Jerome R. Pomeranz

Cytophagic histiocytic panniculitis. A variant of malignant histiocytosis.

This report describes a patient with cytophagic histiocytic panniculitis in which the aggressive use of chemotherapeutic agents resulted in an apparent remission. The histiocytic nature of the process was confirmed by immunohistochemical techniques. There are many similarities with malignant histiocytosis, and it is believed that this entity should be regarded as a variant of malignant histiocytosis.

Pyoderma gangrenosum treated with clofazimine: Report of three cases

Three cases of pyoderma gangrenosum (PG) responsive to clofazimine are reported. The ulcers were recalcitrant to other forms of therapy, and the patients were incapacitated. Healing began within 2 or 3 weeks. To our knowledge, these are the first reported cases of PG responsive to clofazimine in the United States.

The inadequacy of punch-excised melanocytic lesions: sampling through the block for the determination of "margins".

BACKGROUND Dermatopathologists often are asked by clinicians to report margins on punch excisions of melanocytic lesions. OBJECTIVE We sought to determine the adequacy of surgical margins on melanocytic lesions submitted with intention of complete excision using punch removal technique. METHODS We conducted prospective analysis of surgical margins on 266 consecutive patients who underwent attempted complete removal of 405 melanocytic nevi submitted as punch and fusiform excisions. RESULTS Of 206 nonbisected punch excisions, 127 (62%) had final positive margins. Of 159 bisected punch excisions, 76 (48%) had final positive margins. Of 40 elliptical excisions, two (5%) had final positive margins. LIMITATIONS Information on the perilesional rim of nonpigmented skin included in the excision was not available. CONCLUSIONS Of punch excisions, 56% had positive margins. Importantly, 30% of these punch excised specimens were negative on initial levels but had positive margins after extensive sectioning, affirming that fusiform excisions are the preferred method to evaluate margins in melanocytic lesions.

Folliculitis ulerythematosus reticulata. A report of four cases and brief review of the literature

Abstract: Folliculitis ulerythematosus reticulata (FUR) is an uncommon genodermatosis best classified as one of the keratosis pilaris atrophicans group of disorders. It is characterized by erythema and follicular plugging of the cheeks that evolves into honeycomb atraphy. Associated cutaneous and visceral abnormalities can occur. This report describes four patients with FUR. one with an unaffected twin, a finding not previously reported. The significance of an early and accurate diagnosis is emphasized.

Studies on the localization of hapten in guinea pigs fed picryl chloride.

Immunization with components of the upper gastrointestinal tract, stomach and small intestine, obtained at intervals up to 12 h from picryl chloride fed guinea pigs, commonly results in sensitization of the recipients to the hapten. This suggests that ingested picryl chloride localizes in the upper intestinal tract.

Tolerance to the Trinitrophenol Ligand in Guinea Pigs: Studies on the Role of the Solvent Used in Feeding

Guinea pigs fed picryl sulfonic acid in aqueous solvents did not become unresponsive to contact sensitization with picryl chloride. In contrast, a substantial proportion of those fed picryl sulfonic acid, emulsified with triglyceride oil, were tolerant to subsequent immunization with picryl chloride. Feeding a related hapten (picryl chloride) in aqueous solvents was also considerably less effective in the induction of unresponsiveness to contact sensitization than feeding this hapten in vegetable oil. Animals fed picryl sulfonic acid in either aqueous or emulsified triglyceride solvents developed picryl-specific antibody after the initial feeding. However, those fed picryl chloride did not develop antibody and its role, if any, in the mechanism of unresponsiveness is unclear.

STUDIES ON THE ROLE OF THE SOLVENT IN THE INDUCTION OF TOLERANCE FOLLOWING HAPTEN FEEDING

The purpose of these studies was to investigate the role of the solvent in the immune response to hapten feeding. In the past, all the methods used to induce immunological unresponsiveness to simple chemical sensitizers by oral feeding entailed the use of vegetable oil or organic solvents. In the present studies, the trinitrophenol ligand-in the form of picryl sulfonic acid (PSA) or picryl chloride (PC)-was fed in aqueous solvents. Feeding large doses of PSA, a readily water-soluble hapten, in an aqueous solvent (saline) to starved (24 h) guinea pigs did not result in significant unresponsiveness to contact sensitization with PCL in complete Freunds adjuvant (CFA) . In contrast, when PSA was fed in saline emulsified with varying amounts of vegtable oil or in Upjohn fat emulsion, from one-half to two-thirds of the animals fed PSA became unresponsive to subsequent sensitization with PC. Many guinea pigs fed PSA developed picryl-specific antibody, as demonstrated by passive cutaneous anaphylaxis (PCA) , regardless of whether the hapten was given in saline or saline-lipid emulsions. The significance of the antibody is unclear. Guinea pigs fed PC, a slightly water-soluble hapten, in saline-ethanol mixtures also showed a decreased capacity to become unresponsive to contact sensitization. Approximately 20% of the animals fed either 30 mg PC in 10% ethanol or 32 mg PC in 2% ethanol werc unresponsive. PCA tests for antibody were negative. In contrast, previous experiments from this laboratory have shown that slightly over 70% of the animals fed 30 mg PC in olive oil alone become unresponsive to contact sensitization. These experiments demonstrate that the solvent in which the hapten is fed influences the subsequent immunological response to sensitization with the haptenic ligand. The mechanisms of how the addition of vegetable oil alters the immune response to hapten feeding are unclear, but may be related to the way in which the hapten is absorbed and distributed as it comes into contact with gut-associated lymphoid tissue.