Low-dose short-term cyclosporine versus etretinate in psoriasis: improvement of skin, nail, and joint involvement.

Background: High-dose cyclosporine therapy significantly alleviates psoriasis within 2 to 4 weeks but is associated with a high rate of side effects. Reports are conflicting on the frequency and promptness of relapse after discontinuation of cyclosporine therapy.

Objective: Our purpose was to compare the efficacy and safety of low-dose cyclosporine with that of etretinate and the stability of remission after replacing cyclosporine therapy with topical anthralin during tapering of cyclosporine.

The preservation of fungal cultures by lyophilization.

A method for the preservation of fungal strains is presented. The cultures are grown on Sabouraud glucose agar in glass ampoules and lyophilized without further processing. By this method the macroscopical morphology of the cultures is preserved, so that these can be used immediately without recultivation as reference cultures.

PIXE analysis in uninvolved skin of atopic patients and aged skin.

PIXE (proton-induced X-ray emission) analysis was used to determine the elemental distribution in normal-appearing skin of patients suffering from atopic eczema and in the skin of elderly people. With this technique, elements with atomic numbers greater than or equal to 14 can be detected simultaneously in cryosections of skin biopsies down to a concentration of 1 ppm. Compared with a control group, the epidermal concentrations of Zn and Cu, which are constituent parts of a variety of enzymes, were increased in uninvolved skin of patients with atopic eczema.

[Is involvement of skin appendages or thickness of the epidermis an aid in differential diagnosis between lentigo maligna melanoma and superficially spreading melanoma in situ?].

Neither the involvement of hairfollicles nor of the ducts of the sweat glands by melanoma cells nor the thickness of the epidermis are helpful in differential diagnosis of lentigo maligna melanoma and superficial spreading melanoma in situ. The epidermis was thinner in LMM, however, LLM is mostly localized in the face where the epidermis is thinner than in other areas of the integument.

[Cytokinetics and keratins of keratinocytes from skin of the elderly].

Regarding the keratin pattern of non-exposed skin, we found no significant qualitative or quantitative differences between 6 old persons (mean age 85 years) and 4 young adults (mean age 20 years). There was, however, a slight increase of proliferation keratins (K6, K16) in aged skin. In non-exposed skin taken from 6 old (mean age 70 years) and 5 young persons (mean age 37 years), longterm primary submersion cultures of keratinocytes did not show any significant differences as far as the classical parameters of growth behavior were concerned (i.

[The occurrence of polymorphonuclear leukocytes in normal human skin].

We studied the occurrence and quantity of polymorphonuclear leucocytes (PMNL) in normal human skin of various sites and age groups. There were no PMNL in the horny layer and the deeper layers of the epidermis. Very few PMNL were found in the dermis of persons of various age groups and in various localizations.

[Malignant melanoma and HIV infection].

Among 1000 patients with HIV infection consecutively examined at our dermatological department during the last 3 years, we diagnosed 4 cases of malignant melanoma. This figure is clearly higher than the statistical incidence of 4-13 cases per 100.000 people a year observed in West Germany.

[The atypical course of syphilis in HIV infection].

We report on 3 HIV patients showing atypical courses of syphilis. Both the history and serology of the first patient proved a recent re-infection with T. pallidum, whereas the histopathological findings corresponded to an advanced stage of the disease (S II-III).

[Aseptic skin necrosis after subcutaneous injection of alpha interferon].

Aseptic necrosis of the skin developed in two patients with HIV-associated disseminated Kaposi's sarcoma after subcutaneous injection of recombinant interferon-alpha. Both patients were given it at a daily dosage of 20 x 10(6) IU/m2 body surface area. One of the patients, after full remission had been achieved, received a reduced dosage of 3 x 10(6) IU/m2, twice weekly.

[Striated nail discoloration caused by zidovudine].

We report on 2 male patients treated with zidovudine (azidothymidine), who developed longitudinally striated coloration of their nails and lentigines. Both patients are suffering from advanced HIV disease with opportunistic infections. Following treatment with zidovudine 1200 mg daily for 3 and 6 months resp.

[Wound treatment with autogenous epidermal cell expansion culture].

Sheets of autologous epidermal cells grown by expansion culture were used to cover small skin defects in seven patients with postoperative necroses, necroses due to temporal arteritis, varicose ulcers or after tangential excision of tattoos. Several transplantation techniques were used: backing of the cultured epithelia with vaseline gauze, Surfasoft, Adaptic, Silastic foil, culturing directly from Petriperm-foil. Meshed Silastic-foil proved to give the best support.

Malignant blue nevus with metastases to the lung.

A malignant blue nevus of the right upper arm with hematogeneous lung metastases is presented. Histological examination showed that the tumor was composed of spindle, dendritic, and globular cells with hyperchromatic and polymorphic nuclei, atypical mitoses, and tumor cell necrosis. There was no proliferation of atypical melanocytes at the dermoepidermal junction.

[Vesicular pityriasis rosea].

Pityriasis rosea is a frequently occurring skin disease of unknown aetiology. Ten clinical forms of this disease are known, with predominance of the macular type. We observed a healthy 24-year-old patient with the very rare vesicular variant of pityriasis rosea, which has to be differentiated from vesicular virus and drug-induced eruptions.

[Immunohistological studies of immune dermatoses on reconstituted paraffin sections. Value and comparison of different methods].

In a study on 26 patients with autoimmune diseases the immunostaining for immunoglobulins and complement in frozen sections was compared with that in formalin-fixed and paraffin-embedded sections. The formalin-fixed material of pemphigus vulgaris, lupus erythematosus, bullous pemphigoid, and dermatitis herpetiformis (Duhring's disease) was reconstituted and stained by means of the standard two-step technique (TST), the peroxidase-antiperoxidase technique (PAP), and the streptavidin-biotin method (SAB). In comparison with frozen sections, immunoglobulins and complement could also be demonstrated in formalin-fixed sections in all cases of pemphigus vulgaris and in 85% of cases of discoid lupus erythematosus, but in only 60% of cases of bullous pemphigoid or Duhring's disease.

[Keratosis palmoplantaris diffuse circumscripta (Thost-Unna) with micropenis].

We report on a 2-year-old boy showing diffuse palmoplantar keratoderma (Thost-Unna's disease) in association with congenital penis hypoplasia. Family history research proved palmoplantar keratoderma autosomally dominant over 5 generations. The boy's 6-month-old brother also shows penis hypoplasia, as yet, however, without signs of palmoplantar keratoderma.