A. Kint

Repeated cultured epidermal allografts in the treatment of chronic leg ulcers of various origins.

Twelve patients with 16 leg ulcers, existing for at least 3 months and not responsive to conventional inpatient therapy of at least 3 weeks, were treated with repeated applications of cultured allogenic keratinocyte sheets. A marked decrease in size was seen in all ulcers but 2. Complete closure of the ulcer was seen in 62% of the ulcers within 8 weeks. Healing was due to enhanced granulation and increased epithelialization, starting from the periphery of the wound. This edge effect suggests that the epidermal allografts act by stimulation of migration and/or multiplication of the acceptors keratinocytes, rather than by take of the allograft.

Alopecia areata: A Clinical Study

100 cases of alopecia areata are examined and the possible relationship with the presumed etiological factors (atopy, autoimmunity and psychosomatics) are looked for. When atopy or autoantibodies are present alopecia areata always runs a serve course. It is, however, impossible to establish a definite etiological relation between atopy or autoimmunity and alopecia areata.

The onychomatricoma: An electron microscopic study.

The electron microscopic findings in the onychomatricoma are described. In the proximal zone of the onychomatricoma, basal cells have various aspects, some being lacunar while others have only a limited cytoplasmic rim containing mitochondria and tonofilaments. In the parakeratotic cell columns the cells elongate and homogenized tonofilaments appear. Around the lacunae the cells are poorly differentiated and their cytoplasm is granular. It can be concluded that in an onychomatricoma the basal cells have a decreased amount of tonofilaments and desmosomes and that their evolution is not uniform. The tumour can be considered as being the result of a disturbed differentiation of nail matrix cells.

Acitretin as cancer chemoprophylaxis in a renal transplant recipient

The use of acitretin in a renal transplant recipient who had been treated for several premalignant and malignant skin lesions is the subject of this case report. During the treatment period no new dysplastic lesions developed.

Pharmacokinetics and drug interactions of etretinate and acitretin

Acitretin, the metabolite of etretinate, is eliminated far more rapidly from the human body than is etretinate. It had therefore been suggested that only a short period of contraception would be required after the cessation of long-term therapy with acitretin. However, recent studies have demonstrated the presence of etretinate in the plasma of patients who were treated with acitretin. In this article we provide results from a study in our center and discuss earlier data in light of the recently discovered metabolic pathways for acitretin. Reesterification of acitretin to etretinate, however, results in a loss of the metabolic advantages of acitretin. Because of this situation the recommended contraception period after acitretin therapy has been lengthened to 2 years.

Lichen sclerosus et atrophicus: an electron microscopic study.

The ultrastructural changes in seven cases of lichen selerosus et atrophicus are described. An interesting epidermal alteration was the presence of collagen fibrils in the intercellular space; furthermore, the basal cells were altered by condensation and homogenization of the tonofibrils. The basement membrane was not uniform and often multilayered. The anchoring fibrils were numerous. In the cutis intertwining strands of fine filaments, bundles of immature collagen and normal collagen could be found. In lichen sclerosus et atrophicus the dermo‐epidermal interrelationship is disturbed.

High-performance liquid chromatographic determination of etretinate and ALL-trans- and 13-cis-acitretin in human plasma

A high-performance liquid chromatographic procedure is described for the simultaneous determination of etretinate (Tigason), all-trans-acitretin (Neotigason) and 13-cis-acitretin in human plasma. The compounds are extracted from the plasma with n-hexane under acidic conditions. Quantification is performed on a normal-phase column (CP-Spher Si, 5 microns), followed by UV detection at 350 nm. The limit of quantification is 3 ng/ml. The day-to-day precision was 6.7, 13.6 and 9.1% for etretinate (means = 53 ng/ml), all-trans-acitretin (means = 95 ng/ml) and 13-cis-acitretin (means = 149 ng/ml), respectively (n = 13 for each compound). The within-day precision of nine determinations was 3.2, 11.7 and 6.5%, respectively, with mean concentrations of 128.53 and 261 ng/ml, respectively. The method was also applied to the study of the long-term pharmacokinetic behaviour of etretinate in psoriatic patients previously treated with etretinate but now on therapy with all-trans-acitretin.

Dermatitis plantaris sicca

In 22 children with dermatitis plantaris sicca no or insufficient arguments were found to relate the condition to atopy, contact allergy or mycologic infection. Successful therapeutic results with ure

Reticular telangiectatic erythema after implantation of a pacemaker.

A case of a telangiectatic erythema appearing after implantation of a pacemaker is described. The eruption cleared completely after removal of the battery.

Mycosis fungoides and lymphoplasmacytoid immunocytoma in the same patient

The simultaneous occurrence of two different lymphomas in a 57‐year‐old white woman is reported: mycosis fungoides and a leukemic lymphoplasmacytoid immunocytoma. The first was confirmed by histologic study and electron microscopy, and the latter by histologic study and immunoperoxidase staining. The lymphoid cells in the involved bone marrow and peripheral blood expressed the same surface immunoglobulin as was found in the cytoplasm of the immunocytoma cells, i.e., IgM‐λ. The clonal B‐cell expansion was brought into a lasting remission by chlorambucil, but the cutaneous lymphoma proved to be refractory to therapy. The patient died 38 months after diagnosis.