Background: Chronic idiopathic urticaria (CIU) is defined by the almost daily presence of urticaria for at least 6 weeks without an identifiable cause. Symptoms include short-lived wheals, itching, and erythema. CIU i...Background: Chronic idiopathic urticaria (CIU) is defined by the almost daily presence of urticaria for at least 6 weeks without an identifiable cause. Symptoms include short-lived wheals, itching, and erythema. CIU impedes significantly a patient’s quality of life (QoL). Levocetirizine is an antihistamine from the latest generation approved for CIU. Aim: To investigate the efficacy of levocetirizine, 5 mg, and placebo for the symptoms and signs of CIU, as well as for the QoL and productivity. Methods: The primary criteria of evaluation were the pruritus severity scores over 1 week of treatment and over 4 weeks. The QoL was assessed via the Dermatology Life Quality Index (DLQI). Results: Baseline pruritus severity scores were comparable in the two treatment groups (2.06 ±0.58). After 1week, levocetirizine was superior to placebo and demonstrated a considerable efficacy (difference = 0.78, P < 0.001). This efficacy was maintained over the entire study period (4 weeks, P < 0.001). The number and size of wheals were considerably reduced compared with placebo over 1 week and over the total treatment period (P ≤0.001). This was paralleled by an improvement in the QoL (DLQI: 7.3 units in the levocetirizine group and 2.4 units in the placebo group) and a higher productivity at work in the levocetirizine group (3.0 workdays lost per patient per month in the placebo group, 0.3 in the levocetirizine group). No unexpected adverse events occurred. Conclusions: Levocetirizine, 5 mg once daily, is an effective treatment for CIU, characterized not only by a rapid and sustained response, but also by an important improvement in QoL.展开更多
Background: The status of the sentinel lymph node (SLN) is an important parameter to predict the prognosis of melanoma patients but it is amatter of debate if removal ofmicrometastases by SLN biopsy (SLNB) influences ...Background: The status of the sentinel lymph node (SLN) is an important parameter to predict the prognosis of melanoma patients but it is amatter of debate if removal ofmicrometastases by SLN biopsy (SLNB) influences the prognosis of melanoma patients. Objectives: We sought to investigate the impact of SLNB in melanoma patients with regard to recurrence-free survival, overall survival and metastatic pathways. Patients and methods: We studied, retrospectively, 673 melanoma patients with a primary melanoma (tumour thickness ≥ 1 mm) and without clinical evidence of metastases at the time of melanoma diagnosis. In 377 patients the melanoma was removed without SLNB between January 1995 and March 2000 (pre-SLNB group). In 296 patients the melanoma was removedwith SLNB between April 2000 and March 2003 (SLNB group). Otherwise, both groups received identical surgical treatment of the primary melanoma and initial staging procedures performed by the same team of physicians. Follow-up recommendations were also identical in both groups. Results: Both groups showed no significant differences with regard to characteristics of the primary melanoma, sex and age. By Kaplan-Meier analyses, melanoma-related overall survivalwas comparable in both groups. However, recurrence-free survival was increased in pre-SLNB patients due to significantly fewer regional lymph node metastases, whereas frequencies of locoregional cutaneous and distant metastases were comparable in both groups. Conclusions: SLNB advances the detection of regional lymph node metastases and therefore avoids nodal recurrences but does not influence metastatic behaviour of melanoma cells and does not protect patients from melanoma-related death caused by distant metastases. Thus, our retrospective data favour the marker hypothesis for melanoma metastasation. To elucidate further if subgroups of patients benefit from SLNB, prospective randomized studies with long-term follow-up are needed.展开更多
Background: In the published studies on the efficacy of the topical immunomodulator pimecrolimus, different eczema scores were used, and the impact on morphological key signs of eczema was not analysed. Objective: To ...Background: In the published studies on the efficacy of the topical immunomodulator pimecrolimus, different eczema scores were used, and the impact on morphological key signs of eczema was not analysed. Objective: To compare the influence of pimecrolimus cream 1%on different standard eczema scores in infants with atopic dermatitis and to analyse the impact of treatment on the individual morphological key signs of eczema. Methods: Pimecrolimus cream 1%(n=129) or double-blind vehicle control (n=66) was administered for 4 weeks. The Eczema Area and Severity Index (EASI), Investigators’Global Assessment (IGA) and Scoring Atopic Dermatitis Index (SCORAD) were determined and were correlated with each other. Results: Following treatment with pimecrolimus, the EASI, IGA and SCORAD were significantly reduced on day 29 as compared with the vehicle group (P < 0.001, P < 0.001, P=0.002, respectively). There was a close correlation between EASI, IGA and SCORAD. The single parameters of the EASI were already significantly decreased by day 4 in the pimecrolimus group as compared to vehicle (each P < 0.001). Conclusion: Treatment with pimecrolimus 1%cream leads to a rapid improvement of all morphological signs of eczema. The close correlation of different scores was shown for the first time.展开更多
文摘Background: Chronic idiopathic urticaria (CIU) is defined by the almost daily presence of urticaria for at least 6 weeks without an identifiable cause. Symptoms include short-lived wheals, itching, and erythema. CIU impedes significantly a patient’s quality of life (QoL). Levocetirizine is an antihistamine from the latest generation approved for CIU. Aim: To investigate the efficacy of levocetirizine, 5 mg, and placebo for the symptoms and signs of CIU, as well as for the QoL and productivity. Methods: The primary criteria of evaluation were the pruritus severity scores over 1 week of treatment and over 4 weeks. The QoL was assessed via the Dermatology Life Quality Index (DLQI). Results: Baseline pruritus severity scores were comparable in the two treatment groups (2.06 ±0.58). After 1week, levocetirizine was superior to placebo and demonstrated a considerable efficacy (difference = 0.78, P < 0.001). This efficacy was maintained over the entire study period (4 weeks, P < 0.001). The number and size of wheals were considerably reduced compared with placebo over 1 week and over the total treatment period (P ≤0.001). This was paralleled by an improvement in the QoL (DLQI: 7.3 units in the levocetirizine group and 2.4 units in the placebo group) and a higher productivity at work in the levocetirizine group (3.0 workdays lost per patient per month in the placebo group, 0.3 in the levocetirizine group). No unexpected adverse events occurred. Conclusions: Levocetirizine, 5 mg once daily, is an effective treatment for CIU, characterized not only by a rapid and sustained response, but also by an important improvement in QoL.
文摘Background: The status of the sentinel lymph node (SLN) is an important parameter to predict the prognosis of melanoma patients but it is amatter of debate if removal ofmicrometastases by SLN biopsy (SLNB) influences the prognosis of melanoma patients. Objectives: We sought to investigate the impact of SLNB in melanoma patients with regard to recurrence-free survival, overall survival and metastatic pathways. Patients and methods: We studied, retrospectively, 673 melanoma patients with a primary melanoma (tumour thickness ≥ 1 mm) and without clinical evidence of metastases at the time of melanoma diagnosis. In 377 patients the melanoma was removed without SLNB between January 1995 and March 2000 (pre-SLNB group). In 296 patients the melanoma was removedwith SLNB between April 2000 and March 2003 (SLNB group). Otherwise, both groups received identical surgical treatment of the primary melanoma and initial staging procedures performed by the same team of physicians. Follow-up recommendations were also identical in both groups. Results: Both groups showed no significant differences with regard to characteristics of the primary melanoma, sex and age. By Kaplan-Meier analyses, melanoma-related overall survivalwas comparable in both groups. However, recurrence-free survival was increased in pre-SLNB patients due to significantly fewer regional lymph node metastases, whereas frequencies of locoregional cutaneous and distant metastases were comparable in both groups. Conclusions: SLNB advances the detection of regional lymph node metastases and therefore avoids nodal recurrences but does not influence metastatic behaviour of melanoma cells and does not protect patients from melanoma-related death caused by distant metastases. Thus, our retrospective data favour the marker hypothesis for melanoma metastasation. To elucidate further if subgroups of patients benefit from SLNB, prospective randomized studies with long-term follow-up are needed.
文摘Background: In the published studies on the efficacy of the topical immunomodulator pimecrolimus, different eczema scores were used, and the impact on morphological key signs of eczema was not analysed. Objective: To compare the influence of pimecrolimus cream 1%on different standard eczema scores in infants with atopic dermatitis and to analyse the impact of treatment on the individual morphological key signs of eczema. Methods: Pimecrolimus cream 1%(n=129) or double-blind vehicle control (n=66) was administered for 4 weeks. The Eczema Area and Severity Index (EASI), Investigators’Global Assessment (IGA) and Scoring Atopic Dermatitis Index (SCORAD) were determined and were correlated with each other. Results: Following treatment with pimecrolimus, the EASI, IGA and SCORAD were significantly reduced on day 29 as compared with the vehicle group (P < 0.001, P < 0.001, P=0.002, respectively). There was a close correlation between EASI, IGA and SCORAD. The single parameters of the EASI were already significantly decreased by day 4 in the pimecrolimus group as compared to vehicle (each P < 0.001). Conclusion: Treatment with pimecrolimus 1%cream leads to a rapid improvement of all morphological signs of eczema. The close correlation of different scores was shown for the first time.
