Motoo Matsubara

GENERALIZED PUSTULAR PSORIASIS AND BACTEREMIA

A 73‐year‐old man, who developed bacteremia in the course of generalized pustular psoriasis (GPP) which appeared one year after the onset of psoriasis vulgaris, was reported. Blood culture confirmed bacteremia caused by Staphylococcus aureus, Epidermidis and Streptococcus faecalis. We emphasized in this article that bacteremia should be considered in emaciated patients with GPP who have received corticosteroid therapy for a long time, show remarkable shift to the left of neutrophils, and suffer remittent fever.

Organ culture of adult human skin; effect of culture temperature.

In the organ culture of adult human skin, long‐term preservation of cultured epidermis was obtained when the culture temperature was shifted from 37°C to 32°C. The epidermal cell kinetics were compared for both culture temperatures using the findings of mitotic rate, mitotic distribution and autoradiographic labelling index with tritiated‐thymidine (3H‐TdR). As a result, it appeared that a lowered culture temperature controlled the cell cycle in vitro to maintain long‐term, active epidermal proliferation.

AN UNUSUAL FORM OF SUTTON'S PHENOMENON

An unusual form of “Suttons hypomelanotic phenomenon” was found in a 37‐year‐old man who developed hypomelanosis in a naevus pigmentosus pilliferus during the course of generalized vitiligo. Depigmentation was confined, unlike the ordinary halo phenomenon, to the interfollicular epidermis, thus leaving the hypermelanosis on the follicular area (acrotrichium) where augmented basal pigmentation was confirmed by histological examination. Lymphocytic infiltration toward naevus cells was also observed. He had a positive thyroid test (x100) and microsome test (x6400), but thyroid function was within normal limits. This phenomenon is considered to be similar to Suttons phenomenon.

PROTECTIVE EFFECTS OF INTERFERON, VARIOUS ANTI-VIRAL DRUGS AND COMBINATIONS OF THESE ON HERPES SIMPLEX VIRUS INFECTION IN MICE

Young adult mice were inoculated intraperitoneally with 30LD50 of Herpes simplex virus type 1 (Miyama strain). They died within 14 days after the inoculation. Mice were equally protected by intraperitoneal injection of L cell interferon (L‐IF) or mouse brain IF (MB‐IF) given 1 day before, simultaneously and 1 day after the viral inoculation. Mice were also protected when 100μg of polyinosinic acid‐polycytidylic acid (Poly I:C) was given intraperitoneally 1 day before the viral inoculation or on the same day, but not if given on the following day. When adenine arabinoside (ara‐A) was administered every day from the 1st to the 4th day after the viral inoculation, the protective effect also occurred. However, lipopolysaccharide (LPS), amphotericin B methyl ester (AME) and gamma globulin (GG) were ineffective in reducing mortality. The protective effect could be also demonstrated by combining poly I:C and L‐IF at doses which were individually ineffective. On the other hand, no synergism between L‐IF and ara‐A was observed.

Rabbit Zosteriform Eruption Induced by Intra‐arterial Inoculation of Herpes Simplex Virus, Type 1

Seventeen rabbits were inoculated with 0.1 ml of herpes simplex virus (HSV), type 1, Miyama strain (105,75 TCID50/0.1 ml), via the auricular artery; twelve of them developed zosteriform eruptions (ZE) on the skin. Seven rabbits treated with control medium showed no eruptions. This phenomenon was significant (P<0.01).

ADULT T-CELL LEUKEMIA ASSOCIATED WITH HERPES VIRUS INFECTION-: ULTRASTRUCTURE OF INFILTRATED CELLS WITH VIRUS PARTICLES

Adult T-cell leukemia (ATL) was differentiated from chronic lymphatic leukemia by Takatsuki et al. (1-3). ATL has characteristic clinical features and hematological findings. Skin manifestations in ATL are high in frequency and leukemic cells have been shown to easily infiltrate into the skin (3, 4). It is wellknown that patients with ATL occur frequently in the southwest districts ofJapan. We report here the ultrastructure of skin lesions of ATL ascociated with disseminated herpes virus infection.

COMPARATIVE STUDY OF THE SENSITIVITY OF MOUSE DORSAL ROOT GANGLION AND CEREBELLUM TO HERPES SIMPLEX VIRUS IN VITRO

To study the effect of Herpes simplex virus (HSV) on nervous tissue, we examined (1) the possibility of establishment of latent infection in vitro, (2) the replication of HSV in mouse dorsal root ganglion and cerebellar cultures and (3) the effect of anti‐HSV rabbit serum on the maintenance of both cultures. Although both cultures without antibody were finally destroyed after inoculation, replication of HSV in cerebellar cultures was much higher than in the ganglion in both medium and tissue (P<0.005). Infected cultures treated with anti‐HSV antibody (CF: ×128) could survive longer in nerve cells of ganglion than in those of cerebellum.

GENERALIZED PUSTULAR RASH ASSOCIATED WITH PRIMARY ATYPICAL PNEUMONIA

After the acute onset of primary atypical pneumonia, a 4‐year‐old girl suddenly developed a widespread, sterile, pustular eruption with predilection toward the distal parts of the extremities. There was no involvement of the muco‐ocular area. Histological and electron microscopical examinations revealed intraepidermal pustule formation containing neutrophils and eosinophils, and perivascular infiltration of lymphocytes, histiocytes, neutrophils and eosinophils. These clinical findings are similar to those of Tans “acute generalized pustular bacterid” and Teischs “vesiculopustular eruption with mycoplasma infection”. Serological examinations, including complement fixation test, cold agglutination test, and passive hemagglutination test, confirmed a Mycoplasma pneumoniae infection. It is concluded that Mycoplasma pneumoniae infection should be considered in patients with bacterid‐like rashes who do not have streptococcal infections.

A SEMIQUANTITATIVE ANALYSIS OF SKIN SENSITIVITY CHANGES IN HERPES ZOSTER

We have investigated changes in skin sensation in patients affected with Herpes zoster, by comparing the threshold of electric stimulation pain at the lesion site with that at the symmetrical healthy site. The threshold at the lesion was lower than that at the healthy site and had a tendency to recover to normal day by day. When continuous and spontaneous pain were combined, the threshold at the lesion was rather higher, probably due to a kind of masking. The change in threshold during the recovery process is not correlated with the seriousness of this disease.

COMPARATIVE STUDY OF THE SENSITIVITY OF HERPES SIMPLEX VIRUS TYPES 1 AND 2 TO HUMAN LEUKOCYTE INTERFERON IN VITRO

In order to examine the sensitivity of Herpes simplex virus (HSV) types 1 and 2 (nine strains were used) to human leukocyte interferon (HL‐IF), human embryonic fibroblast (HEF) cultures were treated with 1 times 104 IU of HL‐IF 24 hrs before each HSV was inoculated. Forty‐eight and seventy‐two hours after incubation at 37°C in a 5% CO2 atmosphere, cytopathogenic effect (CPE) or giant cell formation by HSV was observed. The TCID50 in control cultures was compared with that in IF‐treated cultures. Although HL‐IF could protect cell culture against HSV infection, no differences in sensitivity between the two types of HSV or among the nine strains of HSV to HL‐IF were recognized.