Alvin J. Cox

Pigmented lesions in newborn infants

1058 newborn infants were examined. Forty‐one (39%) had clinically discernible pigmented lesions compatible with melanocy tic naevi. Biopsy was performed on thirty‐four of the forty‐one and of these; eleven, representing 1.01% of the infants, proved to be melanocytic naevi. No giant (garment) naevi were seen in this series. Two of the eleven naevi pathologically examined showed histological changes similar to those that have been reported in some giant naevi, but the remaining nine were not only different from criteria usually assigned to giant naevi, but they also differed from the usual adult naevi, in that most were predominantly junctional. None of the melanocytic naevi in this series showed any suggestion of malignant change. In newborn infants it is often impossible clinically to distinguish naevi from other types of pigmented lesions, as only eleven out of the thirty‐four pigmen‐ted lesions were melanocytic naevi. Seven of the eleven melanocytic naevi were under 1.5 cm in diameter. No pigmented lesions were found on the palms, soles or genitalia.

Experimental Hyperplasia of the Stomach Mucosa

Summary and Conclusion An increase in number of parietal cells occurs in the mucosa of the guinea pig stomach after protracted stimulation with histamine over a period of 2 to 4 weeks. This is presumably a hyperplasia and may indicate a mechanism to explain differences in the number of secreting cells in different human stomachs.

The occurrence of vitiligo after psoralens and ultraviolet A therapy

The ability of photochemotherapy with 8-methoxypsoralen in conjunction with high-intensity long-wave ultraviolet light (PUVA) to stimulate melanogenesis is well known. This effect on the pigmentary system is evidenced by the diffuse tanning of clinically normal skin in PUVA-treated patients with psoriasis and other disorders, as well as by the repigmentation of lesions in vitiligo. It is now recognized that there may be additional pigmentary effects, resulting in clinical lesions such as PUVA mottling, PUVA lentigines, and localized hypopigmentation. We have documented the occurrence of yet another association with PUVA therapy--the paradoxical appearance of widespread hypopigmentation consistent with vitiligo in three PUVA-treated patients, one with psoriasis and two with mycosis fungoides. Histologic and ultrastructural findings are presented.

Epidermal dystrophy and actinic keratoses in psoriasis patients following oral psoralen photochemotherapy (PUVA): Follow-up study

Focal dystrophy of epidermal cells, which was initially reported in 19 of 37 patients with psoriasis who had been treated with psoralen and ultraviolet A (PUVA), has now been observed in more than half of 70 patients 1 year or more following onset of PUVA therapy. These dystrophic changes, which are similar to those found in actinic keratoses, were present in clinically uninvolved skin of sunlight-protected and sunlight-exposed areas. Control biopsies obtained prior to PUVA therapy of non-sun-exposed skin in 62 patients and sun-exposed skin of 22 of these revealed no such changes. The presence of epidermal dystrophic changes in 9 patients who had a several-month interruption in PUVA therapy indicates that these changes cannot all be attributed to acute effects of PUVA. In 104 PUVA-treated patients returning for dermatologic follow-up after the first year of therapy, 17 (16.3%) developed actinic keratoses during the course of, or following the cessation of, treatment with PUVA. Careful examination of these patients prior to PUVA therapy had revealed no such lesions. In the majority of patients, keratoses were multiple; they occurred in sun-exposed areas, suggesting a possible acceleration or promotion by PUVA of actinically induced lesions.

Therapy of mycosis fungoides with topically applied fluocinolone acetonide under occlusive dressing

The effects of topical fluocinolone therapy on the lesions of mycosis fungoides were evaluated in 6 patients. Concentrations of fluocinolone 0.01 to 0.2% beneath occlusive plastic film were used. Pre‐ and post‐treatment histological studies were carried out. Treatment was effective in modifying lesions both clinically and microscopically. The degree of improvement appeared proportionately related to the concentration used. No serious side effects were observed. Improvement was noted for as long as 9 months when therapy was continued.

Studies in aortic autografts and homografts; do homografts survive?

An abundance of evidence has accumulated which indicates that homografts of all types of tissue eventually are destroyed or replaced by the host. Thus, kidneys or glands when transplanted function only a short time. Although the fate of bone homografts is not entirely certain, it would seem likely that they are replaced by the tissue of the host. The greatest success has been obtained with corneal transplants, but here, too, clouding may occur after a few weeks (10). It would seem strange, indeed, if one could transplant arterial homografts with

The mitotic index in psoriatic plaques and their response to PUVA therapy

The mitotic index of pretreatment plaques of chronic psoriasis was determined before treatment with PUVA. There was a wide variation in mitotic indices in different patients.

Site of vitamin A storage in the liver.

Summary In 3 cases of healed massive necrosis of the liver Vitamin A was more abundant in the parts of the liver from which hepatic cells had disappeared than in those where these cells had not been destroyed. Presumably it was stored in the Kupffer cells, which had been spared by the agent which produced the necrosis.

Chronic Toxicity Studies on Conidendrins and Conidendrols

Summary 1. Weanling rats were fed diets containing one of the following antioxidants: α-conidendrin, β-conidendrin, α-conidendrol, and β-conidendrol. The concentrations were, for the females, 0.125 and 1.0% of the diet; and for the males, 0.5 and 1.0% Body weight increase was normal, or approximately normal, during the first 220 days of the experiment, after which frequent weighings were discontinued. 2. Histological examination of the tissues after 420 days on the diets indicated essentially normal tissues, except for the following: In males receiving the higher concentration of β-conidendrol there was vacuolation (presumably fat) of the liver cells, without indication of severe injury. In several of the males receiving the higher concentration of the conidendrols, there were renal changes suggesting mild, old pyelonephritis. In males, several of the rats receiving the conidendrols had focal abnormalities in the pancreas. 3. There was no evidence of irritation to the skin or to the eye of rabbits, and skin sensitization was not developed in guinea pigs. It is concluded that there is at least a 100-fold margin of safety between the amount of conidendrol suggested for fat antioxidant and the amount ingested by rats eating the 1.0% level.

Action of Thallium in Experimental Animals.

Conclusion White rats given large or small quantities of thallium over periods up to 9 weeks in length showed no abnormality of the estrual cycle or of the reproductive organs. The basal metabolic rate of guinea pigs did not change during administration of small or large doses of thallium, except for a rapid decrease shortly preceding deatn. These findings fail to support previous claims that thallium intoxication is characterized by alteration of endocrine function.