Anne H. Kettler

INFLUENCE OF DIETARY MENHADEN OIL UPON CARCINOGENESIS AND VARIOUS CUTANEOUS REspONSES TO ULTRAVIOLET RADIATION

Abstract Recent reports suggest that eicosapentaenoic acid (EPA) inhibits growth of transplanted tumors and the formation of various chemically induced cancers in animals. Menhaden oil is a source of polyunsaturated lipid with a high content of EPA, an omega‐3 fatty acid. We sought to explore the effects of menhaden oil on photocarcinogenesis by employing the hairless mouse/UV‐carcinogenesis model. Five groups of 40 SKH‐Hr‐1 mice received (a) a semipurined equicaloric diet containing either 0.75% corn oil, 4% corn oil. 4% menhaden oil or 12% menhaden oil and (b) an escalating regimen of UV radiation to a cumulative dose of 70 J/cm2. Additional animals were employed to further examine the role of menhaden oil in acute cutaneous responses to UV, i.e., erythema, edema, and ornithine decarboxylase (ODC) induction. After a 2‐week feeding period UV‐induced ODC activity in mice receiving 12 or 20% menhaden oil was 3 to 13‐fold lower than that of corn oil fed animals. Further studies showed that edema was also markedly decreased. Animals receiving menhaden oil required twice the level of irradiance to evoke a comparable erythema as that which occurred in corn oil fed animals.

Neutrophilic eccrine hidradenitis: Evidence implicating bleomycin as a causative agent

A 13‐year‐old girl receiving multiple agent chemotherapy for osteosarcoma was found to have neutrophilic eccrine hidradenitis (NEH). This dermatosis is marked histopathologically by necrosis of the eccrine structures with a neutrophilic infiltrate. Clinically, the presentation is variable and the differential diagnosis is extensive. Our patients clinical picture was unique in that she had hyperpigmented plaques instead of purpuric nodules or erythematous plaques as described previously. Currently, NEH is felt to be a complication of chemotherapy. The most likely causative agent in our patient was bleomycin. Physicians should be aware of this entity and its variable clinical presentation.

The effect of dietary fish oil supplementation on psoriasis: Improvement in a patient with pustular psoriasis

An open study testing the effects of fish oil supplementation on psoriasis in 26 patients is described. None of the patients with plaque-type psoriasis vulgaris showed clinically significant improvement; however, a patient with generalized pustular psoriasis showed marked improvement with the fish oil supplementation. In this patient, scale leukotriene B4 levels were determined and shown to be significantly decreased after completion of the study, but the leukotriene B4 levels did not correlate with her clinical course. The results of our study are contrasted with those of a recent study that did show beneficial effects of fish oil supplementation on plaque-type psoriasis.

Pagetoid dyskeratosis: A selective keratinocytic response

Pale cells that resemble those of Pagets disease have been found within apparently normal epidermis in a variety of benign papules. Although they have been considered an artifact, they show characteristic premature keratinization. In contrast to other dyskeratotic processes they mature into orthokeratotic squamae. The histopathologic, ultrastructural and immunocytochemical features of these cells are illustrated, and the differential diagnosis is reviewed.

Cutaneous waldenström's macroglobulinemia. A report of a case successfully treated with radiotherapy

Waldenströms macroglobulinemia is a lymphoproliferative disorder that only rarely exhibits specific cutaneous findings. The authors present a case of Waldenströms macroglobulinemia in which the patient developed cutaneous lesions while his systemic disease seemed to be under control with chlorambucil therapy. A review of the scant literature regarding the response of cutaneous Waldenströms to treatment suggests that the skin lesions do not respond well to systemic therapy. This case was successfully treated with radiotherapy.

Radiation‐Induced Erythema Multiforme An Unusual Presentation with Elastic Tissue Phagocytosis

A 51-year-old white man, presented with a two-day history of an eruption on his chest, back, hands, and forearms. He was receiving radiation therapy for biopsy-proven large cell carcinoma of the lung. The tumor was found to be diffusely metastatic by bone scan. Two weeks after completing his last series of radiation treatments, an eruption started on the dorsal aspect of both hands, then spread to his palms, forearms, chest and upper back. The lesions were slightly painful but there was no associated pruritus, fever, myalgias, or arthralgias

Acute acral pustulosis

We report a patient with a pustular eruption in an acral distibution that developed abruptly 4 days after a streptococcal pharyngitis. The histology showed an intraepidermal vesicle filled with neutrophils with an underlying lymphocytic vasculitis. Direct immunofluorescence demonstrated heavy deposition of C3 within the vessel walls. In addition, circulating immune complexes were found.