Peter Kind

Experimental reproduction of skin lesions in lupus erythematosus by UVA and UVB radiation.

Sunlight is a well-established factor in the induction and exacerbation of lupus erythematosus. Although experimental reproduction of lupus erythematosus lesions with wavelengths shorter than 320 nm was demonstrated previously, the effect of wavelengths longer than 320 nm was not investigated adequately. In this study we show that the action spectrum of lupus erythematosus reaches into the UVA region. A total of 128 patients with lupus erythematosus underwent phototesting with the use of polychromatic UVB and long-wave UVA. Subsets of the disease consisted of discoid lupus erythematosus (n = 86), subacute cutaneous lupus erythematosus (n = 22), and systemic lupus erythematosus (n = 20). Skin lesions clinically and histologically compatible with lupus erythematosus were induced in 64% of patients with subacute cutaneous lupus erythematosus, 42% of patients with discoid lupus erythematosus, and 25% of patients with systemic lupus erythematosus. The action spectrum of the induced lesions was within the UVB range in 33% of patients, in the UVA range in 14%, and in the UVB and UVA range in 53%. In positive test reactions patchy dark erythema and urticarial plaques developed within a few days. In some patients typical discoid lesions persisted for months.

Hodgkin's disease followed by lymphomatoid papulosis. Immunophenotypic evidence for a close relationship between lymphomatoid papulosis and Hodgkin's disease.

The clinical association of lymphomatoid papulosis and Hodgkins disease and the striking morphologic similarity of atypical cells in lymphomatoid papulosis to Reed-Sternberg cells in Hodgkins disease suggest that lymphomatoid papulosis and Hodgkins disease are related. To test this possibility we studied the antigenic profile of Reed-Sternberg cells in the lymph nodes and of atypical cells in cutaneous lesions of lymphomatoid papulosis in two patients with Hodgkins disease and lymphomatoid papulosis. In paraffin sections both cell types expressed CD30, CD45 T cell-restricted antigens, and occasionally CD15 antigens. They were negative for CD45 B cell-restricted antigens and for lysozyme. In cutaneous lymphomatoid papulosis lesions a similar immunologic profile of the atypical cells was found; that is, they were positive for CD30, CD2, CD3, and CD25 but negative for B cell and macrophage antigens. The similarity of the immunophenotype of Reed-Sternberg cells in lymph nodes affected by Hodgkins disease and the immunophenotype of atypical cells of lymphomatoid papulosis lesions in the same patients suggests that the malignant cells in both conditions are derived from activated T cells and that they are closely related if not identical.

T-Cell-Dependent Popliteal Lymph Node Reactions to Platinum Compounds in Mice

The requirements for sensitization to complex salts of platinum were investigated in a mouse model by means of the popliteal lymph node (PLN) assay. A single subcutaneous injection of dissolved hexachloroplatinates without adjuvant induced a vigorous primary immune reaction in the draining PLN. Dose-dependent lymph node activation was determined by an increase in both PLN weight and cellularity. In C57BL/6 mice, peak reactions were obtained around day 6 after administration of 90-180 nmol Na2[PtCl6] or (NH4)2[PtCl6] per animal. Mice primed to [PtCl6]2- mounted an enhanced response upon local restimulation with suboptimal doses of the same but not unrelated compounds, indicating a specific secondary response. T cells were required to elicit PLN reactions to [PtCl6]2-, because athymic nude mice completely failed to respond, in contrast to their +/nu littermates. Differences between various inbred strains of mice revealed that Pt-induced PLN responses are genetically controlled. Moreover, the immunogenicity of Pt salts in mice is not confined to hexachloroplatinates, but other compounds, such as the antineoplastic agent cis-dichlorodiamine platinum, are able to induce comparable PLN reactions.

The effect of topically applied corticosteroids and zinc on the metallothionein content of skin in an experimental model

The metallothionein (MT) content in hairless mouse skin was determined after topical application of various glucocorticoids or zinc oxide (ZnO). Dexamethasone (1%) in a cream base or zinc paste (20% zinc oxide) were applied twice daily, at a dose of 0.5 g, to the dorsal surface of the mouse. These experiments were conducted for 7 days. The MT content of the skin increased in a time-dependent manner after dexamethasone application with maximal values (7.1 +/- 0.29 pmol MT/mg wet weight) seen after 5 days, whereas zinc paste caused only slight increases after 3 days of treatment. The effect of hydrocortisone and triamcinolone-acetonide on the MT content of the skin was also studied. The physiological significance of these results is briefly discussed.

Pemphigus erythematosus with suprabasilar acantholysis and lichenoid tissue reaction or a combination of pemphigus vulgaris and lupus erythematosus : a new entity ?

We present a 36-year-old woman with pemphigus erythematosus that showed histopathologically supra-basilar acantholysis and lichenoid tissue reaction. To our knowledge this is the first case of pemphigus erythematosus with such unusual histopathologic presentation to be reported.