A. Varelzidis

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.

SERUM IMMUNOGLOBULINS IN PSORIASIS BEFORE AND AFTER ULTRA VIOLET LIGHT THERAPY

SUMMARY.— A significant increase of the mean IgA globulin value was noted in 105 patients with ordinary psoriasis whereas the mean IgG and IgM globulin levels remained normal. Thirty‐two of these patients received u.v. light therapy which resulted in resolution of the skin lesions. At this stage the IgA levels fell to the normal range. The possibility of the skin eruption influencing the IgA serum levels is discussed.

Coexistence of Pemphigus vulgaris, Malignant Melanoma and Low-Grade Lymphoma

A 53-year-old female patient with pemphigus vulgaris under continuous immunosuppressive therapy for about 2 years presented a superficial spreading malignant melanoma on a pre-existing melanocytic naevus. After surgical removal of the inguinal lymph node group, a diffuse low-grade polymorphous immunocytoma was proved both histologically and immunocytochemically. The possible induction mechanisms are discussed.

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.

Topical Treatment of Condylomata acuminata with Solcoderm

Of 85 patients with condylomata acuminata treated topically with Solcoderm, the lesions were apparently eradicated in all but 11 (12.9%), and recurrences were noted in 6 during a 3-month follow-up. Only 1 treatment was required in 55 (64.7%) of the treated subjects.

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.

Some Further Features for Differential Diagnosis between Squamous Cell Carcinomas and Basal Cell Epitheliomas

Two further methods for the characterization of epidermal skin tumors are described: the antinuclear antibody (ANA) immunofluorescent test, which consists of indirect immunofluorescence with known high titer sera containing homogenous ANAs on epidermal skin tumors, and the ammoniacal-silver cytochemical method, which specifically stains nuclear histones. Squamous cell carcinomas (SCCs), basal cell epitheliomas (BCEs) as well as control specimens from normal skin and benign epidermal hyperplasias were studied. The ANA immunofluorescent test was positive for most SCCs, mixed SCC and basal cell carcinomas and metatypical BCEs. The ammoniacal-silver method gave a characteristic staining pattern shared among SCCs, mixed carcinomas and metatypical BCEs. BCEs, besides metatypical ones, were always negative by the ANA immunofluorescent test and the same applied for the control specimens. The ammoniacal-silver method gave a characteristic staining pattern for BCEs and control sections quite different from the staining pattern of the more aggressive forms of epidermal tumors. The two methods usually yielded parallel results.

Sweat gland function in dermatophytosis.

SummaryIn 54 cases of dermatophytosis, sweat gland disturbances and their possible mechanisms were studied. The basic perspiratory malfunction was intense hypohidrosis, with some hyperhidrotic phenomena being observed at particular points of the exanthem (margin and disc) in a few cases. It is worth noting that in 51.85% of the cases, hypohidrotic phenomena were also observed in areas of normal skin adjacent to the lesions. One of the most important forms of perspiratory disturbances was the closure of sweat ducts at the keratin level. The inflammatory process in the dermis may also affect gland function. Finally, there is a discussion of the significance of perspiratory disturbances in relation to special aspects of the disease.