W. Mitchell Sams

Systemic lupus erythematosus. Studies of the antibodies bound to skin.

Systemic lupus erythematosus is characterized by antibodies demonstrable by immunofluorescence on the renal glomeruli and at the basement membrane area of both normal and involved skin. Acid eluates from glomeruli and from normal-appearing skin of three patients with systemic lupus erythematosus contained an antinuclear antibody. This antibody fixes complement and produces a mixed immunofluorescent pattern. Anti-deoxyribonucleic acid or antiextractable nuclear antigen antibodies may be present. This antibody is concentrated on the skin and glomerular basement membrane in proportion to the total serum IgG concentration. In two cases the skin eluate contains, in addition to the antinuclear antibody, a basement membrane antibody that fixes complement, gives a linear immunofluorescent pattern, and appears to be similar (although not identical) to the pemphigoid antibody.

THE EFFECTS OF DIMETHYL SULFOXIDE ON NERVE CONDUCTION

During the course of studies of the pharmacodynamic effects of dimethyl sulfoxide (DMSO) on isolated organs of the guinea pig, a number of unexpected findings prompted investigation of the effect of DMSO on nerve conduction. Briefly, these findings were: (1) DMSO depressed the response of the isolated diaphragm to both muscle and nerve stimulation and caused spontaneous fasciculations of the resting muscle; (2) DMSO increased the response of the smooth muscle of the stomach to both muscle and nerve stimulation; (3) the amplitude of contraction of the cardiac atrium was augmented considerably by DMSO, although the rate was essentially unaffected; and (4) the cardiac vagal threshold was lowered approximately 50 per cent by DMSO in Ringer’s solution.’ Since most of the effects are typical of cholinesterase inhibitors, this possibility was also explored. Using an in vitro system for enzyme assay, it was found that as little as 4 per cent DMSO inhibits 45 per cent of cholinesterase activity.2 In the systems used in the above studies the effects on the muscles were essentially the same when the muscle was stimulated directly and when it was stimulated indirectly via the attached nerve. Even so, this did not completely rule out the possibility that DMSO might have more subtle effects on the nerve itself. MATERIALS AND METHODS

Elastofibroma. Report of a case with special histochemical and electron-microscopic studies.

In elastofibroma, electron‐microscopic and histochemical techniques demonstrated that four components may be found in such tissue: elastinophilic granular aggregates, reticulin fibers, a homogeneous matrix, and, on occasion, normal elastic fibers. Lipid was observed in the elastinophilic material, and polysaccharide was found in the matrix. The material is found in and around the few fibroblasts and elastic fibers, as well as dispersed throughout the fibrous mass. It is proposed that this is a true elastodysplasia arising from the increased production of elastic matrix material.

Solar urticaria: Studies of the active serum factor

Abstract An attempt has been made to isolate, from 2 patients with solar urticaria, the serum factor which is capable of passively sensitizing the human skin. Electrophoretically, the serum factor behaves like a globulin. Fractionation on DEAE-cellulose and Sephadex suggests that it is not IgG or IgM.

BASEMENT-MEMBRANE ANTIBODIES IN TWO PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS

Abstract Antibodies were eluted from clinically normal skin of three patients who had died of systemic lupus erythematosus. An antinuclear antibody was demonstrated in all three cases and a basement-membrane antibody in two.

INTERCELLULAR ANTIBODIES IN A PATIENT WITHOUT CLINICAL PEMPHIGUS

Antibody localized to the intercellular spaces of stratified squamous epithelium has been demonstrated in the sera of patients with active pemphigus using indirect immunofl~orescence.’~~ A significant correlation between the severity of the disease and the antibody titer is often fo~nd:-‘,~This report describes a patient with intercellular antibodies in the absence of convincing histopathologic evidence of pemphigus.

Effect of Nicotinate Ester, Acetylcholine, and Other Vasodilating Agents on Cutaneous and Mesenteric Vascular Smooth Muscle

Vasodilating agents were tested on smooth-muscle strips of small arterial blood vessels of dog and rabbit skin and mesentery, and two patterns of reaction were demonstrated. The type 1 Vasodilating agents, for example nicotinate, caused relaxation of contracted strips or blocked their contraction. The type 2 Vasodilating compounds, histamine, choline esters, and bradykinin, either caused contraction or had no effect on the vascular smooth-muscle preparation. Responses that were species specific and region specific characterize the action of type 2 vasodilators and must be accounted for in any in-vitro testing procedure for vasodilator drugs.

Pathogenesis and Management of Autoimmune Diseases of the Skin

Patients with lupus erythematosus, pemphigus vulgaris, and bullous pemphigoid all have serum antibodies that bind to or react with structures in the epidermis. For this reason an autoimmune pathogenesis has been considered. This is, however, far from proved. Management of each of these diseases can be difficult and must be individualized. At the heart of therapy for severe cases are corticosteroids, sometimes used in combination with such immunosuppressive agents as azathioprine.