British Journal of Dermatology

ISODA, M.

doi: 10.1111/j.1365-2133.1988.tb02559.xpmid: 3395560

SUMMARYAn extract of tumour tissue from a patient with Kimura's disease was tested for eosinophil chemotactic activity using the Boyden chamber method. Eosinophil chemotactic activity was detected in the tissue extract, and after gel filtration maximum activity was found in the fraction with a molecular weight of approximately 1000 daltons. This factor may play a role in the tissue eosinophilia which occurs in Kimura's disease.Kimura's disease is characterized clinically by marked eosinophilia in the peripheral blood and asymptomatic subcutaneous tumours, and his'tologkally by follicular aggregations of lympho cytes with well‐developed germinal centres, and marked eosinophilic infiltration. The disease is rare, being seen only in Orientals. Subcutaneous angiolymphoid hyperplasia with eosinophilia (ALHE), reported in the West,1 has been used synonymously with Kimura's disease,2–5 However, its relationship to Kimura's disease is still controversial.6,7Tissue eosinophilia in this disease is thought to be the result of an IgE mediated immune response, because of elevated serum IgE levels, infiltration of eosinophils and mast cells into the tumours, and detection of IgE in the lymphoid follicles on immunofluorescence.8 However, there are no reports to our knowledge about eosinophil chemotactic activity in the tissue.The present study was undertaken to examine the eosinophil chemotactic activity of tissue from a typical case of Kimura's disease.

KELLY, SUSAN E.; BHOGAL, B.S.; WOJNAROWSKA, FENELLA; BLACK, M.M.

doi: 10.1111/j.1365-2133.1988.tb02560.xpmid: 3293646

SUMMARYWe studied the antigen binding of sera from 25 patients with pemphigoid gestationis (PG) using skin and amnion as substrates in an indirect immunonuorescencc technique. In addition, skin was studied after prior incubation with I M NaCl which allows BMZ cleavage through the lamina lucida.Linear BMZ staining was obtained with sera from patients with PG using human amnion as substrate. This was seen with both full‐term and second trimester placentae, but not with first trimester placentae. In NaCl incubated skin all sera bound to the epidermal aspect of the separated tissue. The pattern of staining in skin, chemically split skin and amnion was identical to that previously seen with the sera of patients with bullous pemphigoid suggesting that the antigen against which circulating anti‐BMZ antigens are directed may be the same in the two conditions.

EARTH, J.H.; NG, L.L.; WOJNAROWSKA, F.; DAWBER, R.P.R.

doi: 10.1111/j.1365-2133.1988.tb02561.xpmid: 3293647

SUMMARYThirteen patients with the syndrome of acanthosis nigricans and insulin resistance are described. They all had a combination of dermatoscs related to hyperandrogenism (cutaneous virilism): hirsuties (II), acne vulgaris (6), hidradenitis suppurativa (5) and androgenic alopecia (4). In addition, 9 out of 13 had keratosis pilaris. The patients had raised fasting plasma insulin levels compared with matched normal controls (P·0–01) and increased insulin resistance (P·0–02). Insulin resistance correlated with total serum testosterone (rs= 0–65; P).

ORMEROD, A.D.; KOBZA‐BLACK, A.; MILFORD‐WARD, A.; GREAVES, M.W.

doi: 10.1111/j.1365-2133.1988.tb02562.xpmid: 3395561

SUMMARYThirteen patients with both cold and cholinergic urticaria are reported. There was considerable variability, particularly in the cold urticaria which was of the common cold contact type in seven patients, of the generalized cold induced cholinergic type in two and in four patients the lesions induced by direct contact with ice were morphologically like cholinergic urticaria, but appeared despite prior application of an acetyl choline antagonist. The natural history, laboratory findings and the effects of therapy are discussed.

BURGE, S.M.; FENTON, D.A.; DAWBER, R.P.R.; LEIGH, I.M.

doi: 10.1111/j.1365-2133.1988.tb02563.xpmid: 2456090

SUMMARYThe pathogenesis of Darier's disease was investigated by immunohistochemical staining of skin biopsies from involved and uninvolved skin in 14 patients, using monoclonal antibodies specific for keratins expressed in simple epithelia, stratified squamous epithelia and during skin specific differentiation as well as keratins expressed in mucosa and some benign epidermal hyperproliferative states.Uninvolved perilesional skin from Darier's patients showed a normal profile of keratin expression, whereas in lesional skin there was apparent delay in the expression of the suprabasal skin specific keratins. Suprabasal keratins were not detected in basal cells, thus there was no true premature keratinization. The presence of hyperproliferative keratins was restricted to suprabasal cells in lesional skin. Four patients were receiving treatment with ctretinate at the time of biopsy, but results in these patients did not differ from patients using topical treatments. Etretinate did not influence the profile of keratin expression in uninvolved or involved skin. The expression of type VII collagen was examined and was normal throughout uninvolved and iL‐sHiiitil skin in Darier's disease.

ENGLISH, J.S.C.; SWERDLOW, A.J.; MACKIE, R.M.; O'DOHERTY, C.J.; HUNTER, J.A.A.; CLARK, J.; HOLE, D.J.

doi: 10.1111/j.1365-2133.1988.tb02564.xpmid: 3395562

SUMMARYCounts of melanocytic naevi of 2 mm or greater diameter on all body sites were conducted in 197 Caucasian adults in Scotland. Mean naevus numbers were greater in young than in older adults, and in females than in males. Naevus counts on the upper limbs, lower limbs, and trunk were strongly and significantly correlated with each other and with whole body counts. Thus, where whole body counts are impractical, counting naevi at any of these individual sites should provide a satisfactory method for studying naevus distribution in large populations.The rapid rise in the incidence and mortality of malignant melanoma over recent years has led to increased interest in the epidemiology of malignant melanoma and especially its relationship to melanocytic naevi. Several recent case‐control studies have shown that naevus counts are a strong risk factor for melanoma,1–4 but relatively little is known about the distribution of and the risk factors for naevi. There have been few studies of whole body naevus counts in populations; such counts are time consuming and can be difficult to conduct in non‐hospitalized patients. In the present study we have examined the relationship between naevus numbers at different sites, and also between site‐specific naevus counts and whole‐body counts, in a Caucasian population in Scotland.

ALLEN, M.H.; TIDMAN, M.J.; MACDONALD, D.M.

doi: 10.1111/j.1365-2133.1988.tb02565.xpmid: 2456091

SUMMARYImmunogold‐silver staining (IGSS) was evaluated for the localization of cutaneous antigens in frozen and paraffin‐embedded tissue, employing antibodies to a variety of intracellular, cell‐surface and extracellular epitopes in an indirect immunogold reaction, followed by silver enhancement. The principal advantages of IGSS are the avoidance of toxic reagents and theproduction of a silver precipitate that is permanent, clearly visible and of sufficient contrast with the reaction products of alternative immunolocalizing techniques to be of value in double‐labelling procedures. It seems to localize antigenic determinants well, but does not appear to be particularly sensitive, especially for the demonstration of antibodies to extracellular constituents. Limitations of IGSS include the propensity to non‐specific staining, and the need to vary the duration of the devcJopment stage during silver enhancement.

NORRIS, J.F.B.; CUNLIFFE, W.J.

doi: 10.1111/j.1365-2133.1988.tb02566.xpmid: 2969256

SUMMARYWe examined 69 biopsies of acne lesions known to be 6, 24 or 72 h old and found that the lymphocyte was the predominant cell at 6 and 24 h. The helper:suppressor T cell ratio in the inflammatory infiltrate was 2–8: i. PolymorphonucJear leukocytes were increasingly seen at 24 and 72 h and were associated with disruption of the duct. We hypothesize that this early lymphocytic infiltrate represents a cell mediated immune response to an antigen within the duct lumen.

GOODFIELD, M.J.D.; HUME, A.; ROWELL, N.R.

doi: 10.1111/j.1365-2133.1988.tb02567.xpmid: 2969257

SUMMARYFinger blood flow was measured by laser Doppler flowmetry in 15 patients with Raynaud's phenomenon (RP) due to systemic sclerosis (SS), and 15 normal controls. Measurements were performed in a temperature controlled room at 28 °C. The blood flow in the patients was significantly lower than in the controls (P < 0.001), After hand warming in water at 35°C for 10 min, blood flow in the patients and controls did not differ significantly.Following this, the response to a standardized cold stress produced similar falls in both groups to levels that were not significantly different and these occurred over a similar time course. After cold stress ended, there was recovery of blood flow in both groups, and blood flow after 20 min was not significantly different between the two groups.The induced vasodilatation persisted, in those patients in whom it was remeasured, for at least 2 h. Repeating the experiments at a room temperature of 24 C produced similar results.This indicates that considerable vasodilatation is possible in these patients, and can be produced by simple means. It also indicates that local and central thermorcgulatory reflexes are intact. Cold induced symptoms in patients with SS arc related to low resting blood flow, not to cold sensitivity, and simple warming may provide a useful treatment.

ORTEL, B.; WECHDORN, DANIELA; TANEW, A.; HONIGSMANN, H.

doi: 10.1111/j.1365-2133.1988.tb02568.xpmid: 2969258

SUMMARYThe effect of nicotinamide on the phototest response was investigated in 14 patients suffering from polymorphous light eruption (PMLE). In contrast to the favourable effect in the prevention of PMLE reported by other groups, oral nicotinamide did not affect the phototesting results in our patients.