Abstract: LETTER INTRODUCTION: Acute phototoxic dermatitis and phototoxic onycholysis on sun exposure are well-known side-effects of doxycycline administration. In contrast, little information has been published about photoallergic skin reactions due to doxycycline, and they are not mentioned in recent literature reviews on drug photosensitivity. A single case report, describing a patient who developed photoallergic eczema only on sun-exposed skin areas 3 days after initiation of doxycycline therapy for acne vulgaris, was published. To the best of our knowledge we describe here for the first time an erythrodermic photoallergic drug reaction due to doxycycline administration for erythema chronicum migrans.
Abstract: PURPOSE: A short HIV/AIDS risk behaviour knowledge index based on questions about HIV transmission and prevention of HIV infection during sexual intercourse and intravenous drug use is proposed and implemented for an HIV average risk population in Munich.
METHODS: Knowledge levels about HIV/AIDS risk behaviour was assessed in a group of people (n = 210) in sexually active age range of 18-49 years which was at an average risk of contracting HIV. Four questions about HIV transmission by unprotected vaginal, anal, or oral sexual intercourse, and by needle sharing, and two questions about HIV prevention by condom use, and the single use of needles and syringes were chosen from ten others for making a four level risk behaviour knowledge index (HIV/AIDS Transmission through Sex and Intravenous Drug Use, HATSIDU) internally consistent according to Cronbach's alpha.
RESULTS: HATSIDU index (mean 3.0, SD +/- 1.18) was not associated (p>0.05) with sex and marital status, but depended (p < 0.05) on age, education and social status. General population of Munich in a sexually active age group of 40-49 years, or those without further education or the unemployed, had a significantly lower knowledge of HIV risk behaviour.
CONCLUSION: The HATSIDU is a simple and usable index for the assessment of HIV/AIDS risk behaviour knowledge in a population with an average risk of HIV infection.
Abstract: OBJECTIVES: HIV incidence in Germany is increasing even though the German Federal Centre for Health Education reported that the entire German population (99 %) has sufficient knowledge of sexual HIV transmission. We tried to find out the reason for this discrepancy.
METHODS: HIV transmission knowledge was investigated in a Munich population (n = 317) and the findings compared with a nationwide study.
RESULTS: No differences in knowledge regarding needle sharing and HIV/AIDS curability were found but, in relation to sexual HIV transmission, only 55.5 % of Munich respondents had sufficient knowledge of vaginal, anal and oral transmission routes.
CONCLUSIONS: The knowledge level reported in the nationwide study is overestimated as a result of the ambiguous character of the questions used.
Abstract: BACKGROUND: Dermatologists are often the first-line specialists who recognize and diagnose human immunodeficiency virus (HIV) infection because of pathognomic skin signs. It is therefore important to investigate attitudes and knowledge regarding HIV/acquired immunodeficiency syndrome (AIDS) amongst dermatological patients in order to provide information for dermatologists and to draw their attention to the issues.
OBJECTIVES: Awareness of HIV/AIDS, its prevention, and hypothetical behaviour were surveyed in dermatological outpatients.
PATIENTS/METHOD: The anonymous cross-sectional survey was conducted with consecutive German-speaking outpatients aged 18-65 years, who registered at the dermatological outpatient's clinic (excluding venereology, genitourinary or HIV medicine) of the University of Munich (Germany).
RESULTS: Three hundred forty-seven (77.5%) questionnaires were accepted for analysis. Most of the patients knew about HIV incurability (89.4%), HIV transmissibility during needle sharing (95.3%), or vaginal (87.4%) and anal intercourse (79.5%), as well as about HIV prevention by condom use (97.8%), and use of single needles (76.2%). However, knowledge gaps and misconceptions were detected regarding the risk of HIV transmission during oral sex, and the efficacy of sexual fidelity and avoidance of blood transfusions in HIV prevention. The lowest knowledge level (< 50% correct answers) was detected in patients aged 50-59 years, in unemployed, divorced/widowed, and in those without or with incomplete school education.
CONCLUSIONS: Patient education about HIV/AIDS in dermatological ambulant settings should be performed differentially with regard to socio-demographic factors, and focused on the topic of oral sexual HIV transmission and on some other specific misconceptions.
Abstract: Molluscum contagiosum is a common viral skin infection in children with atopic diathesis and not rare in HIV patients. We report a 45-year-old psoriasis patient who developed eruptive mollusca contagiosa during an antipsoriatic treatment with efalizumab.
Abstract: BACKGROUND: Granuloma annulare (GA) is a benign granulomatous and inflammatory skin disorder. The pathogenesis remains enigmatic and convincingly effective treatment options are not available. Inspired by a report showing photodynamic therapy (PDT) to be effective in a single patient with GA, we sought to evaluate this benefit in a series of patients with GA.
OBSERVATIONS: PDT was performed in 7 consecutive patients with histologically confirmed GA located at the extremities. First, 20% ALA gel was applied under an occlusive dressing for 5 h, followed by illumination with 100 J/cm(2) by a standard red-light source. In total, 2-3 PDT sessions were performed, with an interval of 2-4 weeks between each session. Treatment was stopped when complete remission was achieved or when GA lesions remained unchanged after 2 consecutive PDT sessions. The overall response rate was 57%. In 2 patients (29%), GA cleared completely, in 2 patients (29%) the skin lesions improved markedly and in 3 patients (43%) no clinical response could be observed.
CONCLUSION: These promising results should be evaluated in larger controlled studies. In selected patients, PDT might be a valuable recruit for the sparse armory available to treat GA.
Abstract: The recently published German S3- guidelines for the treatment of psoriasis vulgaris offer an extensive evidence-based documentation and evaluation of currently available treatment modalities. In order to incorporate this detailed information into the actual treatment decisions in individual patients, we have transformed the recommendations regarding phototherapy and systemic therapies into an algorithm. This algorithm should allow a stepwise treatment approach in adult patients with moderate to severe psoriasis, in whom topical therapy is not sufficient. It can also facilitate documentation of treatment. In our hands the treatment algorithm proved to be feasible and reliable in a large number of patients.
Abstract: Polymerase chain reaction (PCR) was used to detect the 47-kDa immunogen gene of Treponema pallidum in peripheral blood mononuclear cells (PBMCs), skin lesions, and serum, but less consistently in purified granulocytes or ejaculates of patients with manifest and latent syphilis. Therefore, skin lesions and PBMCs may serve as the most reliable sources for a PCR-based diagnosis of syphilis.
Abstract: Although serological tests are usually sufficient for the diagnosis of syphilis, they can be unhelpful in identifying the stage of Treponema pallidum infection in various situations. We used fine-needle aspiration of inguinal lymph nodes followed by PCR and Southern blotting to test for treponemal DNA in three patients with suspected secondary or latent syphilis. All three patients were positive by this technique. This approach could serve as a useful new tool for the diagnosis of syphilis in uncertain cases.
