Tamiko Hashizume

Combination of patch test and IgE for dust mite antigens differentiates 130 patients with atopic dermatitis into four groups

BACKGROUND Patients with atopic dermatitis sometimes have positive responses to patch testing (PT) with dust mite antigens, which is believed to correlate with the elevated levels of specific IgE for those antigens. OBJECTIVE The purpose of this study is to identify the correlation between the PT and serum IgE concerning the mite antigens. METHODS We studied 130 patients with atopic dermatitis by the PT reaction and the serum level of specific IgE for Dermatophagoides pteronyssinus antigens. RESULTS Fifty-one of the 130 patients assessed as PT-positive had either high (32 of 130 patients; 24.6%) or low or no (19 of 130 patients; 14.6%) levels of mite-specific IgE; there was a significant difference between the groups with elevated and low IgE. Similarly, a total of 79 PT-negative patients also showed an elevated or low mite-specific IgE (42 of 130 patients [32.3%] or 37 of 130 patients [28.5%], respectively). It was noted that clinical morphologic findings were peculiar to three of the four groups; however, the patients who were PT-negative with a low IgE (37 of 130 patients) showed no particular clinical lesions. CONCLUSION Comparing the results from our 130 patients, there was no correlation between the serum IgE level and the PT reaction for dust mite antigens. Conversely, the results of PT and mite-specific IgE could be used to divide these patients into four distinct groups, each with its own particular clinical morphology, suggesting the heterogeneity of this disease.

Two Cases of Pilomatrix Carcinoma

We report two cases of pilomatrix carcinoma. Wide surgical excision, radiation, and chemotherapy were required for the first patient. The tumor eventually revealed the characteristics of a carcinoma, both clinically and histopathologically, as it recurred. In the second case, although the tumor exhibited the histology of pilomatricoma in the central part of the lesion, there were numerous outgrowing irregular nests of basaloid tumor cells with cellular atypia and frequent mitoses; these are the characteristic features of the pilomatrix carcinoma in its early stages.

Interferon-γ and interleukin-2 production by peripheral blood mononuclear cells from a paiient with gold contact allergy

resolution of 512 x SI 2 image dots and 2Sf> intensity levels. The use of the fluorescence technique allows a picture of maximal contrast to be obtained: the iiuurescent ulcerated and reference surfaces appear white, whereas the surrounding non-fluorescent healthy skin is presented as black (Fig. 3). This enables the image processing software (Optimas. Bioscan, U.S.A.) to determine independently the borders ofthe ulcer and