Michael J. Fellner

Intercellular antibodies in blood and epidermis

Antibodies directed against intercellular epithelial structures (ICE) have been important in the diagnosis of pemphigus vulgaris. Our study of thirty‐seven patients with maculopapular eruptions following therapy with penicillins, clearly indicate that antibodies morphologically indistinguishable from those found by standard techniques in pemphigus vulgaris are also found here. Indirect staining by fluorescence and horse‐radish peroxidase indicated localization against ICE identical to that seen in pemphigus, in about half the patients. Direct staining of skin from two penicillin‐allergic patients revealed similar staining in the familiar pattern, which closely resembles the network of lines in giraffe skin. Detection of circulating antibody directed against a component of epithelium introduces new insight into the pathophysiology of maculopapular penicillin eruptions, although further work is required to show what the exact relationship is to pemphigus vulgaris, the potentially fatal skin disease.

PATTERNS AND INTENSITY OE AUTOFLUORESCENCE AND ITS RELATION TO MELANIN IN HUMAN EPIDERMIS AND HAIR

ABSTRACT: The skin of 41 patients including 16 blacks, 15 Caucasiatis, and 10 Hispanics, was observed using a fluorescent microscope. Three patterns of autofluorescence were observed: intercellular, cytoplasmic, and a combination of inter cellular and cytoplasmic. The hair of 75 subjects, including 18 Negroes and 55 Caucasians, was observed. Two patterns were found: medullar and at the cortex.

Selected aspects of penicillin allergy.

SUMMARY.— Skin tests for immediate hypersensitivity with penicillin derivatives and haemagglutination tests for penicilloyl‐specific IgG and IgM antibodies are useful in the prevention, diagnosis and management of clinical adverse reactions mediated by IgE antibodies. In rare instances, the skin tests themselves may cause clinical adverse reactions. Under suitable conditions, hyposensitization or temporary loss of skin sensitivity can be successfully brought about, even in individuals with a high degree of immediate hypersensitivity.

Congenital Unilateral Benign Papillomatosis of the Mouth

A 29-year old man had an unusual unilateral lesion of the mucous membranes of the mouth, including the lips, buccal mucosa, hard and soft palate, and uvula. The lesion was a conglomerate of tiny papillomas and had been present since birth. At the age of 8 years, a mass extending from the uvula into the pharynx was surgically excised. The histopathological findings showed acanthosis, papillomatosis, and an inflammatory infiltrate. The findings represent a rare case and perhaps a unique one, to my knowledge.