Elizabeth S. Gray

Smooth muscle antibodies and alopecia areata

In seventy‐eight patients with alopecia areata, the incidence of auto‐antibodies to smooth muscle was greater than that in an age and sex matched control population.

Pseudorheumatoid Nodule (Deep Granuloma Annulare) of Childhood: Clinicopathologic Features of Twenty Patients

Abstract: Pseudorheumatold nodule of childhood is seen uncommonly by pathologists and is thought to be a variant of granuloma annoIan. We report a series Of 20 patients (13 M, 7F)age1 to 17 years. Fourteen lesions arose on the front of the tower limb, and 14 children had numerous lesions at diagnosis. Seven developed some form of recurrence, except for one case occurring at the site of the original lesion. Only one patient had a weakly positive rheumatoid factor, and was the patient with remote recurrence. As a significant number of lesions arose around the foot when the child was beginning to walk or starting to wear shoes, It la suggested that trauma plays a role in the development of some of these lesions.

Subepidermal Calcified Nodule in Children: a Clinicopathologic Study of 21 Cases

Abstract: Twenty‐one cases of subepidermal calcific nodule are presented. These lesions occur twice as commonly in males compared to females, with the head (particularly the ear), and neck as favored locations. No case was identified correctly clinically and only 1 case had a history of trauma, which appeared unrelated to the lesion. Histologically, there was a variety of appearances, with two‐thirds of specimens exhibiting a warty architecture. Younger lesions were composed of large, amorphous, calcific dermal deposits and were frequently associated with epidermal ulceration. The older lesions were not ulcerated and the calcium deposits were in small spherules. There was no evidence of pilomatrixoma or pre‐existing nevus. It is hypothesized that subepidermal calcified nodule represents dystrophic calcification secondary to dermal injury‐several in our series showed the architectural changes of verruca vulgaris.

Effects of Cyclosporin A on Fetal Development in the Rat

The fetotoxicity of cyclosporin A (CsA) was examined in multiparous Sprague-Dawley rats given the drug (25 mg/kg/day) during different phases of gestation, the effects on the outcome of pregnancy being ascertained on day 19. CsA given from days 1 to 7 caused a small but significant reduction in litter size, with no significant increase in the number of resorptions. When the drug was administered from day 8 to 14 there was no significant change in litter size, but a very striking increase in the incidence of resorptions. This fetotoxic effect was also evident but less marked when the drug was withheld until day 15. Reduction in fetal weight was only present in the group given CsA from days 8 to 14. In surviving fetuses the presence of focal decidual necrosis was more frequent in mothers receiving CsA, suggesting a possible mechanism whereby CsA may mediate its fetotoxic effects.

Histopathological Features of Acral Melanocytic Nevi in Children: Study of 21 Cases

ABSTRACT Benign melanocytic lesions in children may give cause for some concern histologically. This is because they represent a specific entity, or they reflect the state of evolution of the lesion or the anatomical location. This latter phenomenon has been poorly documented in children. In this study, we address the problem of atypical features frequently seen in benign nevi from acral sites in a group of patients aged 18 years or less. Twenty-one cases (12 female, 9 male) were identified from the Department of Pathology files during the years 1975–1988. All were Caucasian. Histological examination revealed that 6 cases were congenital and 15 were aquired; of these, 19 cases (90%) had a junctional component and all of these exhibited architecture atypia in the form of either lentiginous proliferation (84%) or confluence of junctional nests (84%). Forty-two percent (8/19) showed a mixture of both. Thirty-seven percent (7/19) exhibited transepidermal elimination of melanocytic nests, with 13/19 (68%) showing single cell infiltration of the epidermis. Atypical size, shape, and location of the junctional nests were present in 10/19 cases (53%). Within this group there appears to be no relationship between the age of the patient and the degree of architectural atypia. Mild cytological atypia was common. This report stresses the importance of anatomic subsite in the assessment of melanocytic lesions in children as well as in adults.

Triploidy, partial mole and dispermy. An investigation of 12 cases

Twelve triploid abortuses were investigated to determine the origin of the additional haploid set and were retrospectively examined for the development of partial hydatidiform mole. Eight out of ten suitable triploids were diagnosed as partial mole. Dispermy was indicated as the cause of triploidy in 6 informative cases of which 3 were also partial moles. However, one diandric triploid had no features of partial mole. The problem of maternal cell contamination in triploids and the difficulty of diagnosing partial moles on pathological grounds alone are discussed.

Restrictive dermopathy: a disorder of skin differentiation with abnormal integrin expression

Dean JCS, Gray ES, Stewart KN, Brown T, Lloyd DJ, Smith NC, Pope FM. Restrictive dermopathy: a disorder of skin differentiation with abnormal integrin expression.

Sites of prealbumin production in the human fetus using the indirect immunoperoxidase technique

An indirect immunoperoxidase technique was used to investigate the site of prealbumin synthesis in the human fetus from between 8 and 43 weeks. Prealbumin staining was noted in the A cells of the fetal pancreas, both in the primary and secondary generations of the islets of Langerhans, from as early as 12 weeks gestation. Electron microscopy localized the staining to the cytoplasmic secretory granules. Prealbumin was also present in the gastrointestinal mucosa in cells which had a distribution similar to that of argentaffin cells. Positive staining was noted in the lining epithelium of the renal proximal convoluted tubules, but ultrastructural studies indicated that this was probably related to reabsorption, and not to synthesis.

Owl's-Eye Cells

Figure 1. Owls-Eye Cells. The photomicrograph shows a section of kidney taken at autopsy from a three-month-old boy who died of disseminated cytomegalovirus infection contracted in utero. A single periglomerular renal tubule contains large, intranuclear viral inclusion bodies typical of those found in cells infected with cytomegalovirus. Such inclusion bodies are commonly seen at autopsy or in biopsy specimens from the kidneys, lungs, and other organs in cases of congenital or acquired cytomegalovirus infection. (Hematoxylin and eosin, x1920.).

Chorion in culture

This study is based on the processing of 115 samples of pure chorion. The different types of colony morphology, together with cytogenetic analysis, indicate the predisposition of chorion cells to artefacts of culture. Chorion survives longer than other foetal tissues and can be cultured when those are dead or contaminated (e.g. in macerated foetuses and missed abortions) making it a suitable and popular tissue for cytogenetic purposes. However, our results indicate that it is slow in culture and prone to chromosome variation so that pseudomosaicism frequently arises and may lead to misdiagnosis. We therefore suggest that cytogenetic analysis of spontaneous abortion material is interpreted with caution in cases where chorion is the only tissue cultured, especially when mosaicism is found.