A. Tosca

Vitiligo as a Reaction to Topical Treatment with Diphencyprone

During the topical treatment of 45 patients, who had extensive forms of alopecia areata, with the allergen diphencyprone, 3 of them (6.7%) developed vitiligo. Two were females and 1 male aged 53, 19 and 28 years respectively. None of these patients had a personal or family history of vitiligo. Vitiligo appeared 3-5 months after the onset of treatment and was localized only to the areas of topical application in the younger woman and the man. In the older woman, vitiligo extended to several areas apart from those where the medicament was applied. After the end of diphencyprone treatment, vitiligo had a spontaneous significant improvement only in the man. Mitochondrial autoantibodies were found in the older woman only. To our knowledge, vitiligo due to diphencyprone has not been previously reported.

Malignant Syphilis in HIV-Infected Patients

ABSTRACT: Two cases of atypical syphilis in HIV‐infected patients assuming characteristics of malignant syphilis are described with special emphasis on the peculiarities of histologic and immunohistochemical findings.

Environmental factors influencing the biologic behavior of patterns of pemphigus vulgaris: epidemiologic approach.

Background. Pemphigus vulgaris is an autoimmune disorder, in which environmental factors seem to play a role, both in the pathogenesis and the activity of the disease. The purpose of the study was to correlate the biologic activity of pemphigus vulgaris with sun exposure and air temperature.

Mycosis fungoides: Evaluation of immunohistochemical criteria for the early diagnosis of the disease and differentiation between stages

Lesional skin specimens from twenty-eight patients with mycosis fungoides were studied by evaluating immunohistochemical criteria, primarily with monoclonal antibodies. It was demonstrated that significant differences exist between the control and the premycotic-stage group in regard to the monoclonal antibodies BE1, BE2, and OKT9. The detection of specific antigenic determinants on the surface of cell populations early in the course of the disease seems to be of considerable value for the early diagnosis of the disease. Statistically significant differences were found between the premycotic stage and the plaque stage in regard to T lymphocytes, macrophages, OKT6+, OKT4+, OKT8+, and BE2+ cells in the dermal infiltrate. Significant differences were also shown between the plaque and tumorous groups, concerning macrophages, T cells, and OKT9+ cells in the dermis, as well as epidermal dendritic cells. Differences between stages may supplement histologic data for the follow-up of the disease with or without treatment.

A case of partial face-sparing lipodystrophy combining features of generalized lipodystrophy

cases of Down syndrome and milia-like calcinosis cutis associated with syringomas have been reported.3~ 4 The pathogenesis of idiopathic calcinosis cutis remains unclear. Some authors support the active role of the sweat duct in the formation of idiopathic subepidermal calcium deposits3y 6 It has also been proposed that idiopathic calcinosis cutis derives from the dystrophic calcification of preexistent cysts.7> * In our patient there was no evidence of an associated tumor, transepidermal calcium elimination, or calcium deposits in the sweat ducts. Our patient also had multiple connective tissue nevi. Although we found only one report of generalized nevus anelasticus in a patient with Down syndrome? elastosis perforans serpiginosa, another disorder of elastic tissue, occurs frequently in these patients. To our knowledge this is the first description of milia-like idiopathic calcinosis cutis and multiple nevns anelasticus in a patient with Down syndrome. Journal of the American Academy of Dermatology January 1995

Nuchal nevus flammeus as a skin marker of prognosis in alopecia areata.

In this work, the incidence of nuchal nevus flammeus was studied in 205 patients suffering from various forms of alopecia areata, as well as in a group of 555 volunteers without alopecia areata examined in our outpatient clinic. The incidence of nuchal nevus flammeus in the totalis-universalis form of alopecia areata was 58.2% (examined patients, n = 79), in ophiasis-extensive forms 22.8% (examined patients, n = 70) and in simple forms of alopecia areata 3.6% (examined patients, n = 56). In the group of 555 volunteers without alopecia areata the incidence of nuchal nevus flammeus was 4.5%. Our results show that nuchal nevus flammeus could be a valuable skin marker indicating a more severe course of alopecia areata.

Sweat gland disturbances in granuloma annulare and necrobiosis lipoidica.

We Studied sweat gland distribution, density and activity in thirteen cases of granuloma annulare and ten cases of necrobiosis lipoidica, using a combination of the plastic impression and starch‐iodine methods. The pattern of sweat gland disturbance in the two diseases was entirely different. In necrobiosis lipoidica an intense and uniform hypohidrosis was detected throughout the lesion, whereas in granuloma annulare the disturbance followed the morphology of the lesion (the papular border showed complete anhidrosis, whereas the flat central part of the lesion showed only moderate hypohidrosis or normal sweating). The method assigns numerical values to the ‘relative density’ and the ‘relative activity’ of the functioning sweat glands compared with normal skin, thus permitting statistical evaluation of the results.

Epidemiology of cutaneous leishmaniasis in Greece.

ABSTRACT: Cutaneous leishmaniasis is a disease endemic in Greece. Cases collected between the years 1975 and 1979 are analyzed from a clinco‐epidemiologic point of view. Prevalence is highest in the Ionian islands and Crete. The disease most commonly affects individuals 10 to 20 years of age. The exposed parts of the body are most commonly involved, particularly the face. The period of highest incidence is mid‐winter.

Anhidrotic Ectodermal Dysplasia

In 2 patients with anhidrotic ectodermal dysplasia, we were able to show that the hypoplastic eccrine glandular elements may give rise to normal eccrine glands both anatomically and functionally, afte

Delayed hypersensitivity and differences of histologic pattern in allergic cutaneous vasculitis.

Fourteen patients with allergic cutaneous vasculitis of either the polymorphonuclear (PMN)- or the mononuclear (MN)-predominant type were studied as regards the following parameters: the disease duration, histology, monoclonal antibody typing of the mononuclear cell infiltrate from recent lesions, and the delayed hypersensitivity (DH) response, assessed both by recall antigens (tuberculin type) and the dinitrochlorobenzene skin test. From the results, it was shown that in PMN-predominant vasculitis, DH reactions were well elicited, whereas in MN-predominant vasculitis, DH skin reactions were somehow impaired. In MN-predominant cases, many OKT3 +, OKT4+, OKT8+, and OKM1+ cells were usually seen to surround the skin vessels, whereas in PMN-predominant cases, rare OKT8+, OKT4+, or OKM1+ cells were seen in the dermis. The epidermal dendritic cell system, as revealed by the Na 134 monoclonal antibody, was unaffected in both types of allergic cutaneous vasculitis.