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Standige Anderungen der Dermatophytennomenklatur stosen bei vielen Dermatologen auf Unverstandnis. Es werden die Hintergrunde und methodischen Entwicklungen, die zu fruheren und aktuellen Veranderungen der Dermatophytentaxonomie und der Entdeckung neuer Dermatophyten gefuhrt haben, erlautert. Es erfolgt eine Auswertung der jungeren themenrelevanten Literatur sowie eigener Untersuchungsergebnisse zur Bestimmung und Entdeckung von Dermatophytenarten sowie zu taxonomischen Entwicklungen auf diesem Gebiet. Das phylogenetische Artkonzept ist heute die Basis fur taxonomische Einteilungen, auch bei den Dermatophyten. Genetische Untersuchungsmethoden haben dazu entscheidende Fortschritte gebracht und sind heute Stand der Technik. Bei der Entdeckung neuer Dermatophytenarten fuhrten vielfach initial klinische Beobachtungen und morphologisch auffallige Kulturen zu weiteren exakten mykologischen Charakterisierungen. Auch heute sind noch nicht alle Dermatophytenspezies eindeutig definiert. Bei ausschlieslicher Verwendung selektierter genetischer Merkmale zur Erstellung phylogenetischer Kladogramme werden weitere taxonomisch relevante Informationen vernachlassigt. Die starkere Einbeziehung morphologischer, physiologischer, okologischer, epidemiologischer und pathophysiologischer Daten scheint bei der phylogenetischen Analyse geboten, und Dermatologen sind gefordert, diese Informationen weiterhin beizutragen.

Wir berichten uber eine Tinea faciei durch Nannizzia (N.) persicolor. Der 4‑jahrige Junge hatte sich vermutlich an einem Meerschweinchen infiziert. Gesicherte Infektionen durch N. persicolor sind in Deutschland sehr selten. Moglicherweise wird dieser zoo- und geophile Dermatophyt aber aufgrund seiner Ahnlichkeit mit Trichophyton (T.) mentagrophytes auch nur selten erkannt. Die diagnostischen Merkmale von N. persicolor und seine Unterscheidung von T. mentagrophytes werden deshalb dargestellt. Insbesondere bei Kontakt zu Nagetieren sollte auch an N. persicolor gedacht werden.

We report on a tinea faciei caused by Nannizzia (N.) persicolor. The 4‑year-old boy had probably been infected by a guinea pig. Unambiguous infections caused by N. persicolor are rarely seen in Germany; however, this zoophilic and geophilic dermatophyte may only be rarely identified due to its resemblance to Trichophyton (T.) mentagrophytes. Therefore, the diagnostic attributes of N. persicolor and its differentiation from T. mentagrophytes are described. Particularly in case of contact with rodents, N. persicolor should be kept in mind.

Dermatophytoses are infections of the skin, hair or nails caused by dermatophytes. Dermatophytes can induce typical diagnostic clinical lesions (tinea), but can also mimic other dermatoses. Therefore, physicians need to be familiar with the whole spectrum of tinea and must constantly be mindful of possible dermatophytosis. An examination with Wood’s light can be helpful. In superficial lesions, the demonstration of dermatophytes may be achieved by dermatoscopy or laser scanning. An essential step of the following diagnostic procedure is the skilful collection of samples for the proof of fungi. Microscopy of KOH mounts or equivalent preparations produced from infected material and histology are approved methods. The necessary identification of dermatophytes on species level can finally be accomplished by conventional methods based on cultures or by new techniques based on molecular differentiation or MALDI-TOF analysis. These modern methods are clearly on the increase and can considerably improve and accelerate dermatophyte identification.

In the event of non-specific epidermal lesions, the importance of a comprehensive anamnesis becomes especially apparent. In the following, we report on a patient case in which only a focused anamnesis was able to bring light into the darkness of numerous differential diagnoses - and to produce the diagnosis of a rare but in this collective common illness: primary cutaneous cryptococcosis.

Anamorphs of Arthroderma (A.) benhamiae, which can cause inflammatory tinea lesions in humans, have been progressively spreading in Germany.Identification of A. benhamiae anamorphs by conventional methods.Evaluation of our own results obtained with A. benhamiae anamorphs and from the relevant literature.Infections with A. benhamiae anamorphs are usually transferred by guinea pigs or other animals. A. benhamiae anamorphs can be cultured on growth media used for dermatophytes and can be characterized morphologically and physiologically. In Germany the yellow variant is seen most often but a white variant that equals Trichophyton (T.) interdigitale has also been observed. On Sabouraud agar the yellow variant develops markedly yellow thalli, whereas the white variant produces white aerial mycelium. Microconidia are formed by the yellow variant-if at all-only scarcely and delayed; they are small, roundish, and arranged in a grape-like order. The white variant produces peg-shaped microconidia alongside hyphae as well as roundish ones in grape-like clusters, and subsequently some macroconidia, chlamydospores, and spiral hyphae. In microcultures with both variants circuit-like hyphal structures can consistently be demonstrated. On Trichophyton agars only the yellow variant is clearly dependent on thiamine. The urease test is negative with the yellow variant and positive with the white variant. Most strains of both variants are negative in the hair perforation test.The characteristics described allow reliable identification of the yellow variant of the A. benhamiae anamorph by conventional methods; a distinction between the white variant and T. interdigitale can be more difficult. Dermatologists should be able to identify this agent in clinical routine.

Under favorable conditions even molds can cause skin infections. Fusarium spp. belong to this group of agents. Onychomycoses due to Fusarium spp. are regularly encountered and cannot be clinically distinguished from nail infections triggered by dermatophytes. They can occur in otherwise healthy persons. Skin lesions caused by Fusarium spp. may be necrotizing, ulcerating, pustular, vasculitis-like, panniculitis-like or granulomatous. Single lesions can develop after fungal inoculation into damaged tissue; multiple ones are often due to a septic dissemination of Fusarium in severely immunocompromised patients. An immediate verification of the agents can be life-saving in such cases. Pathogenic Fusarium spp. should be identified at the species level and need to be tested for their susceptibility to antimycotics. In case of multiple lesions, systemic therapy is required. Many strains of Fusarium spp. are susceptible to amphotericin B, voriconazole and posaconazole; itraconazole and terbinafine may be helpful in certain cases.

The development of guidelines is a complex process in which verified findings as well as different points of view and interests must be amalgamated into practical consent. Contact dermatitis is a very common disease that in most cases is not treated by dermatologists. Therefore a guideline for contact dermatitis must offer orientation for physicians of different specialities. For this reason the contact dermatitis guideline covers not only diagnostic and therapeutic aspects of contact dermatitis but also refers to essentials of epidemiology and pathophysiology of the disease in order to allow a better understanding. Such knowledge facilitates appropriate decisions in individual cases. The avoidance of strict algorithms emphasises the advisory function of this guideline. It was developed on S1-level by independent authors related to various working groups and it is endorsed by the German Dermatologic Society.

Although the prevalence of contact allergy in children is largely unknown, the most frequent contact allergens in childhood are nickel, fragrances, p-phenylenediamine, thimerosal, preservatives and components of skin care and hygiene products. Children with persistent eczema or otherwise suspected contact allergy should be patch tested. For children, the same preparations of allergens and test techniques can be used as for adults. Patch tests should be done with allergens suggested by history and with a shortened standard series, at best with small Finn-Chambers that are attached for 1 day only. Positive readings need to be assessed with regard to clinical relevance. In children, the treatment of allergic contact dermatitis follows the same principles as in adults. Topical corticosteroids are agents of well proven efficiency whereas non-steroidal anti-inflammatory drugs should not be applied to the skin because there is of a risk of contact sensitization. For reasons of prophylaxis it is important to avoid potential contact allergens in childhood.

Taxonomy is an artificial system to classify living organisms. For this purpose, different concepts of how to define a species can be used. In recent years, DNA analysis has especially helped to better understand the phylogenetic relations of dermatophytes and thus influenced the distinction ofdermatophyte species. In some cases species previously considered separate were made synonymous. It may be necessary to discriminate different varieties within a particular species if this is required by their typical morphologic, physiologic or epidemiological characteristics. Trichophyton eboreum with its perfect state Arthroderma olidum was recently described as a new species. The taxonomic order of dermatophytes must continuously be updated by integrating new findings; at the same time, meaningful and proven criteria should be retained.

The oxidation induction time (OIT) test is a powerful technique for evaluating the oxidative stability and/or degradation of polymers. It is especially effective in examining the relative utility of antioxidants on the stability of oxidizable polymers. It is also useful in determining whether or not antioxidants have been leached from the polymer, thus negating their effectiveness. In this study, the OIT test has been used to show the loss in effectiveness of antioxidant from the interior surface of poly(1-butene) pipe used to convey potable water. The loss in antioxidant effectiveness was confirmed by significantly reduced OIT times. Confirmation of oxidation of the polymer was subsequently made by IR analysis. © 2005 Wiley Periodicals, Inc. Adv Polym Techn 24:215–225, 2005; Published online in Wiley InterScience (www.interscience.wiley.com). DOI 10.1002/adv.20045

Zusammenfassung Hintergrund und Fragestellung: Teebaumol, ein Destillationsprodukt der Blatter des australischen Teebaumes Melaleuca alternifolia, erfreut sich zunehmender Beliebtheit als Alternativheilmittel fur die Behandlung diverser Hauterkrankungen. Das Ol ist ein Gemisch aus zahlreichen allergologisch relevanten Substanzen wie Monoterpenen und Sesquiterpenen. In dieser multizentrischen Studie sollte evaluiert werden, ob die Zunahme des Verbrauches von Teebaumol zu einer Sensibilisierungshaufigkeit in Deutschland und Osterreich gefuhrt hat, die die Aufnahme in die Standardreihe rechtfertigen wurden. Patienten und Methode: Fur die Epikutantestung wurde ein standardisiertes Teebaumol, 5 % in Diethylphthalat (DEP), verwendet. Getestet wurden konsekutive Ekzem-Patienten von 11 Hautkliniken in Deutschland und Osterreich. Die Ablesung erfolgte nach zwei und drei Tagen gemas den Empfehlungen der Deutschen Kontaktallergiegruppe (DKG). Ergebnisse: Von insgesamt 3 375 getesteten Patienten reagierten 36 (1,1 %) positiv auf Teebaumol. Die Sensibilisierungshaufigkeit zeigte grose geographische Unterschiede von 2,3 % (Dortmund), 1,7 % (Buxtehude), 1,1 % (Essen), 0,7 % (Graz) bis 0 % (Berlin, Wien). 14/36 Patienten (38,9 %) zeigten auch eine positive Reaktion auf Terpentin. Schlusfolgerung: Fur einzelne Testzentren ist Teebaumol ein wichtiges Allergengemisch. Bei anamnestischen Hinweisen uber die Anwendung teebaumolhaltiger Produkte sollte es getestet werden. Angesichts der grosen regionalen Unterschiede in der Sensibilisierungshaufigkeit ist die Aufnahme in die Standardreihe noch nicht zu empfehlen. Summary Background and aim: Tea tree oil, a distillation product of the Australian tea tree (Melalence alternitolia) is increasingly used as an alternative remedy for various dermatological diseases. Tea tree oil contains several allergenic monoterpenes and sesquiterpenes. In this multicenter study it was evaluated, whether the increasing use of tea tree oil has lead to an increased frequency of sensitization in Germany and Austria which would justify its inclusion into the standard series. Patients and method: For patch testing a standardized tea tree oil was used, dissolved 5 % in diethylphtalate (DEP). Consecutive patients of 11 dermatological departments in Germany and Austria were tested. Readings were taken on day 2 and 3 according to the guidelines of the German Contact Dermatitis Research Group (DKG). Results: 5 % tea tree oil was positive in 36/3375 patients (1.1 %). Sensitization frequencies showed great regional variations and ranged from 2.3 % (Dortmund), 1.7 % (Buxtehude), 1.1 % (Essen), 0.7 % (Graz), to 0 % (Berlin, Vienna). 14/36 patients (38.9 %) also showed a positive patch test reaction to oil of turpentine. Conclusion: Our results show that tea tree oil is an important contact allergen for some centers. It should be tested, if medical history suggests its previous use. Considering the great regional differences in frequencies of sensitization its inclusion into the standard series is not recommended yet.

Polysaccharides of the red seaweed Apophloea lyallii were extracted with hot water in a yield of 63.6% w/w of the dry seaweed. The polysaccharides were non-sulphated and were composed of various proportions of d -xylose, 2-O-methyl d -galactose, d -glucuronic acid, d - and l -galactose, 3-O-methyl galactose, and d -glucose. The aldobiuronic acid 3-O-(β- d -glucopyranosyluronic acid)- d -xylopyranose was isolated from the acid hydrolysate of the polysaccharides. The polysaccharides were fractionated by DEAE-sephadex ion exchange chromatography, and two of the fractions obtained were characterised by neutral sugar analyses, linkage analyses, and NMR spectroscopy. A major fraction obtained was shown to be largely composed of a unique (2-O-methyl galacto)–glucurono–xylo-glycan with a repeating unit represented by [α- d -(2-O-Me-Galp)-(1→4)-β- d -GlcAp-(1→3)-α- d -Xylp-(1→4)-]n. The structure of this new glycan was explored by beta-elimination analyses. A minor fraction obtained by ion exchange chromatography contained (1→4)-linked xylose, (1→4)-linked galactose, (1→4)-linked 3-O-methyl galactose, (1,3,4)-linked galactose, and terminal uronic acid in a ratio of approximately 1:0.3:0.5:0.4:0.4.

The reproducibility of diagnostic patch testing is an important quality criterion which has been addressed by several studies. The reanalysis presented utilises data of a previous study of the German Contact Dermatitis Research Group (DKG) on the synchronous left versus right reproducibilty of patch testing with 10 allergens of the standard series, quantifying reproducibility with Cohen's K coefficient. The degree of concordance between dichotomised reactions at 72 hours ("positive" versus "not positive") varies between allergens. The K coefficient was 0.80 and above for nickel sulphate, p-phenyl-enediamine, cobalt chloride and balsam of Peru, while for the two allergens tested in water, i.e., (chloro-) methylisothiazolinone and formaldehyde, it was below 0.70. Longer patch test exposure (48 hours compared to 24 hours) mostly improved concordance, which was, however, a significant effect only for potassium dichromate (p < 0,05). For the evaluation of concordance between chemically related allergens in terms of cross-reactivity, a quotient between the K coefficient found with the related allergens and the K coefficient found with the marker allergen involved (with synchronous duplicate application) is suggested.

Thiuram mix is tested in the standard series at a test concentration of 1% pet. The single thiurams (DPTD, TMTD, TMTM, TETD), however, are usually tested at 0.25% pet. in Germany. In other countries, the individual components of thiuram mix are tested at 1% pet. The German Contact Dermatitis Research Group (DKG) compared both patch test concentrations in 530 patients in order to find out if (i) a significant number of positive patch tests are missed by testing at the lower concentration, (ii) problems with irritant test reactions occur by increasing the test concentration to 1%, and (iii) the sensitivity of the thiuram mix rises when the breakdown test is done with the higher concentration. Slightly more positive reactions were seen with the higher concentration, but this increase did not reach statistical significance. The reaction index, as a measure for the relation of positive to irritant and/or questionable reactions, remained unchanged for the individual thiurams. The sensitivity of the mix also did not change when the breakdown test was performed with 1% pet. instead of 0.25% pet. Thus, we conclude that both concentrations are of equal diagnostic value in patch testing.

The identification of Trichophyton mentagrophytes var. nodulare is described, based on a strain recently isolated from tinea pedis. Different culture media and physiological tests were used in order to compare this strain with related strains. The main characteristics of T. mentagrophytes var. nodulare were its deep yellow-orange pigmentation, which was released from the mycelium, the flat growth of its colonies and the formation of nodular bodies. Supplementation of Sabouraud glucose agar with 3% NaCl reduced the aerial mycelium and stimulated the formation of conidia. Until now an identification of T. mentagrophytes var. nodulare based on DNA-patterns has not been published. Trichophyton mentagrophytes var. nodulare is supposed to be an anthropophilic dermatophyte causing ordinary tinea and onychomycosis. The low number of reports indicates that it is a very rare variety.

Background: The combination of methyldibromoglutaronitrile (MDBGN) and phenoxyethanol (PE) is widely used as a preservative in body care products. Sensitization rates to MDBGN have increased parallel to its increasing use in cosmetics, skin care products, and moist toilet paper since the early 1990s, whereas PE is obviously not a sensitizer. The optimum patch preparation for diagnosing a contact allergy to MDBGN is still a matter of debate. Objective: This study was performed to assess an adequate patch test concentration for MDBGN/PE and MDBGN. Methods: Based on previous results from other countries, the German Contact Dermatitis Research Group (DKG) performed parallel patch tests with MDBGN/PE 0.5% in petrolatum (pet.) and 1% pet. in 4,615 patients and with MDBGN 0.1% pet. and 0.3% pet. in 988 patients. The results of these tests, performed in routine patch testing, were collected and analyzed be the Information Network of Departments of Dermatology (IVDK). Results: Comparing MDBGN/PE 0.5% pet. with 1.0% pet., the percentage of patients showing a positive test reaction increased from 2.3% to 3.5% ( P [lt ] .001), mainly because of an increase in weak positive reactions. The reaction index remained stable at 0.54. Comparing MDBGN 0.1% pet. with 0.3% pet., the percentage of patients with positive reactions increased from 1.4% to 3.3% ( P [lt ] .001), and the reaction index decreased from 0.33 to [minus ]0.10. With the lower test concentration, 79% of the positive reactions were only +, with the greater concentration, this was true of 64%. Conclusion: Testing MDBGN/PE 1.0% pet. shows additional cases of contact allergy to MDBGN that would have remained undetected with MDBGN 0.5% pet. The greater test concentration seems to have no disadvantages in quality. The DKG decided to keep MDBGN/PE 1.0% pet. in the standard series. MDBGN 0.3% pet. leads to far more doubtful or irritant test reactions than MDBGN 0.1% and may produce false-positive patch test results. Therefore, the DKG recommends testing MDBGN 0.3% pet only in special cases.

Objective Thimerosal is an important preservative in vaccines and ophthalmologic preparations. The substance is known to be a type IV sensitizing agent. High sensitization rates were observed in contact-allergic patients and in health care workers who had been exposed to thimerosal-preserved vaccines. There is evidence for the involvement of the glutathione system in the metabolism of thimerosal or its decomposition products (organomercury alkyl compounds). Thus detoxification by polymorphically expressed glutathione S-transferases such as GSTT1 and GSTM1 might have a protective effect against sensitization by these substances. Methods To address this question, a case control study was conducted, including 91 Central European individuals with a positive patch-test reaction to thimerosal. This population was compared with 169 healthy controls and additionally with 114 individuals affected by an allergy against para-substituted aryl compounds. The latter population was included in order to test whether possible associations were due to substance-specific effects, or were a general feature connected with type IV immunological diseases. Homozygous deletions of GSTT1 and GSTM1 were determined by polymerase chain reaction. Results Glutathione S-transferase M1 deficiency was significantly more frequent among patients sensitized to thimerosal (65.9%, P = 0.013) compared with the healthy control group (49.1%) and the "para-compound" group (48%, P = 0.034). Glutathione S-transferase T1 deficiency in the thimerosal/mercury group (19.8%) was barely elevated versus healthy controls (16.0%) and the "para-compound" group (14.0%). The combined deletion (GSTT1-/GSTM1-) was markedly more frequent among thimerosal-sensitized patients than in healthy controls (17.6% vs. 6.5%, P = 0.0093) and in the "para-compound" group (17.6% vs. 6.1%, P =0.014), revealing a synergistic effect of these enzyme deficiencies (healthy controls vs. thimerosal GSTM1 negative individuals, OR = 2.0 [CI = 1.2-3.4], GSTT1-, OR = 1.2 [CI = 0.70-2.1], GSTM1/T1-, OR = 3.1 [CI = 1.4-6.5]). Conclusions Since the glutathione-dependent system was repeatedly shown to be involved in the metabolism of thimerosal decomposition products, the observed association may be of functional relevance.

Trisaccharides, methyl alpha-L-fucopyranosyl-(1-->2)-beta-D-galactopyranosyl-(1-->2)-alpha-D-xy lopyranoside and methyl alpha-L-fucopyranosyl-(1-->2)-beta-D-galactopyranosyl-(1-->2)-beta-D-xyl opyranoside, which are related to the side chain of xyloglucan have been synthesised. The beta-galactopyranosyl linkage of each was constructed using silver trifluoromethanesulfonate-promoted glycosylations of 2-O-acetyl-3,4,6-tri-O-benzyl-beta-D-galactopyranosyl chloride and the corresponding anomer of methyl 3,4-tri-O-benzyl-D-xylopyranoside. The resulting disaccharides were deacetylated and fucosylated using assisted halide reactions with tri-O-benzyl-alpha-L-fucopyranosyl bromide. Hydrogenolytic debenzylation of the resulting protected trisaccharides gave the methyl glycosides of the fucose-containing xyloglucan side chain. The structure of methyl alpha-L-fucopyranosyl-(1-->2)-beta-D-galactopyranosyl-(1-->2)-alpha-D-xy lopyranoside as the monohydrate was confirmed by an X-ray crystallographic study.

Xyloglucan extracted with 4 M KOH from enzymically-depectinated and non-depectinated apple pomace was shown to be fucogalactoxyloglucan. The xyloglucan from the enzymically-depectinated apple pomace was found to be of lower molecular weight than that from the non-depectinated pomace. Xyloglucan from the non-depectinated pomace had an intrinsic viscosity of 244 ml/g. The oligosaccharides XXFG and XLFG were isolated from the 1,4- β - d -glucanase hydrolysate of the xyloglucan and their 13 C NMR spectra were obtained for the first time. Assignment of the anomeric 13 C NMR signals of these oligosaccharides permitted the unambiguous assignment of the anomeric region of the 13 C NMR spectra of the fucogalactoxyloglucan. In the spectra of the oligosaccharides, splitting was observed in the C-6 signal from the fucosyl residues, indicating their proximity to the reducing glucosyl residues and thus yielding information about the conformation of xyloglucan in solution. Integration of the anomeric signals of 1 H NMR spectra permits the rapid and non-destructive screening of the composition of xyloglucans from different plants.

Since January 2001, the European Surveillance System on Contact Allergies (ESSCA), supported by European Union funding (contract QLK4-CT-2001-00343), has started to collect patch-test data. This comprises a standardized clinical history and the patch-test results using the European standard series, from 17 centres in 9 European countries listed above. In 2002 and 2003, 10 511 patients' test results have been pooled and analysed. The anamnestic data partly reflect the subspecialties of some centres. The most common allergen was nickel sulfate (17.3%); however, large international variations were observed. The prevalence of contact allergy to Myroxylon pereirae resin (balsam of Peru) (5.8%) is coming close to the frequency found with the fragrance mix (6.4%). Regarding contact allergy to chromium compounds, different frequencies were noted in the 2 centres focused on occupational dermatitis (2.3% in the FIOH versus 7.4% in the Nofer Institute). These most likely reflect the beneficial effect of addition of ferrous sulfate in one, but not the other country. As differences may partly be due to different patch-test reading, standardization may need to be refined further. By providing post-marketing surveillance in the field of contact allergy, ESSCA will meet its objective of increased consumer safety across Europe.

Homopolymeric (M- and G-) and heteropolymeric (MG-) blocks have been prepared from alginates that have been isolated from seven Southern Hemisphere brown seaweeds and from three commercial algal alginates. The blocks have been analysed by 1 H and 13 C NMR spectroscopy, and the analyses show that well-defined M- and G-homopolymers are obtained only from the five polysaccharides that have been previously designated as either high-M or high-G alginates. However, the five intermediate algal alginates (which have F M values between 0.6 and 0.7) appear to contain mainly MG or heteropolymeric blocks. It is concluded that the results of NMR spectroscopic analysis of whole alginates can give a misleading picture of the block structure of some alginates. The NMR analyses of the homopolymers isolated from both the high-M and high-G alginates also show that the order of the d -mannuronosyl and l -guluronosyl residues in these blocks fits a first-order Markov distribution pattern. This suggests that 5-epimerization of some of the GDP- d -mannuronosyl residues at the monomer level, followed by addition copolymerization catalyzed by a GDP-guluronic acid transferase system, as originally suggested by Lin and Hassid [1,2], may contribute to the biosynthesis of the homopolymeric block structures in these high-M and high-G alginates isolated from brown algae. The NMR analysis of homopolymeric blocks from several algal alginates are shown to have first-order Markov distributions of d -mannuronosyl and l -guluronosyl residues. This is consistent with a biosynthetic pathway that involves a C-5 epimerisation at the monomer level.

Zusammenfassung. Steroidhormone gehoren zu denjenigen Faktoren, die aufgrund epidemiologischer und klinischer Beobachtungen moglicherweise den Verlauf von Mykosen beim Menschen beeinflussen konnen. Eine Reihe von Pilzen, darunter auch human-pathogene Arten, konnen Steroidhormone bilden, metabolisieren oder lassen sich in ihrem Wachstum durch sie beeinflussen. Da die ebenfalls steroidreaktive menschliche Haut ihrerseits selbst Steroidhormone bildet und verstoffwechselt, ist eine hormon-mediierte Wechselwirkung zwischen pathogenen Pilzen und Wirt bei Dermatomykosen denkbar. Summary. It is indicated by some epidemiological and clinical observations, that steroidal hormones may belong to those factors that are capable to influence the clinical courses of mycotic infections in man. Several fungal species, including pathogenic ones, are able to produce or metabolize steroidal hormones, or their growth can be affected by such hormones. Since, on the other hand, the steroid-responsive human skin is also capable to synthesize and convert steroidal hormones, the relationship between pathogenic fungi and host may be influenced by hormonal mediators in dermatomycoses.

Alginates have been extracted from seven brown algae found in the Southern Hemisphere and characterized by 1 H and 13 C NMR analyses. The results are compared with similar analyses obtained in this work for three commercially available alginates isolated from Macrocystis pyrifera , a species of the Northern Hemisphere. Overall the ten alginates display a wide range of compositions, ranging from the very high mannuronic acid containing alginate extracted from Durvillaea antarctica ( F M = 0.80) to the moderately high guluronic acid containing alginate from Marginariella boryana ( F G = 0.56). All data are examined in terms of two addition copolymerization models, namely the Bernoullian and the first-order Markov models. Monomer distributions in the high M and intermediate composition alginates have M-diad frequencies calculated from the NMR analyses that agree closely with Bernoullian distributions, the best agreements being obtained for those alginates in which F M is greater than 0.72. However, as the monomer composition tends towards a higher G content, both of the above statistical models fail to satisfactorily describe the distributions of either the M or the G residues. A feature of this work is the excellent agreement obtained for the 1 H and the 13 C NMR analyses

The disaccharides methyl 2- O -( α -l-fucopyranosyl)- β -d-galactopyranoside and methyl 2- O -( α -l-fucopyranosyl)- α -d-galactopyranoside have been synthesised using the assisted halide reaction of tri- O -benzyl- α -l-fucopyranosyl bromide with methyl 3,4,6-tri- O -benzyl- β -d-galactopyranoside and methyl 3,4,6-tri- O -benzyl- α -d-galactopyranoside to construct the interresidue glycosidic linkages. A crystal structure of methyl 2- O -( α -l-fucopyranosyl)- β -d-galactopyranoside was determined using Mo-Kα X-ray data at 183 K. The space group is P 1 (No. 1) with the unit cell containing two molecules of the disaccharide with unique conformations and a water molecule. The structure was refined to R = 0.0566 for 2969 reflections. The l-fucopyranosyl and d-galactopyranosyl residues have the nominal 1 C 4 and 4 C 1 conformations, respectively. The interresidue torsion angles are comparable with those generated in a recent molecular modelling study.

Under favorable conditions even molds can cause skin infections. Fusarium spp. belong to this group of agents. Onychomycoses due to Fusarium spp. are regularly encountered and cannot be clinically distinguished from nail infections triggered by dermatophytes. They can occur in otherwise healthy persons. Skin lesions caused by Fusarium spp. may be necrotizing, ulcerating, pustular, vasculitis-like, panniculitis-like or granulomatous. Single lesions can develop after fungal inoculation into damaged tissue; multiple ones are often due to a septic dissemination of Fusarium in severely immunocompromised patients. An immediate verification of the agents can be life-saving in such cases. Pathogenic Fusarium spp. should be identified at the species level and need to be tested for their susceptibility to antimycotics. In case of multiple lesions, systemic therapy is required. Many strains of Fusarium spp. are susceptible to amphotericin B, voriconazole and posaconazole; itraconazole and terbinafine may be helpful in certain cases.

Chronic spontaneous urticaria (CSU), a mast cell-driven condition, is debilitating, common, and hard to treat. Miltefosine, a lipid raft modulator, can inhibit mast cell responses in vivo.To study the safety and efficacy of systemic miltefosine treatment in CSU patients resistant to standard-dosed antihistamines.In this investigator-initiated multicentre, randomized, double-blind, placebo-controlled study, CSU patients were treated for 4 weeks with daily doses of up to 150-mg miltefosine (n = 47) or placebo (n = 26). Disease activity was assessed using the urticaria activity score. Safety and tolerability of miltefosine were also assessed.After 4 weeks of treatment, Urticaria Activity Score (UAS7) levels were substantially more reduced in miltefosine-treated patients (-6.3 vs. -3.5 in placebo-treated patients; P = 0.05). Also, the number of weals, but not the intensity of pruritus, was significantly reduced in miltefosine-treated patients vs. placebo-treated patients (P = 0.02). In general, adverse events were frequent in both groups (miltefosine: 88%, placebo: 65% of patients) but mostly mild to moderate in severity. We did not observe any serious adverse events.The results of this study indicate that miltefosine is an effective and safe treatment option for CSU patients who do not respond to standard-dosed antihistamines.

The differentiation between mast cell mediator-mediated and bradykinin-mediated forms of angioedema can be difficult. Bradykinin-mediated hereditary angioedema is a rare autosomal dominant hereditary disease which is characterized by recurrent edema attacks of varying magnitude. The edema occurs in the skin and mucous membranes and can be temporarily disfiguring, very painful and life-threatening by attacks in the laryngeal region. Because of the multitude of differential diagnoses, a final diagnosis is only achieved after an average duration of more than 10 years. The anamnestic and laboratory diagnostic algorithm presented here is designed to assist a simpler differentiation of the various forms of angioedema and to reach the correct diagnosis more quickly.

Recent observations indicate that Arthroderma benhamiae can cause bullous tinea, that onychomycosis increasingly occurs in children and that molds can cause tinea-like lesions. If a mycotic infection is suspected, the pathogen needs to be identified. The first genetic assays for the detection of dermatophytes have successfully been tested under routine conditions. Using appropriate techniques, genetic diagnosis is faster and more sensitive than a culture. Laboratory standards that would facilitate widespread implementation of genetic identification of dermatophytes have not yet been established. For the identification of yeasts, MALDI-TOF has already been established in many laboratories. This method is being refined for the diagnosis of hyphomycetes too. Newer antimycotics that are approved for certain systemic mycoses such as the triazoles voriconazole and posaconazole and the echinocandines caspofungin, micafungin und anidulafungin may be considered for dermatomycoses that cannot be treated by other therapies. Thermotherapy and photodynamic therapy are additional options in particularly difficult cases.

Background . Assessment methods for atopic dermatitis (AD) are not standardized, and therapeutic studies are difficult to interpret. Aims . To obtain a consensus on

Detection of Trichophyton rubrum in superficial skin infections by conventional methods is time consuming and not always successful. However, with modern molecular methods, an alternative is in sight. The aim of this study was to compare the detection of T. rubrum by conventional methods and by a direct specific PCR assay under routine conditions. Skin scrapings (n = 464) and nail samples (n = 230) collected from suspected tinea lesions were equally divided for KOH-mounts, cultures and PCR-analysis. For the latter, DNA was extracted and PCR was performed with T. rubrum-specific primers. Of the scale samples, 16% were positive for T. rubrum in the culture and PCR as well, 9% were positive in the PCR only and 3% in the culture only, whereas 5% were only KOH-positive. The corresponding results for nail samples were 17%, 20%, 3% and 7%. PCR results were available after 2-5 days, culture results after 2-3 weeks. Our results show that a specific PCR assay can successfully be used to detect T. rubrum directly in samples collected from superficial skin lesions and nails under routine conditions. Compared with conventional methods, it is faster and more sensitive. We recommend its complementary use.

Tissue samples ofMacrocystis pyrifera from 2 sites in southern New Zealand and harvested over a period of 12 months were analysed for alginate content and composition (M:G ratio). Plants were divided into three frond classes of different length and each frond was further separated into age categories of blades and stipes (viz young, mature and old blades; mature and old stipes). Within each size class, younger blades had higher alginate content than older blades. Stipes did not show such variation with age. Alginate from younger blades and stipes had higher proportions of mannuronic acid residues than those from old blades and stipes. The range of M:G ratios for age categories of either blades or stipes from longer fronds was greater than those for smaller fronds. Alginate content and M:G ratios of stipes were always higher than for blades. The difference between M:G ratios of blades and stipes was greater for smaller fronds than for longer ones. Differences between collection sites and seasonal trends are also discussed.

The structure and distribution of the neutral side chains of three pectic polysaccharide fractions of kiwifruit, possessing widely differing degrees of branching, were studied by chemical methods, gel-permeation chromatography, and 13C-n.m.r. spectroscopy, following degradation with a purified endo-polygalacturonase. Three categories of side chain were identified: (a)(1 → 4)-linked β- d -galactosyl residues, which occurred in regions where the galacturonan backbone contained little rhamnose and small proportions of other neutral sugars; (b) side chains containing proportionately less galactose and more arabinose, xylose, and fucose, which occurred in regions where the galacturonan backbone contained increased proportions of rhamnose; and (c) large (1 → 4)-β- d -galactans, which were attached to the rhamnogalacturonan backbone. The possible contribution of these side chains to cell-wall breakdown during kiwifruit ripening is discussed.

Pectic polysaccharides solubilized in vivo during ripening, were isolated using phenol, acetic acid, and water (PAW) from the outer pericarp of kiwifruit (Actinidia deliciosa [A. Chev.] C.F. Liang and A.R. Ferguson var deliciosa ;Hayward') before and after postharvest ethylene treatment. Insoluble polysaccharides of the cell wall materials (CWMs) were solubilized in vitro by chemical extraction with 0.05 molar cyclohexane-trans-1,2-diamine tetraacetate (CDTA), 0.05 molar Na(2)CO(3), 6 molar guanidinium thiocyanate, and 4 molar KOH. The Na(2)CO(3)-soluble fraction decreased by 26%, and the CDTA-soluble fraction increased by 54% 1 day after ethylene treatment. Concomitantly, an increase in the pectic polymer content of the PAW-soluble fraction occurred without loss of galactose from the cell wall. The molecular weight of the PAW-soluble pectic fraction 1 day after ethylene treatment was similar to that of the Na(2)CO(3)-soluble fraction before ethylene treatment. Four days after ethylene treatment, 60% of cell wall polyuronide was solubilized, and 50% of the galactose was lost from the CWM, but the degree of galactosylation and molecular weight of pectic polymers remaining in the CWMs did not decrease. The exception was the CDTA-soluble fraction which showed an apparent decrease in molecular weight during ripening. Concurrently, the PAW-soluble pectic fraction showed a 20-fold reduction in molecular weight. The results suggest that considerable solubilization of the pectic polymers occurred during ripening without changes to their primary structure or degree of polymerization. Following solubilization, the polymers then became susceptible to depolymerization and degalactosidation. Pectolytic enzymes such as endopolygalacturonase and beta-galactosidase were therefore implicated in the degradation of solubilized cell wall pectic polymers but not the initial solubilization of the bulk of the pectic polymers in vivo.

In order to study the relevance of intercellular adhesion molecule 1 (ICAM-1), vascular cell adhesion molecule 1 (VCAM-1) and endothelial leukocyte adhesion molecule 1 (ELAM-1) for lymphocyte extravasation in the early phase of allergic contact dermatitis, the time courses of lymphocyte infiltration and adhesion molecule expression during initiation of this disorder were determined. Sequential biopsies of positive allergic patch test reactions were obtained 4, 8, 16 and 24 h after antigen application, cryostat sectioned and stained with monoclonal antibodies for ICAM-1, VCAM-1, ELAM-1 and lymphocytes by use of an immunoperoxidase technique. The slides were evaluated semiquantitatively according to appropriate gradation scales that had been defined separately for the staining with each antibody. Our results show that there is a significant upregulation of VCAM-1 and ELAM-1 expression within the first 8 h after antigen application, when lymphocyte extravasation is just beginning. In contrast, ICAM-1 is already expressed in higher levels in normal skin and is hardly enhanced during the first 8 h of patch test reactions. The main influx of lymphocytes occurs 16-24 h after antigen application and is accompanied by a further increase in all three adhesion molecules. We conclude that VCAM-1 and ELAM-1 rather than ICAM-1 may be of particular importance for the start phase of allergic contact dermatitis and that all three of them contribute to an amplification of this inflammation.

Although the prevalence of contact allergy in children is largely unknown, the most frequent contact allergens in childhood are nickel, fragrances, p-phenylenediamine, thimerosal, preservatives and components of skin care and hygiene products. Children with persistent eczema or otherwise suspected contact allergy should be patch tested. For children, the same preparations of allergens and test techniques can be used as for adults. Patch tests should be done with allergens suggested by history and with a shortened standard series, at best with small Finn-Chambers that are attached for 1 day only. Positive readings need to be assessed with regard to clinical relevance. In children, the treatment of allergic contact dermatitis follows the same principles as in adults. Topical corticosteroids are agents of well proven efficiency whereas non-steroidal anti-inflammatory drugs should not be applied to the skin because there is of a risk of contact sensitization. For reasons of prophylaxis it is important to avoid potential contact allergens in childhood.

Cell-wall polysaccharides were solubilised from cell-wall materials (CWMs) isolated from kiwifruit at 2 ripening stages, after treatment for 1 and 7 days with ethylene. The fractions soluble in cyclohexane- trans -1,2-diaminetetra-acetate (CDTA), Na 2 CO 3 , guanidinium thiocyanate (GTC), and KOH were purified by ion-exchange and gel-permeation chromatography, and subjected to methylation analysis. The pectic polymers in the 7-day fractions had increased proportions of 4-linked galactosyl, 2- and 2,4-linked rhamnosyl, and terminal arabinosyl, xylosyl, and galactosyl residues, and decreased proportions of 4-linked galacturonosyl residues. In the major Na 2 CO 3 -soluble pectic fraction, there was an increase in the proportion of branched polymers of high molecular weight during ripening. Therefore, a large proportion of the polyuronides may have been solubilised without significant structural modification, indicating that the action of endo-polygalacturonase was not involved. There was a decrease in M w of the xyloglucan fraction during ripening, but no detectable changes in the primary structure or in the 4- O -methylglucuronoxylan and galactoglucomannan fractions.

Taxonomy is an artificial system to classify living organisms. For this purpose, different concepts of how to define a species can be used. In recent years, DNA analysis has especially helped to better understand the phylogenetic relations of dermatophytes and thus influenced the distinction of dermatophyte species. In some cases species previously considered separate were made synonymous. It may be necessary to discriminate different varieties within a particular species if this is required by their typical morphologic, physiologic or epidemiological characteristics. Trichophyton eboreum with its perfect state Arthroderma olidum was recently described as a new species. The taxonomic order of dermatophytes must continuously be updated by integrating new findings; at the same time, meaningful and proven criteria should be retained.

Genetic factors presumably play a role in contact allergy (CA). There is, however, a lack of conclusive evidence from clinical studies. This may be on account of the strongly competing or modifying impact of exogenous factors, namely the potency of allergens and the intensity of exposure, and the fact that - in principle - everybody can be sensitized. Regarding phenotype, in contrast, polysensitization (PS) seems to indicate a subset of individuals at greater risk. In human sensitization experiments with dinitrochlorobenzene, induction was facilitated in PS, and elicitation enhanced. Recent clinical epidemiological data, taking confounders for PS, such as age, sex, and other skin diseases into account, demonstrated the following: (i) PS was the greatest risk factor to be sensitized to a number of (even weak) index allergens, indicating higher susceptibility on the level of induction; (ii) patch test reactions in PS patients were generally stronger indicating higher susceptibility on the level of elicitation. These findings are complemented by reports on polymorphisms of TNF-alpha and IL-16 in PS patients. Future studies on the genetics of CA should be performed in subgroups with PS, focussing on polymorphisms relevant for CA-specific and nonspecific (inflammatory) processes.