Haut und Psychosomatik – Psychodermatologie heute

ZusammenfassungDie heutige Psychodermatologie beruht auf dem biopsychosozialen Krankheitsmodell der Psychosomatik. Danach sind biologische, psychologische und soziale Faktoren auf verschiedenen Ebenen (von den Molekülen bis zur Biosphäre) durch komplexe, nicht lineare Interaktionen über den gesamten Krankheitsverlauf wesentlich an der Pathogenese jeder Krankheit beteiligt. Es gilt als experimentell gesichert, dass "Emotionen in die Haut gelangen". Die rezente Forschung belegt enge anatomische, physiologische und funktionelle Verbindungen zwischen Haut und Nervensystem; letztere sind ontogenetisch eng verwandt. Diese Verbindungen spiegeln sich in zahlreichen Hautkrankheiten wider, bei denen psychische und somatische ätiologische Faktoren eng miteinander verflochten sind. Dieser Verflechtung sollte ein ganzheitlicher Zugang des Arztes gerecht werden.Bei Anamneseerhebung, Diagnosestellung und Therapiewahl sollten biologische, psychische und soziale Faktoren hinreichend berücksichtigt werden. Die "Sichtbarkeit" des Hautorgans führt dazu, dass die Dermatologie unter den klinischen Fächern eine Sonderstellung einnimmt und dass ein ganzheitlicher psychosomatischer Zugang zum Patienten besonders wichtig ist. Die Lebenslaufperspektive (life course approach) kann zu den Zugangsmethoden der modernen Psychodermatologie gerechnet werden. In Anlehnung an das moderne Konzept der Psychodermatologie gibt es heute weitere entsprechende Teilgebiete wie zum Beispiel Psychogastroenterologie und Psychokardiologie. Im Anschluss an den theoretischen Teil werden einige exemplarisch ausgewählte Hautkrankheiten unter dem psychosomatischen Blickpunkt ausführlicher besprochen

Coral-bead Skin Lesions Associated with Erosive Arthritis: A Quiz

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Biología y tasa de consumo del Defoliador (euprosterna elaeasa dyar) de plantaciones de palma aceitera (elaeis guineensis jacq), en la empresa Palmas del Shanusi S.A. - Región Loreto

El objetivo del presente trabajo es determinar la duración de los diferentes estados de desarrollo y capacidad de alimentación que tienen las larvas en cada estadio, para establecer el control oportuno de Euprosterna elaeasa. Se colectaron 300 larvas del último estadio, que fueron llevadas a la sala de crianza y criados hasta obtener el adulto. Los adultos que emergieron se acondicionaron en parejas en el campo, dentro de un farol de alambre, hasta completar 10 faroles, con la finalidad de obtener huevos y dar inicio al estudio. La duración de los estados de desarrollo: huevo, larva, prepupa, pupa y adulto fueron de 8, 37, 0.4, 21 y 7 días, respectivamente. El ciclo de vida en promedio fue de 76 días. El tamaño de huevo, larva y pupa fue de 2 mm, 19 mm y 8 mm, respectivamente. La expansión alar de los adultos fue de 24 mm. El periodo de preoviposición en promedio fue de 2 horas; oviposición 4 días. Número de huevos/hembra fue 220. La viabilidad de huevos fue de 93% y la proporción entre hembras y machos fue de 1:2. El consumo foliar acumulado durante la etapa larval de E. elaeasa fue 60.65 cm2 del follaje; el noveno estadio larval requiere de 53.6% del consumo total

Psoriatic Pseudobalanitis Circinata as a Post-Viral Koebner Phenomenon

In the absence of any other lesions on the body, the diagnosis of localized genital psoriasis can be difficult, requiring further examinations including a biopsy. We report a case of psoriatic pseudobalanitis circinata triggered by a herpes virus infection, and we discuss the Koebner phenomenon and the therapeutic management of psoriasis of the genital area

The psychological burden of skin diseases: a cross-sectional multicenter study among dermatological out-patients in 13 European countries.

The contribution of psychological disorders to the burden of skin disease has been poorly explored, and this is a large-scale study to ascertain the association between depression, anxiety, and suicidal ideation with various dermatological diagnoses. This international multicenter observational cross-sectional study was conducted in 13 European countries. In each dermatology clinic, 250 consecutive adult out-patients were recruited to complete a questionnaire, reporting socio-demographic information, negative life events, and suicidal ideation; depression and anxiety were assessed with the Hospital Anxiety and Depression Scale. A clinical examination was performed. A control group was recruited among hospital employees. There were 4,994 participants--3,635 patients and 1,359 controls. Clinical depression was present in 10.1% patients (controls 4.3%, odds ratio (OR) 2.40 (1.67-3.47)). Clinical anxiety was present in 17.2% (controls 11.1%, OR 2.18 (1.68-2.82)). Suicidal ideation was reported by 12.7% of all patients (controls 8.3%, OR 1.94 (1.33-2.82)). For individual diagnoses, only patients with psoriasis had significant association with suicidal ideation. The association with depression and anxiety was highest for patients with psoriasis, atopic dermatitis, hand eczema, and leg ulcers. These results identify a major additional burden of skin disease and have important clinical implications.Peer reviewedFinal Published versio

Canine Hereditary Ataxia in Old English Sheepdogs and Gordon Setters Is Associated with a Defect in the Autophagy Gene Encoding RAB24

Old English Sheepdogs and Gordon Setters suffer from a juvenile onset, autosomal recessive form of canine hereditary ataxia primarily affecting the Purkinje neuron of the cerebellar cortex. The clinical and histological characteristics are analogous to hereditary ataxias in humans. Linkage and genome-wide association studies on a cohort of related Old English Sheepdogs identified a region on CFA4 strongly associated with the disease phenotype. Targeted sequence capture and next generation sequencing of the region identified an A to C single nucleotide polymorphism (SNP) located at position 113 in exon 1 of an autophagy gene, RAB24, that segregated with the phenotype. Genotyping of six additional breeds of dogs affected with hereditary ataxia identified the same polymorphism in affected Gordon Setters that segregated perfectly with phenotype. The other breeds tested did not have the polymorphism. Genome-wide SNP genotyping of Gordon Setters identified a 1.9 MB region with an identical haplotype to affected Old English Sheepdogs. Histopathology, immunohistochemistry and ultrastructural evaluation of the brains of affected dogs from both breeds identified dramatic Purkinje neuron loss with axonal spheroids, accumulation of autophagosomes, ubiquitin positive inclusions and a diffuse increase in cytoplasmic neuronal ubiquitin staining. These findings recapitulate the changes reported in mice with induced neuron-specific autophagy defects. Taken together, our results suggest that a defect in RAB24, a gene associated with autophagy, is highly associated with and may contribute to canine hereditary ataxia in Old English Sheepdogs and Gordon Setters. This finding suggests that detailed investigation of autophagy pathways should be undertaken in human hereditary ataxia.American Kennel Club Canine Health Foundation (grant CHF 0407)American Kennel Club Canine Health Foundation (grant CHF 0925)Old English Sheepdog Club of AmericaTarTan Gordon Setter ClubEuropean Science Foundation (EURYI)Canine Health Information Center (DNA Repository