Chizuko Sarashi

URTICARIAL VASCULITIS WITH BLISTER FORMATION: BULLOUS (VESICULAR) URTICARIAL VASCULITIS

A 37‐year‐old woman developed blistering on urticarial erythematous lesions. She had multiple joint pain, subfever, alopecia, high antinuclear factor, and hypocomplementemia. She was diagnosed as having SLE. Her SLE symptoms responded well to steroid therapy, whereas her urticarial lesions responded to DDS but not to steroid. Histology of her skin lesions resembled that of dermatitis herpetiformis. We suggested the term “bullous (Vesicular) urticarial vasculitis” to distinguish such a case with peculiar manifestations in urticarial vasculitis.

Malignant Hemangioendothelioma in Discoid Lupus Erythematosus

A 51‐year‐old gardener developed malignant hemangioendothelioma in a lesion of discoid lupus erythematosus (DLE) after repeated occurrence of squamous cell carcinoma and keratoacanthoma. The hemangioendothelioma arose in the same DLE lesion where squamous cell carcinoma had appeared. It was treated with surgical exision followed by intraveneous dimethyltriazenoimidazole carboxamide (DTIC). He has not shown any signs of recurrence for a follow‐up period of 45 months. This is the first report, to our knowledge, of the occurrence of malignant hemangioendothelioma in a DLE lesion.

PLASMA VISCOSITY CHANGES IN CUTANEOUS VASCULITIS

Blood and plasma viscosity in patients with vascular disease was measured using a rotational cone‐plate viscometer. Increased blood viscosity at moderate (76.8 sec–1) and high (384.0 sec–1) shear rates was found in patients with Bürgers disease. Reduced blood viscosity was noted in patients with livedo vasculitis.

EXPERIMENTAL CUTANEOUS VASCULITIS IN HAMSTER CHEEK POUCH CHAMBERS

Induction of cutaneous vasculitis has been attempted in hamster cheek pouch chambers. Only slugging of blood flow and narrowing of blood vessels were noted in the chambers by injecting a mixture of antigen and antibody at an antibody excess ratio. Hemorrhagic reaction was observed at venules connecting newly growing capillaries to epidermal grafts. Massive infiltration of polymorphonuclear leukocytes was noted at hemorrhagic sites where deposition of the antibody on the blood vessel wall was found. As hemorrhagic response was observed in half of the hamsters injected with the mixture and in those preimmunized and then injected with antigens, our system will provide an aid in analyzing human cutaneous vasculitis.