C.M. Ridley

Lichen sclerosus et atrophicus and autoimmunity—a study of 350 women

A study of autoimmune related phenomena in 350 women with histologically confirmed lichen sclerosus et atrophicus revealed that 21.5% had one or more autoimmune related diseases, 21% had one or more first degree relatives with an autoimmune‐related disease, 42% had an autoantibody at a titre > 1:20, and 59.5% had one or more of these autoimmune‐relateda phenomena. No statistically significant differences in the natural history of lichen sclerosus et atrophicus were demonstrated between those patients with autoimmune‐related phenomena and those without.

Generalized hair follicle hamartoma associated with alopecia and myasthenia gravis: report of a second case.

In 1969 an apparently unique patient with myasihenia gravis alopecia and an associated widespread hair follicle hamartoma was reported by Brown, Crounse & Winkelmann (1969). We describe here a case which shows striking clinical and pathological similarities 10 that original patient.

Chronic erosive vulval disease

The clinical features and differential diagnosis of chronic erosive vulval disease are described. Many cases are examples of erosive lichen planus but a similar picture is sometimes associated with cicatricial pemphigoid, lichen sclerosus et atrophicus, vulval intra‐epithelial neoplasia, and vestibulitis, while a few examples still defy categorization.

Clinical features and therapy of Lichen Sclerosus et Atrophicus affecting males

The clinical features and response to therapy of histologically confirmed lichen sclerosus et atrophicus affecting 25 males are reported. The disease affected the penis alone in 22 patients and the trunk alone in the remaining 3 patients. Of those with penile lesions, the majority had involvement of both the glans penis and the prepuce. Circumcision proved to be an effective therapy in 8 out of the 11 patients in whom it was performed.

The immunopathology of hypopigmented mycosis fungoides

Two dark‐skinned patients presented with well‐defined hypopigmented macules, a biopsy of which showed the characteristic features of mycosis fungoides. Immunohistochemical studies with UCHT1 antiserum (a pan T cell marker) confirmed the almost complete T lymphocyte nature of the infiltrate. UCHT4 antiserum (a suppressor/cytotoxic marker) showed that the epidermal infiltrate consisted predominantly of T suppressor/cytotoxic cells and Leu3a antiserum (a T helper cell marker) showed that the dermal infiltrate was composed of helper and suppressor/cytotoxic cells in approximately equal proportions. Ultrastructural studies identified normal melanocytes in the basal layer of the epidermis from both patients but mitochondrial vacuolation was seen occasionally in Case 2. We believe that this is the first report which documents T cell subsets in skin biopsies from patients with hypopigmented mycosis fungoides. The finding of a predominance of suppressor/cytotoxic T lymphocytes in the epidermal infiltrate of these two patients contrasts with the usual predominance of T helper lymphocytes in the more common forms of mycosis fungoides.

Lichen sclerosus et atrophicus and autoimmunity in 250 women

Whilst the aetiology and pathogenesis of lichen sclerosus et atrophicus (LSA) remain unknown, it has been established that patients with LSA have an increased incidence of autoantibodies (Goolamali et al., 1974) and autoimmune related disorders (Harrington & Dunsmore, 1981; Meyrick Thomas, Ridley & Black, 1983, 1984).