologous proteins. Basically, amyloidoses can be divided into systemic or organ-limited (e.g. cutaneous) forms and can be acquired or hereditary in nature. The subclassification discriminates between primary amyloidosis (in the absence of an obvious predisposing disease) and secondary amyloidosis (if caused by a certain underlying disease). The subclassification of amyloidoses is based on the main protein constituent and therefore on the chemical composition of the amyloid fibrils. However, the exact etiopathogenesis of amyloid formation remains unclear. In addition to the clinical presentation, histology, electron microscopy and biochemical-immunological differentiation are also decisive for a proper diagnosis. In cutaneous amyloidosis the deposition of amyloid either occurs along reticulin fibers and the basal membrane (perireticulary amyloidoses) or along collagen fibers (pericollagenous amyloidosis). The purpose of this article is to provide an up-to-date overview on the different kinds of cutaneous amyloidoses.
    Full-text · Article · Apr 2009 · Der Pathologe
  • J. Steinbauer · S. Karrer · M. Landthaler · R.-M. Szeimies

    No preview · Article · Feb 2009 · Aktuelle Dermatologie
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    ABSTRACT: In SSc, diagnosis and classification is based mainly on skin sclerosis. Herein, we investigated in a large multicentre cohort, to what extent skin sclerosis reflects organ involvement and additional clinical symptoms. A total of 1200 SSc patients from the register of the German Systemic Sclerosis Network (DNSS), classified as either lcSSc or dcSSc, were analysed for their serological characteristics, clinical symptoms and organ manifestations in relation to skin involvement measured by the modified Rodnan skin score (mRSS). SSc patients with different mRSS did not differ significantly in their disease duration and in most of the clinical symptoms. They showed a similar distribution of most organ manifestations such as pulmonary arterial hypertension as well as cardiac, renal and nervous system involvement. More severe skin thickening was found to be associated with pulmonary fibrosis and gastrointestinal symptoms, as well as with digital ulcers and musculoskeletal involvement. In patients with SSc, potentially life-threatening complications and clinical symptoms with high impact on the quality of life occur independently from the extent of skin sclerosis. The diagnosis in SSc patients with a low mRSS could be missed or they could be insufficiently treated.
    No preview · Article · Feb 2009 · Rheumatology (Oxford, England)
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    ABSTRACT: Photodynamic therapy refers to a new form of phototherapy in which non-psoralen photosensitizing drugs are administered systemically or topically to an individual. The drugs alone are inactive, but once activated by high-intensity light usually from a laser, they are exceptionally effective at inhibiting the growth of hyperproliferative tissues. PDT was originally designed for the treatment of malignancies because of the unique property of several photosensitizers to localize preferentially within tumors. Porfimer sodium (Photofrin), a first generation PDT photosensitizer, has already received regulatory approval in the USA, Canada, Japan, and Europe for the management of bladder, esophageal, and lung cancers. Although PDT has not been formally approved for dermatological malignancies, its efficacy in the treatment of superficial skin cancer has been demonstrated in several clinical studies [23, 38, 43, 85, 103, 125, 151, 163, 185]. Clinical trials are currently being conducted for this indication, and approval is likely within the next few years. Because of the accessibility of the skin, there is increasing interest in using this novel form of therapy for psoriasis and other benign cutaneous disorders as well.
    No preview · Article · Jan 2009
  • E. Kohl · J. Hillenkamp · M. Landthaler · R.-M. Szeimies
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    ABSTRACT: Zahlreiche Erkrankungen betreffen aufgrund gleicher ontogenetischer Herkunft Haut und Augen. So stellt z.B. das Auge einen weiteren wichtigen Manifestationsort des malignen Melanoms dar. Da die Lidhaut bis zu 4-mal dünner ist als die übrigen Gesichtspartien, sind die Augenlider prädisponiert zur Ausbildung toxischer und allergischer Dermatitiden. Differenzialdiagnostisch sind hiervon v.a. das atopische und seborrhoische Lidekzem abzugrenzen. Mit dem atopischen Ekzem assoziiert auftretende Erkrankungen sind die Keratoconjunctivitis vernalis sowie die atopische Keratokonjunktivitis. Eine konjunktivale Beteiligung unterschiedlichen Schweregrads ist bei zahlreichen Blasen bildenden Erkrankungen möglich. Bei periokulär lokalisierten Tumoren sollte auch an Neoplasien der dort vorhandenen Adnexstrukturen gedacht werden. Ophthalmologische Nebenwirkungen können im Rahmen einer Dermatotherapie mit Glukokortikoiden, Antimalariamitteln, Psoralenen, oralen Retinoiden und Tetrazyklinen auftreten. Numerous diseases affect both skin and eyes due to similar ontogenetic origin. The eye is the second most common site of melanoma after the skin. The eyelids are predisposed for development of toxic and allergic dermatitis as the skin in this region is four times thinner than the other facial skin. The differential diagnosis must include atopic and seborrhoeic eyelid dermatitis. Atopic and vernal keratoconjunctivitis are associated with atopic eczema. Various immunobullous disorders involve the conjunctiva with varying severity. Side effects of dermatologic treatments with glucocorticoids, antimalarials, psoralens, retinoids, or tetracyclines may involve the eye.
    No preview · Article · Jan 2009 · Der Hautarzt
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    ABSTRACT: To compare the efficacy and cosmetic outcome (CO) of photodynamic therapy with topical methyl aminolevulinate (MAL-PDT) with simple excision surgery for superficial basal cell carcinoma (sBCC) over a 1-year period. In this multicentre, randomised, controlled, open study, patients were treated at baseline either with MAL-PDT (two sessions, 7 days apart, repeated 3 months later if incomplete clinical response) or surgery (at baseline). Primary endpoints were clinical lesion response (CR) 3 months after last treatment and CO assessed by the investigator 12 months after last treatment. Secondary endpoints were CR at 12 months (i.e. recurrence) and CO assessed by the investigator at 3 and 6 months and by the patient at 3, 6 and 12 months. Overall, 196 patients were enrolled with 1.4 sBCC lesions on average per patient. Mean lesion count reduction at 3 months was 92.2% with MAL-PDT vs. 99.2% with surgery [per protocol (PP) population] confirming the non-inferiority hypothesis (95% confidence interval, -12.1, -1.9). A total of 92.2% lesions showed CR at 3 months with MAL-PDT vs. 99.2% with surgery (PP population). At 12 months, 9.3% lesions recurred with MAL-PDT and none with surgery. CO was statistically superior for MAL-PDT at all time points. At 12 months, 94.1% lesions treated with MAL-PDT had an excellent or good CO according to the investigator compared with 59.8% with surgery. This difference was confirmed with the patients' assessment. The proportion of excellent CO markedly improved with time with MAL-PDT unlike surgery. MAL-PDT offers a similarly high efficacy and a much better CO than simple excision surgery in the treatment of sBCC.
    Full-text · Article · Aug 2008 · Journal of the European Academy of Dermatology and Venereology
  • S. Karrer · R.-M. Szeimies
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    ABSTRACT: Während die Wirksamkeit der topischen photodynamischen Therapie (PDT) in der Behandlung von oberflächlichen, nicht pigmentierten Hauttumoren inzwischen durch klinisch kontrollierte Studien hinreichend belegt ist, liegen nur wenige kontrollierte Studien vor, die die Wirksamkeit der PDT auch in der Behandlung zahlreicher nichtonkologischer Hauterkrankungen zeigen. Im vorliegenden Beitrag wird der Einsatz der PDT bei entzündlichen Dermatosen, Erkrankungen der Talgdrüsen und Haarfollikel, Infektionen der Haut, sklerosierenden Hauterkrankungen und kosmetischen Indikationen vorgestellt und diskutiert. While efficacy of topical photodynamic therapy (PDT) for the treatment of superficial non-melanoma skin cancer is already well-proven by several controlled clinical trials, there are only a few controlled studies showing efficacy of PDT for non-oncologic skin disorders. This report provides information on the use of PDT for inflammatory skin disorders, disorders of the pilosebaceous unit, infections of the skin, sclerotic skin diseases and cosmetic indications.
    No preview · Article · Jul 2007 · Der Hautarzt
  • R.-M. Szeimies · J. Krutmann

    No preview · Article · Jul 2007 · Der Hautarzt
  • P Babilas · K Scherer · M Landthaler · B. Ehrenstein · R M Szeimies
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    ABSTRACT: Eine 61-jährige Patientin stellte sich mit rötlich lividen, subkutanen Knötchen im Bereich des rechten Beines vor. Über die letzten 10 Tage bestand Fieber bis 40°C, seit 2 Monaten Mattigkeitsgefühl. Vier Monate zuvor war ein femuropoplitealer Bypass implantiert worden. Unter der Verdachtsdiagnose einer Weichteilinfektion nach Implantation einer infizierten Endoprothese wurde die Patientin stationär aufgenommen und antibiotisch behandelt. Unter der initialen Antibiose war der Lokalbefund der Patientin progredient, darüber hinaus entwickelten sich septische Abszessherde in den großen Gelenken des rechten Beines, in der Leber sowie im ZNS. Erst eine mikrobiologische Kultur mit langer Bebrütungszeit von Abstrichmaterial erbrachte den Nachweis einer Infektion mit den langsam wachsenden Norkardien ssp. Daraufhin konnte die Patientin zielgerichtet mit Meropenem über 6 Monate behandelt werden. Unter dieser Therapie stellte sich eine restitutio ad integrum ein. A 61-year-old woman presented with purple-red subcutaneous nodules on her right leg. She had experienced fever up to 40 degrees C for the past 10 days and felt generally weak over the last two months. Four months earlier, a vascular graft had been implanted in her right femoral artery. Based on the diagnosis of skin infection due to implantation of an infected prosthesis, she was hospitalized and treated with an antibiotic regime. During the initial antibiotic treatment, the symptoms deteriorated, and she developed joint, hepatic and CNS abscesses. Finally, a microbiologic culture with an extended incubation time revealed the diagnosis of an infection with the slowly growing bacterium Nocardia ssp. Hereupon the patient was treated purposeful with Meropenem over six months. This treatment resulted in complete recovery.
    No preview · Article · Apr 2007 · Der Hautarzt
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    ABSTRACT: Based on good results in the treatment of superficial skin tumours, since the early 1990s topical photodynamic therapy with aminolaevulinic acid (ALA PDT) has been used for disseminated, inflammatory dermatoses including psoriasis. However, there is still a lack of well-documented trials. A prospective randomized, double-blind phase I/II intrapatient comparison study was conducted in 12 patients to investigate whether topical ALA PDT is an effective treatment for chronic plaque-type psoriasis. In each patient three psoriatic plaques were randomly treated with a light dose of 20 J/cm(2) and 0.1%, 1% and 5% ALA, respectively. Treatment was conducted twice a week until complete clearance or for a maximum of 12 irradiations. Therapeutic efficacy was assessed by weekly determination of the psoriasis severity index (PSI). The mean percentage improvement was 37.5%, 45.6% and 51.2% in the 0.1%, 1% and 5% ALA-treated groups, respectively. Irradiation had to be interrupted several times because of severe burning and pain sensation. Topical ALA PDT did not prove to be an appropriate treatment option for plaque-type psoriasis due to disappointing clinical efficacy, the time-consuming treatment procedure and its unfavourable adverse event profile.
    No preview · Article · Sep 2006 · Journal of the European Academy of Dermatology and Venereology
  • C. Hafner · K. Koellner · T. Vogt · M. Landthaler · R.-M. Szeimies
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    ABSTRACT: Zusammenfassung Ein 39-jähriger Patient entwickelte nach einem Malaysia-Aufenthalt ein generalisiertes petechiales Exanthem sowie Fieber, Krankheitsgefühl und Gliederschmerzen. Es zeigte sich ein Anstieg des Dengue-IgG-Titers bei gleichzeitig grenzwertigem Dengue-IgM-Titer. Hämorrhagische Verläufe des Dengue-Fiebers beim Erwachsenen sind eher selten. Bei Zweitinfektionen können nichtneutralisierende Antikörper aus einer vorhergehenden Infektion jedoch aufgrund des sog. ldquorantibody-dependent enhancementldquo das Auftreten dieser Komplikation begünstigen.
    No preview · Article · Aug 2006 · Der Hautarzt
  • R.M. Szeimies · S Karrer
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    ABSTRACT: Epithelial cancers of the skin, e.g. basal cell carcinoma and squamous cell carcinoma, are the most common tumours in humans with increasing incidence. Hence the development of new therapeutic strategies is of utmost interest. For many years the most often used conventional therapies for these diseases were surgical procedures such as curettage and electrodesiccation, excision or, with so far the best outcome in terms of remission rates, micrographic surgery. Other ablative treatment modalities are cryotherapy, radiation therapy or the use of lasers (Er:YAG, CO(2)). All those above-mentioned treatments have in common that they are quite unspecific and do not target the tumour itself or its environment, thus leading to unwanted effects in the surrounding tissue such as scar formation or other cosmetically disfiguring events. Therefore, the development of novel, more pathogenesis-based therapies such as the use of retinoids, cyclooxygenase inhibitors, topical immunomodulators, inhibitors of the sonic-hedgehog signalling pathway or photodynamic therapy are challenging new approaches.
    No preview · Article · Jun 2006 · British Journal of Dermatology
  • Dany J. Touma · R.-M. Szeimies
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    ABSTRACT: At the beginning of the 20th century Hermann von Tappeiner, director of the Institute of Pharmacology at the University of Munich, coined the term "photodynamic reaction" to describe the oxygen-dependent tissue reaction following photosensitization and irradiation with light [1]. Today it is known that photodynamic therapy (PDT) requires the simultaneous presence of a photosensitizer, light and oxygen in the diseased tissue. The photosensitizer accumulates in the target cells and absorbs light of a certain wavelength. The energy is transferred to oxygen and highly reactive oxygen species (ROS)-mainly singlet oxygen-are generated. Following an appropriate light dose the reactive oxygen species directly lead to cell and tissue damage by inducing necrosis and apoptosis and indirectly stimulate inflammatory cell mediators (Fig. 14.1). In recent decades, PDT has gained worldwide popularity, first as an experimental therapy for a variety of human cancers. Mainly porphyrins, chlorin derivatives or phthalocyanines have been studied so far for primary and adjuvant cancer therapy [2]. However, for dermatologi-cal purposes, only hematoporphyrin derivatives (HPD) such as porfimer sodium (Photofrin) and porphyrin-inducing precursors such as 5-aminolevulinic acid (ALA) and methyl ami-nolevulinate (MAL) are of practical use. As systemic photosensitizing drugs induce prolonged phototoxicity [3], topical photosensitizers are preferred for use in dermatology. Meanwhile drugs such as ALA and MAL have reached approval status for the treatment of epithelial cancers or their precursors throughout the world and there is growing interest in the use of PDT not only for nonmelanoma skin cancer but also for other skin tumors such as lymphoma or for tumor surveillance in transplant patients as well as for non-oncological indications such as psoriasis, localized scleroderma and skin rejuvenation [4-6].
    No preview · Article · Jan 2006
  • P. Babilas · M. Landthaler · R.-M. Szeimies
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    ABSTRACT: Ammoniumpersulfat ist ein potentes Bleich- und Oxidationsmittel, das in Haarbleichmitteln eingesetzt wird. Aufgrund der frequenten Verwendung von Haarbleichmittel durch Friseure kommt es in dieser Berufsgruppe gehäuft zu Kontaktsensibilisierung gegenüber Ammoniumpersulfat. Auch über asthmatoide oder rhinitische Beschwerden im Sinne einer Soforttypreaktion nach Einatmen von Ammoniumpersulfatdämpfen wird berichtet. Ausgeprägte systemische Reaktionen sind eher selten. In der vorliegenden Fallbeschreibung wird über eine 24-jährige Patientin berichtet, die während ihrer Tätigkeit als Friseurin ein Handekzem nach Kontakt zu Haarbleichmitteln ausbildete. Nach Aufgabe ihres Berufes heilte das Handekzem ab. Später kam es bei privatem Gebrauch von Ammoniumpersulfat enthaltenden Haarbleichmitteln zu einer schweren Soforttypreaktion mit Bewusstlosigkeit. In der klinischen Testung zeigte die Patientin 3 h nach Applikation eines Epikutantests mit Friseurstoffen abermals eine anaphylaktische Reaktion. Der Reibetest auf Ammoniumpersulfat (2,5%) ergab bei einer 1:100-Verdünnung in Vaselin eine 2fach positive Reaktion.
    No preview · Article · Dec 2005 · Der Hautarzt
  • T. Maisch · R.-M. Szeimies · N. Lehn · C. Abels
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    ABSTRACT: Grundlage der photodynamischen Inaktivierung von Bakterien ist die Generierung von reaktiven Sauerstoffspezies durch einen zellulär lokalisierten Photosensibilisator in Anwesenheit von Sauerstoff, der durch Licht der entsprechenden Wellenlänge angeregt wird. Im Hinblick auf mögliche Indikationen in der Dermatologie wird die Anwendung der photodynamischen Inaktivierung von Bakterien bei lokalen Haut- und Wundinfektionen oder zur Reduktion einer nosokomialen Besiedelung multiresistenter Bakterien von Hautarealen diskutiert. Der entscheidende Vorteil bei der lokalen Applikation von Photosensibilisatoren mit anschließender Bestrahlung liegt darin, dass unabhängig vom Resistenzmuster eines Bakteriums eine Inaktivierung ähnlich wie bei einem Antiseptikum erfolgt. In der vorliegenden Arbeit werden die physikalisch-chemischen sowie biologischen Grundlagen der antibakteriellen photodynamischen Therapie und mögliche dermatologische Indikationen beschrieben.
    No preview · Article · Nov 2005 · Der Hautarzt

  • No preview · Conference Paper · Jul 2005
  • A. L. Branzan · M. Landthaler · R.-M. Szeimies
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    ABSTRACT: Zusammenfassung Hautveränderungen bei Patienten mit Tumorerkrankungen können viele Ursachen haben und sind nicht leicht einzuteilen. Chemotherapieassoziierte kutane Nebenwirkungen sind meist toxischer Genese und zeigen oft charakteristische Reaktionsmuster, die sich dem dermatologisch geschulten Auge erschließen. Schwerwiegende chemotherapieassoziierte Reaktionen die zur Dosisreduktion, zum Um- oder Absetzen des Zytostatikums zwingen, sind dabei sehr selten, meist handelt es sich um reversible, selbstlimitierende Krankheitsbilder. Im vorliegenden Beitrag werden die häufigsten Krankheitsbilder besprochen.
    No preview · Article · Jun 2005 · Der Hautarzt
  • R.-M. Szeimies · S. Karrer · H. Bäcker
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    ABSTRACT: Zusammenfassung Die Inzidenz epithelialer Tumoren und ihrer Vorstufen ist weltweit über die letzten Jahre stark angestiegen. Mittlerweile sind auch zunehmend jüngere Patienten betroffen, die Risikofaktoren sind bekannt. Die Wahl des für den jeweiligen Individualfall adäquaten Behandlungsverfahrens spielt daher eine große Rolle. Bei der Wahl der Therapie sollten die hohe therapeutische Effektivität, eine möglichst niedrige Langzeitrezidivrate und ein geringes Nebenwirkungsprofil der Behandlung ausschlaggebend sein. Im Folgenden werden unterschiedliche Therapieverfahren bei aktinischen Keratosen, Morbus Bowen, Basalzellkarzinom und spinozellulärem Karzinom dargestellt und kritisch gewürdigt.
    No preview · Article · May 2005 · Der Hautarzt
  • S Meyer · T Burgdorff · R M Szeimies · T Vogt · M Landthaler · S Karrer
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    ABSTRACT: Metoprolol, a widely prescribed beta-adrenergic receptor blocker, has occasionally been associated with a diversity of cutaneous reactions. We present a 79-year-old male patient with erosive lichen planus (LP) on the feet and hands who was successfully treated with topical tacrolimus. Six months after the lesions had been cured the patient received the beta-receptor blocker metoprolol for the treatment of hypertonus. Within only 2 weeks of metoprolol intake the erosive lesions on the palms and feet recurred. After discontinuation of the drug and repetitive topical treatment with tacrolimus a complete remission of the lesions could be achieved. The recurrence of erosive LP probably secondary to metoprolol and the therapeutic success of topical tacrolimus in the treatment of LP are discussed.
    No preview · Article · Apr 2005 · Journal of the European Academy of Dermatology and Venereology

Publication Stats

3k Citations
318.97 Total Impact Points

Institutions

  • 2009-2014
    • Knappschaftskrankenhaus Recklinghausen
      Recklinghausen, North Rhine-Westphalia, Germany
  • 1995-2014
    • University Hospital Regensburg
      • Klinik für Dermatologie
      Ratisbon, Bavaria, Germany
  • 1995-2012
    • Universität Regensburg
      • • Lehrstuhl für Dermatologie und Venerologie
      • • Department of Internal Medicine II
      Regensburg, Bavaria, Germany
  • 2010
    • Prosper-Hospital Recklinghausen
      Recklinghausen, North Rhine-Westphalia, Germany
  • 2005
    • University of Freiburg
      Freiburg, Baden-Württemberg, Germany