Lipomembranous changes in chronic panniculitis.

The clinical and histopathologic findings in 13 patients with lipomembranous changes in the subcutaneous adipose tissue as part of the inflammatory reaction are presented. Nine patients had clinical evidence of vascular disease and four had clinical evidence of connective tissue disease. Histopathologic evidence of endarteritis obliterans, venous stasis, and hemorrhage was present in more than half the patients, and the clinical lesion of liposclerosis was frequently present.

Chronic dermatitis evolving to mycosis fungoides: report of four cases and review of the literature.

In four patients with long-standing chronic dermatitis, evolution into cutaneous T-cell lymphoma was observed. Two patients were men and two were women; they were aged forty-nine to sixty-five years at first presentation. Duration of dermatitis at admission was from two months to fifteen years, with the clinical and histologic diagnosis documented on initial examination.

A new histopathologic feature of necrobiosis lipoidica diabeticorum: lymphoid nodules.

We have found a previously undescribed histopathologic feature of necrobiosis lipoidica diabeticorum among 310 biopsied cases: lymphoid nodules. This feature does not correlate with unique clinical lesions or forms of the disease. The lymphoid nodules are similar in appearance to those in other chronic dermal inflammations.

Diffuse dermal neutrophilia in urticaria.

Twenty-three cases of diffuse dermal neutrophilia and urticaria were reviewed. Evidence of vasculitis or other disease was not present. Direct immunofluorescence was done in 19 cases and was positive but nonspecific in 14.

Superficial granulomatous pyoderma: a localized vegetative form of pyoderma gangrenosum.

Twenty-five patients had superficial ulcerative and vegetative pyoderma with granulomatous histologic findings. Healing occurred without systemic corticosteroid therapy in all but three patients. All patients had clinical pyoderma gangrenosum.

Necrobiosis lipoidica diabeticorum with cholesterol clefts in the differential diagnosis of necrobiotic xanthogranuloma.

The histopathologic findings in 331 cases of necrobiosis lipoidica diabeticorum seen during a 50-year period were reviewed. Three cases showing cholesterol cleft formation were found. All 3 cases were associated with severe diabetes mellitus.

A histological study of the evolution of solar urticaria.

The histological evolution of solar simulator-induced lesions of solar urticaria was investigated in four severely affected white patients. A series of two to 32 minimal whealing doses of radiation, each much lower than the 24-hour minimal erythema dose, was administered to separate buttock sites. Biopsy specimens were obtained from the exposed areas at five minutes and two and 24 hours later, as well as from adjacent nonexposed skin.

Cholinergic urticaria, passive transfer experiments from human to monkey.

Passive transfer experiments in cholinergic urticaria were carried out from 16 patients to a Macaca cymnologous monkey. Intravenous Evans blue dye was used to demonstrate vascular permeability. The animal was challenged after 24 h first by heating the serum-injected dorsal skin to 45 degrees C and secondly by superinjection of acetylcholine into serum-injected sites, and a control site.

Lung cancer and scleroderma.

Among 14 patients with carcinoma of the lung and scleroderma, 9 had no history of smoking. The 14 cases of primary lung carcinoma occurred in a population of 3550 patients with a diagnosis of scleroderma. Scleroderma preceded the diagnosis of lung cancer by at least 6 years in 8 cases.

Paraffin section light-chain immunostaining of large-cell lymphocytoma.

Sixteen biopsy specimens from 11 patients with cutaneous large-cell lymphocytoma were studied by a peroxidase method using monospecific antisera to kappa and lambda Ig light chains. Five specimens had polyclonal presence of both kappa and lambda chains. Four specimens were graded as devoid of immunoreactivity, and eight were graded as non-specific because the albumin control staining was as intense as or more intense than the immunoglobulin light chains.

Neutrophilic urticaria.

Eight patients with neutrophilic urticaria were identified in a 5-year biopsy experience (1980-1984). All patients had a neutrophilic venulitis without fibrinoid necrosis, hemorrhage, or leukocytoclasia. Four patients had a history of angioedema, and two had a personal history of atopic disease.

Alpha 1-antitrypsin deficiency panniculitis: a histopathologic and immunopathologic study of four cases.

Four cases of alpha 1-antitrypsin deficiency associated with panniculitis were reviewed. The following histopathologic characteristics were typically present: (a) large areas of normal panniculus adjacent to severe necrotic panniculitis; (b) acute panniculitis--masses of neutrophils causing necrosis and replacing fat lobules; (c) chronic inflammation and hemorrhage at the periphery of acute panniculitis; (d) focal collection and proliferation of histiocytic cells and lipophages; (e) secondary leukocytoclastic vasculitis in areas of necrosis and lymphocytic vasculitis in areas of severe inflammation, but no evidence of primary vasculitis; (f) phlebothrombosis; and (g) in partial (heterozygous) deficiency, pronounced lipophages and giant-cell replacement of fat cells. Endarteritis obliterans was noted.

Cutaneous manifestations of Takayasu's arteritis. A clinicopathologic correlation.

Takayasu's arteritis is a chronic, granulomatous, large-vessel arteriopathy of unknown cause. We retrospectively reviewed the medical records of 38 patients with Takayasu's arteritis and identified 21 with cutaneous findings. Seven patients had lesions that were related to their systemic vasculitis.

[Effect of L-tryptophan on fasting intestinal motility and intestinal transit time in the human].

Since previous experiments in dogs suggested L-tryptophan to disturb the migrating motor complex (MMC) we set out to study its effects in man. In six healthy volunteers intraduodenal instillation of 50 mmol L-tryptophan did not disrupt the interdigestive motility pattern. In comparison to saline L-tryptophan caused a brief and local increase of motor activity in the upper small bowel.

Localized scleroderma (morphea) and antibody to Borrelia burgdorferi.

Enzyme-linked immunosorbent assay (ELISA) and immunofluorescence assay (IFA) were performed in 25 and 32 cases of morphea, respectively. The more sensitive and specific ELISA was positive in only 1 of 25 cases and the mean value was lower in cases of morphea than in controls. IFA showed minimally reactive titers in 6 (19%) of 32 cases.

Symptomatic dermographism (factitious urticaria)--passive transfer experiments from human to monkey.

Passive transfer experiments were carried out on three species of monkey, Macaca mulatta, Macaca nemestrina and Macaca fascicularis, using human serum from patients affected with severe symptomatic dermographism (factitious urticaria), cholinergic urticaria, chronic idiopathic urticaria and normal subjects. The monkeys were tested for dermographism by means of a calibrated dermographometer 24 h after intradermal injection of the serum, using Evans blue as a marker. Positive responses were seen initially in the M.

Cholinergic urticaria. A clinical and histologic study.

We studied the natural history, the prevalence of atopy, and the frequency of systemic symptoms during attacks in 35 patients with cholinergic urticaria, the histologic condition of the eruption in seven patients (20%), and the response to intradermal injections of acetylcholine, histamine, and methacholine in 18 patients (51%). In most patients symptoms began between the ages of 10 and 30 years, persisted for many years, and caused them to modify their activities to avoid the provoking factors of exercise, emotion, and heat. The condition usually improved with time, and five patients (14%) had a spontaneous remission.

Mortality of workers compensated for silicosis during the period 1959-1963 in the Veneto region of Italy.

After reports appeared from other countries indicating an excess risk of lung cancer among silicotics, a cohort of workers compensated for silicosis during the period 1959-1963 in the Veneto region of Italy was constructed and followed for mortality through 1984. The results of the study showed a large mortality excess for infectious diseases (180 observed versus 9.5 expected), due to silicotuberculosis, and for diseases of the respiratory system (270 observed versus 33.

Histopathology of necrobiotic xanthogranuloma with paraproteinemia.

Fifty-three cutaneous biopsies from 22 patients with necrobiotic xanthogranuloma (NXG) were reviewed. One or more biopsies from each patient displayed a typical pattern of palisading histiocytic xanthogranuloma with bands of hyaline necrobiosis. Multiple foam cells and Touton giant cells were present, and atypical, bizarre-appearing foreign body giant cells were characteristic.

Familial granuloma annulare. Report of two cases and review of the literature.

We report two sisters with granuloma annulare who possessed identical histocompatibility antigens. The occurrence of granuloma annulare in families and the demonstration of particular human lymphocyte antigens (HLA) with granuloma annulare may indicate that hereditarily predisposed individuals could develop this specific cell-mediated immune reaction in response to an unknown antigen (e.g.

Sensitivity to wild vegetation.

74 patients suspected of having allergic contact dermatitis to wild vegetation were patch tested with either extracts of 13 plants of the family Compositae and 7 other weeds or trees. Anthemis cotula (dog fennel) and Xanthium strumarium (cocklebur) gave the most frequent positive results, demonstrating a change of frequency in sensitivity compared to the 1950s, when Ambrosia artemisiifolia (ragweed) was recognized as the most frequently sensitizing weed. The reasons for these changes of incidence and clinical patterns are examined.

The cellular inflammatory response in nicotinate skin reactions.

Sequential skin biopsies of nicotinate-treated skin from nine normal subjects, three aspirin-pretreated normal subjects and six atopic eczema patients were examined. An erythematous skin reaction was seen in the nine normal subjects and to a lesser degree in one atopic eczema patient, but not in the aspirin-pretreated subjects nor in five remaining atopics. Accumulation of a mononuclear cell perivascular infiltrate was seen from 15 min onwards in the normal subjects.

Extracellular deposition of eosinophil granule major basic protein in pressure urticaria.

Utilizing affinity chromatography-purified antibody to the eosinophil granule major basic protein and formalin-fixed paraffin embedded tissue, we investigated the localization of major basic protein by immunofluorescence in twenty-four skin biopsy specimens from ten patients with pressure urticaria. Fourteen of twenty-four biopsy specimens were obtained from spontaneously occurring urticarial lesions of 4 to 48 hours' duration, and ten of the twenty-four specimens were from dermographometer-induced lesions that had been present from 40 minutes to 24 hours. Twenty-one of twenty-four biopsy specimens showed extracellular fluorescence of eosinophil granule major basic protein within the dermis.

Familial anetoderma.

Two families with anetoderma are described. Unlike previous reports of familial anetoderma, the disease process seemed to be limited to the skin, and there were no associated ocular, gastrointestinal, or orthopedic anomalies in the affected patients or in any other family members. Although infrequently reported, anetoderma may occur in families, and patients must be examined for associated systemic abnormalities for a thorough assessment of their skin disorder.