Herwig Ebner

Colloid milium: light and electron microscopic investigations

A case of colloid milium (‘juvenile type’) is presented. Histochemically the colloid material showed the well known similarity to amyloid where especially in the upper portions of the colloid immunoglobulin and complement depositions could be found. Fibrin was demonstrated predominantly in the periphery of individual colloid islands.

Untersuchungen über die Blasenbildung beim Lichen ruber planus

SummaryTwo cases of bullous Lichen planus were examined electron-microscopically. The following results were obtained: 1.Blister formation takes place predominantly between the basal lamina and the cytomembranes of basal keratinocytes, that meansintrabasal.2.Basal cells show distinct degenerative changes, with may result in cytolysis. Frequently a fibrillar transformation of keratinocytes is observed. No evidence for cleft formation caused by a damage of the tonofilament-desmosome complex was found. Acytolytic origin of the blister is assumed.3.In the blister cavity fibrin masses and numerous inflammatory cells can be demonstrated besides cytolytic and “fibrillar” keratinocytes. The roof of the bulla is formed by the lower stratum spinosum. There the keratinocytes are swollen with intracellular edema; dyskeratotic cells and fibrillar bodies can be found. Similar alterations are observed in the surroundings of the bulla.ZusammenfassungDie elektronenmikroskopische Untersuchung von 2 Lichen ruber bullosus-Fällen ergab folgende Befunde: 1.Die Blasenbildung erfolgt vorwiegend zwischen Basallamina und Plasmalemm der basalen Keratinocyten, das heißtintrabasal.2.Die Basalzellen weisen ausgeprägte, bis zur Cytolyse gehende Degenerationszeichen auf. Auch eine fibrilläre Umwandlung von Keratinocyten ist häufig nachweisbar. Im vorliegenden Material fand sich kein Hinweis, daß eine spezielle Schädigung des Tonofilament-Desmosom-Komplexes die Hohlraumbildung verursacht. Einecytolytische Entstehung der Blase wird angenommen.3.Im Blaseninhalt finden sich neben cytolytischen und fibrillär umgewandelten Keratinocyten Fibrinmassen und zahlreiche, eingewanderte Infiltratzellen. Die Blasendecke wird vom unteren Stratum spinosum gebildet. Die Keratinocyten sind in diesem Bereiche durch ein intracelluläres Ödem geschwollen, dyskeratotische Zellen und fibrilläre Körper sind nachweisbar. Ähnliche Veränderungen lassen sich auch in der Blasenrandzone erkennen.

Epidermal Changes in Lichen Planus

Ultrastructural investigations in 15 patients with lichen planus (LP) revealed a multitude of epidermal changes. The most consistent findings were (1) multiplication, irregular folding or dislocation of the basal lamina, (2) fragmentation with degenerative changes of basal keratinocytes, (3) formation of numerous fibrillar Civatte bodies and, (4) presence of dyskeratotic elements. In addition, mitotic figures of keratinocytes and Langerhans cells were observed. These findings support the view that the primary event in LP represents an injury involving epidermal basal cells. Furthermore, the replacement of destroyed tissue seems to originate not only from the margin of the lesions or the skin appendages but also from unaffected cells within the LP papule.

Allgemeiner immunstatus bei patienten mit generalisiertem lichen ruber planus

30 patients suffering from generalized lichen planus (= L.p.) have been examined by the following methods in order to more precise information regarding their immune-status: 1. Quantitative determination of immuno-globulins including complement fraction (beta 1C/A) 2. Intracutaneous tests with recall-antigens 3. Investigation of cutaneous sensitivity to DNCB 4. Lymphocytemigrationinhibition- and Lymphocytetransformationstests. The results obtained were not statistically significant when comparing the results of this investigation in patients suffering from L.p. with the control group. Therefore, the theory that immunological processes are the basis of these occurences is still under discussion. Further studies applying more specific methods should be conducted in order to clarify this problem.Summary30 patients suffering from generalized lichen planus (= L.p.) have been examined by the following methods in order to obtain more precise information regarding their immune-status:1.Quantitative determination of immuno-globulins including complement fraction (β 1C/A)2.Intracutaneous tests with recall-antigens3.Investigation of cutaneous sensitivity to DNCB4.Lymphocytemigrationinhibition- and Lymphocytetransformationstests. The results obtained were not statistically significant when comparing the results of this investigation in patients suffering from L.p. with the control group. Therefore, the theory that immunological processes are the basis of these occurences is still under discussion. Further studies applying more specific methods should be conducted in order to clarify this problem.ZusammenfassungBei 30 Patienten mit generalisiertem Lichen ruber planus (L.r.pl.) wurden folgende Untersuchungen durchgeführt, um Informationen über den allgemeinen, immunologischen Status zu erhalten:1.Quantitative Bestimmung der Immunglobuline und Komplementfraktion (β 1C/A)2.Intrakutanteste mit Recall-Antigenen3.Prüfung der percutanen Sensibilisierbarkeit gegen DNCB4.Lymphozytenmigrations- und -transformationstests. Die Auswertung der Untersuchungsresultate ergab keine statistisch signifikanten Unterschiede zwischen Lichen ruber-Patienten und Kontrollgruppe. Dadurch läßt sich die Annahme, daß dem L.r.pl. immunologische Vorgänge zugrunde liegen, nicht entkräften; weitere Studien mit spezifischeren Methoden wären zur Klärung dieser Frage erforderlich.

Cell proliferation in the Lichen planus infiltrate. Investigations by light- and electron-microscopic autoradiography.

In seven patients suffering from lichen planus (LP) light‐ and electron‐microscopic 3H‐thymidine (3HT) labeling studies were performed and the following results were obtained. 1. Using the light‐microscope, a large number of 3HT labeled cells can be observed in the dermal infiltrate of LP. Most of the labeled nuclei belong to mononuclear, ‘round cells’ while isolated endothelial cells. fibroblasts, histiocytes and mast cells could be found labeled. 2. The mean labeling index of ‘round cells’ in our patients was 4.27 ± 1.57%. 3. The evaluation of the electron microscopic autoradio‐graphs showed that, as far as ‘round’ cells were concerned, exclusively nuclei of cells showing the morphological criteria of stimulated lymphocytes were labeled. These findings support the view that in LP, as in allergic contact dermatitis, a high proliferative activity of lymphocytes takes place.

Elastic globes@@@Elastic globes: Histochemische und elektronenmikroskopische Untersuchungen@@@Histochemical and Electron Microscopic Investigations

SummaryThis paper presents observations concerning the histochemistry and ultrastructure of elastic globes (E.G.). The following results were obtained:1.E.G. are amorphous masses, up to 25 µ in size, predominantly localized at the dermal-epidermal junction. They are eosinophilic, PAS-positive and show the same histochemical characteristics as normal elastic tissue. Examination with the fluorescence microscope reveals a distinct autofluorescence.2.Electronmicroscopically the E.G. are well defined, ovoid bodies localized immediately below the basal lamina. They consist of electron-transparent, homogenous or finely granular matrix, in which a dense lattice of osmiophilic inclusions is embedded. Depending upon the direction in which the specimen is cut these in-clusions appear as granular, laminated or fibrillar structures. A close relationship between E.G. and fibroblasts is apparent.3.On the basis of our investigations the E.G. are considered as morphologic variants of the normal elastic fibers. Because of their higher content of microfibrils it is assumed that they represent young, newly synthetisized elastic tissue. The localization of E.G. at the dermal-epidermal junction could be explained by an increased synthesis of elastic tissue in this area.ZusammenfassungDie vorliegende Arbeit beschäftigt sich mit der Histochemie und Feinstruktur der elastic globes (E.G.). Folgende Befunde wurden erhoben:1.E.G. sind bis 25 µ große, amorphe, vorwiegend in der epidermo-corialen Verbundzone gelegene Gebilde. Sie sind eosinophil, PAS-positiv und verhalten sich auch sonst histochemisch wie normales elastisches Gewebe. Fluorescenzmikroskopisch läßt sich eine deutliche Autofluorescenz dieser Körper nachweisen.2.Elektronenmikroskopisch stellen die E.G. gut abgegrenzte, rundliche, knapp unter der Basallamina gelegene Körperchen dar. Sie bestehen aus einer elektronenoptisch hell erscheinenden, amorphen bis feingranulären Matrix, in die ein dichtes Netzwerk osmiophiler Einschlüsse unregelmäßiger Dichte eingelagert ist. Je nach Schnittrichtung wirken diese Einlagerungen granulär, streifig oder fibrillär. Auffällig ist die enge räumliche Beziehung zwischen E.G. und Fibroblasten.3.Auf Grund der vorliegenden Befunde werden die E.G. als morphologische Varianten des elastischen Fasersystems betrachtet. Da sie feinstrukturell durch einen vermehrten Gehalt an osmiophilen Mikrofibrillen charakterisiert sind, wird angenommen, daß es sich um junges, frisch synthetisiertes elastisches Gewebe handelt. Die Lokalisation der E.G. könnte durch eine gesteigerte Elasticasynthese in der epidermo-corialen Verbundzone erklärt werden.