R M Szeimies

Knappschaftskrankenhaus Recklinghausen, Recklinghausen, North Rhine-Westphalia, Germany

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Publications (146)318.97 Total impact


  • No preview · Article · Apr 1996 · Gastrointestinal Endoscopy
  • R M Szeimies · S Karrer · A Sauerwald · M Landthaler
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    ABSTRACT: The incidence of actinic keratoses (AK) is rising and there is still a need for therapeutic alternatives. To demonstrate the efficacy and tolerability of topical photodynamic therapy (PDT) using 5-aminolevulinic acid (ALA) in the treatment of AK. Ten patients with 36 lesions (19 at hands and arms, 17 on the head) received ALA-PDT once (occlusive application of a 10% ALA emulsion for 6 h, irradiation with red light, 580-740 nm, 150 J/cm2) and were then monitored for 3 months. Therapeutic efficacy was judged using a score evaluating infiltration and keratosis of AK. After 28 days, significantly lower score sums were observed (head: mean = 15%; hand: mean = 67%) compared to the initial score (100%). Complete remission was achieved in 71% of AK localized on the head. No notable side effects were observed. This study demonstrated the potential of good efficacy and tolerability in the treatment of AK using topical ALA-PDT. How efficacy for lesions on the hand can be improved and whether PDT is able to concur with established treatment modalities remains to be shown in further studies.
    No preview · Article · Feb 1996 · Dermatology
  • U Wlotzke · U Hohenleutner · R Hein · R M Szeimies · M Landthaler
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    ABSTRACT: We present, to the best of our knowledge, the first case of a malignant, primary plaque-type blue naevus in a 61-year-old male. Two biopsy specimens had been examined within 13 years, and revealed a common and cellular blue variant as a precursor. Locally invasive growth and regional lymph node swelling were present, but these alone could not confirm malignancy before evaluation of all clinical and histopathological features, as they are known to occur with benign cellular blue naevi. The recent literature and our case indicate that there is a malignant potential in every histological and clinical variant of blue naevus.
    No preview · Article · Jan 1996 · Der Hautarzt
  • Source
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    ABSTRACT: A promising new therapeutic modality for skin cancer, administration of the heme precursor 5-aminolevulinic acid followed by light irradiation, is known as photodynamic therapy. Photofrin, the only clinically approved sensitizer, has an absorption maximum at 630 nm, the wavelength used in most experimental and clinical trials with 5-aminolevulinic acid. We investigated photodynamic efficacy of irradiation with coherent light at wavelengths ranging from 622 to 649 nm in vitro and in vivo as well as the content and distribution of intracellular porphyrin after administration of 5-aminolevulinic acid. HaCaT immortalized human keratinocytes were sensitized with 30 micrograms/ml 5-aminolevulinic acid for 24 h in vitro. By cell viability determined with the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide assay, the best cell-killing effects were observed after irradiation at 635 nm. Using an amelanotic melanoma (A-Mel-3) grown subcutaneously in Syrian Golden hamsters, we confirmed these results in vivo: tumor growth was markedly delayed in animals treated with 100 mg/kg 5-aminolevulinic acid intravenously and irradiated with coherent light at 635 nm as compared to animals irradiated at 630 nm. This photodynamic effect is probably mediated by large amounts of the photosensitizing porphyrin, protoporphyrin IX, localized in cell membranes as visualized by confocal laser scan microscopy and as determined by high pressure liquid chromatography in vitro. The results suggest that irradiation at 635 nm with a coherent light source is more effective than irradiation at 630 nm for photodynamic therapy with 5-aminolevulinic acid.
    Full-text · Article · Dec 1995 · Journal of Investigative Dermatology
  • H Messmann · A Holstege · R M Szeimies · G Lock · S G Bown · J Schölmerich

    No preview · Article · Nov 1995 · Endoscopy
  • R M Szeimies · M Landthaler
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    ABSTRACT: Photodynamic therapy (PDT) is an experimental treatment modality which is based on photochemical destruction of tumour tissue by means of different sensitizers and irradiation with red light. The greatest disadvantage of systemic administration of photosensitizers (mostly porphyrins) is cutaneous photosensitization of the patient, which lasts for some months. An alternative therapeutic technique for superficial skin tumours is the topical application of sensitizers, especially 5-aminolevulinic acid (ALA). Therapeutic selectivity derives from enhanced ALA penetration across abnormal parakeratotic stratum corneum and from preferential accumulation of bioconverted protoporphyrin IX, which serves as photosensitizer in cells of epithelial origin. Two patients suffering from different epithelial tumours (superficial basal cell carcinoma, Bowen's disease) and treated with topical PDT after ALA application are reported. Both tumours showed complete remission, and up to 12 months after treatment there were no clinical or histological signs of tumour recurrence. Cosmetic results were good.
    No preview · Article · Jun 1995 · Der Hautarzt
  • R.-M. Szeimies · M. Landthaler
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    ABSTRACT: Summary Photodynamic therapy (PDT) is an experimental treatment modality which is based on photochemical destruction of tumour tissue by means of different sensitizers and irradiation with red light. The greatest disadvantage of systemic administration of photosensitizers (mostly porphyrins) is cutaneous photosensitization of the patient, which lasts for some months. An alternative therapeutic technique for superficial skin tumours is the topical application of sensitizers, especially 5-aminolevulinic acid (ALA). Therapeutic selectivity derives from enhanced ALA penetration across abnormal parakeratotic stratum corneum and from preferential accumulation of bioconverted protoporphyrin IX, which serves as photosensitizer in cells of epithelial origin. Two patients suffering from different epithelial tumours (superficial basal cell carcinoma, Bowen's disease) and treated with topical PDT after ALA application are reported. Both tumours showed complete remission, and up to 12 months after treatment there were no clinical or histological signs of tumour recurrence. Cosmetic results were good.
    No preview · Article · May 1995 · Der Hautarzt
  • A Leunig · R M Szeimies · E Wilmes · R Gutmann · W Stolz · J Feyh
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    ABSTRACT: The incidence of sudden hearing loss has increased. The pathogenetic mechanisms are still unknown, but viral infections and vascular phenomena with acute impairment of microvascular perfusion are thought to play a major role. Infusion of hydroxyethyl starch (HES) is used as a regimen to treat sudden hearing loss. In our clinic, anaphylactic reactions due to HES have not been observed so far. However, the use of HES is still discussed controversially due to long-term storage of HES molecules in tissue and due to high incidence of long-lasting pruritus. In a retrospective analysis of 118 patients treated with HES for sudden hearing loss, we observed pruritus starting in 64% of patients one to three weeks after therapy. This symptom with a duration between two weeks and four months was refractory to medical interventions. During therapy with HES improvement of hearing was observed in 75% of patients, in 62% improvement of hearing persisted still at the end of the observation period (7 months post infusionem). Light and electron microscopic assessment of human skin biopsies of one patient after treatment with HES showed storage of HES especially within dermal macrophages. Pathogenetically a pathway independent of histamin seems responsible for the induction of pruritus. Accordingly, classic antihistaminic drugs had no therapeutic effect in our patients. Dextran is used as an alternative to hydroxyethyl starch. In contrast to HES, the often mentioned higher incidence of severe anaphylactic reactions due to dextran has dramatically decreased with hapten inhibition (after preinjection of monovalent haptendextran Promit).(ABSTRACT TRUNCATED AT 250 WORDS)
    No preview · Article · Apr 1995 · Laryngo-Rhino-Otologie
  • A. Leunig · R.-M. Szeimies · E. Wilmes · R. Gutmann · W. Stolz · J. Feyh

    No preview · Article · Mar 1995 · Laryngo-Rhino-Otologie
  • S Karrer · R M Szeimies · U Hohenleutner · A Heine · M Landthaler
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    ABSTRACT: A 74-year-old woman presenting with multiple unilateral localized basal cell carcinomas present for 30 years on the left side of her body is reported. There was no history of arsenic ingestion or X-ray exposure. Typical signs of nevoid basal-cell carcinoma syndrome (Gorlin's syndrome) like jaw keratocysts, skeletal malformations, and small palmoplantar pits were missing. Although treatment with many therapeutic regimens was tried, there were still tumor recurrences. Photodynamic therapy was performed after topical application of 5-aminolevulinic acid. This treatment resulted in good tumor control with an optimal cosmetic result.
    No preview · Article · Feb 1995 · Dermatology
  • M Landthaler · R M Szeimies · U Hohenleutner
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    ABSTRACT: Malignant skin tumors can be treated by CO2 laser excision or vaporization, neodymium: yttrium aluminum garnet (Nd:YAG) laser coagulation, and systemic or topical photodynamic therapy (PDT). Possible indications for CO2 laser vaporization include superficial basal cell carcinomas, actinic keratoses, Bowen's disease, actinic cheilitis, and leukoplakias. The Nd:YAG laser may be used for coagulation of basal cell carcinomas, squamous cell carcinomas, Kaposi's sarcoma, and metastatic skin tumors. Systemic and topical PDT is still an experimental modality and is mostly applied for treatment of basal cell carcinomas. However, laser treatment of skin tumors is not yet considered as standard therapy and should be confined to selected patients. Further clinical studies are necessary to determine the role of laser therapy in this special indication.
    No preview · Article · Feb 1995 · Recent results in cancer research. Fortschritte der Krebsforschung. Progrès dans les recherches sur le cancer
  • R.-M. Szeimies · S. Karrer · A. Heine · U. Hohenleutner · M. Landthaler
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    ABSTRACT: A case of a 62-year-old woman suffering from psoriasis is reported, who was treated orally with arsenic 25 years ago (cumulative close: 800 mg of arsenic trioxide). Over 10 years arsenic keratoses, basal cell carcinomas, Bowen's disease and invasive squamous cell carcinomas mainly on her hands and feet have been observed, skin changes were clearly a consequence of arsenic therapy. Control of disease was poor, her right little finger had to be amputated. Topical photodynamic therapy with 5-aminolevulinic acid was performed on her right hand. Clinical and histological examinations 6 months after treatment showed an excellent cosmetic result with no signs of tumor residue.
    No preview · Article · Jan 1995
  • R M Szeimies · W Stolz · U Wlotzke · H.C. KORTING · M Landthaler
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    ABSTRACT: We report a case of recalcitrant pruritus after infusion therapy with hydroxyethyl starch (HES) for sudden deafness. The diagnosis was confirmed by detection of typical HES storage vacuoles within dermal macrophages and perineural cells. Treatment with antihistamines and antipruritic agents, UVB irradiation, and neuroleptic drugs, was ineffective. Topical capsaicin (0.05%) twice daily produced excellent symptomatic relief, without side-effects.
    No preview · Article · Oct 1994 · British Journal of Dermatology
  • R M Szeimies · R Hein · W Bäumler · A Heine · M Landthaler
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    ABSTRACT: Since coherence of laser light is not necessary for photodynamic therapy of skin lesions, attempts have been made to construct incoherent lamps. A recent development is the PDT 1200 (Waldmann Medizintechnik/Germany), a light source consisting of a 1200 watt metal halogen lamp. Emission of 600 to 800 nm radiation is achieved by using cut-off filters. Power density can be varied from 30 mW/cm2 to 200 mW/cm2 in an area from 100 to 300 cm2. Biological effectiveness was proved by comparison with the radiation of an argon-pumped dye laser (Kiton red) emitting light at 630 nm. Three human cell lines were incubated with photofrin at different concentrations. After irradiation, cell viability was tested (MTT assay). Results proved biological effectiveness of the light source PDT 1200. No significant difference in cell viability was detected using either concentration of sensitizer. Therefore, we believe that PDT 1200 is a promising new light source for photodynamic therapy of skin lesions.
    No preview · Article · Apr 1994 · Acta Dermato Venereologica
  • R M Szeimies · T Sassy · M Landthaler
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    ABSTRACT: Penetration potency of delta-aminolevulinic acid (ALA) was studied by examining fluorescence of endogenous protoporphyrin IX in different histological types of basal cell carcinoma. Ten basal cell carcinomas were coated with an ointment containing 10% ALA prior to excision; five served as controls. Tumors were excised either 4 h or 12 h after application of ALA using a modified Mohs' micrographic surgical technique. Horizontal sections were cut from deep dermis to tumor surface and examined under a fluorescence microscope. After 4 h of application, only skin appendages demonstrated fluorescence typical of protoporphyrin IX. After 12 h, fluorescence was detectable in tumor cells in deep dermis. The five controls revealed no fluorescence at any site. These results may confirm the high penetration potential of topically applied ALA and its usefulness in photodynamic therapy. For tumors penetrating to deep dermis, an application time of more than 4 h seems necessary, at least when hydrophilic solvents for ALA are used.
    No preview · Article · Feb 1994 · Photochemistry and Photobiology

  • No preview · Article · Dec 1993
  • R.-M. Szeimies · R. Hein · A. Heine · M. Landthalert

    No preview · Article · Sep 1993 · Melanoma Research
  • R.-M. Szeimies · C. Rübe · P. Kaudewitz · N. Sepp · G. Burg · H. Feist · M. Landthaler · N. Willich

    No preview · Article · Sep 1993 · Melanoma Research
  • Article: Lasers
    M. Landthaler · R. M. Szeimies · U. Hohenleutner

    No preview · Article · Sep 1993 · Melanoma Research
  • M Landthaler · A Rück · R M Szeimies
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    ABSTRACT: Photodynamic therapy (PDT) is still an experimental modality using red light in conjunction with a systemic or topical photosensitizer. The photosensitizers have a longer retention time in malignant tumors compared with the normal surrounding tissue. Irradiation with a red light at wavelength of 630 nm results in photochemical generation of cytotoxic singulet oxygen. The systemic sensitizer mostly used is hematoporphyrin derivative (HPD) and the light sources are argon-pumped dye lasers, gold vapour lasers and even more simple light sources based on conventional lamps. The most important side effect of systemic application of HPD is light hypersensitivity in the UVA range, which lasts up to several weeks. Multiple studies in recent years have proved that superficial basal cell carcinomas, squamous cell carcinomas, Bowen's disease and epidemic Kaposi's sarcoma respond to systemic PDT. Up to now, however studies with greater numbers of patients and a sufficient follow-up have been lacking. Topical application of sensitizers like amino-levulinic acid (ALA) and tetraphenylporphine sulfonate (TPPS) have been used for the treatment of superficial basal cell carcinomas and squamous cell carcinomas. Possible future applications of PDT are virus papillomas and psoriasis. Even if PDT is an experimental therapeutical modality at present, it may become more clinical relevant in the future.
    No preview · Article · Mar 1993 · Der Hautarzt

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