A.M.A. Archives of Dermatology

CALLAWAY, J. LAMAR

1959 A.M.A. Archives of Dermatology

doi: 10.1001/archderm.1959.01560240001001pmid: 13806989

Abstract This attempt at listing some fundamental contributions by dermatologists and dermatologic laboratories to the progress of medicine generally, is made to point up the influence of dermatology as a scientific specialty that it is. This admittedly incomplete survey will unquestionably do a grave injustice to many noteworthy contributors. Had I not committed myself to this task of compiling data and had I not received helpful suggestions from many of you, I should long ago have abandoned the idea. However, I feel so strongly that dermatology and dermatologists have, on occasion, been unjustly maligned and not given proper recognition that this effort seems justified. Errors of omission and errors of commission may be numerous, but none will be intentional. Recognizing the inadequacy of a personal and somewhat prejudiced evaluation of what may constitute a real or significant contribution, this summary is an attempt to catalogue

SMITH, J. GRAHAM

1959 A.M.A. Archives of Dermatology

doi: 10.1001/archderm.1959.01560240015002

Abstract Introduction A new technique for measuring the sebum excretion rate has been developed. It eliminates some of the errors inherent in other methods. The amount of sebum excreted by the sebaceous gland has been shown to be influenced by several major factors. Miescher and Schönberg20 have demonstrated that the amount of sebum excreted is dependent upon the size of the sebaceous gland. The larger the gland, the more sebum excreted, and vice versa. The size of the gland changes with age. Prior to puberty, in the human the sebaceous gland is small, and little sebum is excreted.7,23 At puberty there is a great increase in sebum excretion which continues through adolescence.14,16 There are conflicting reports as to whether adolescent males7,16,28 or females5 have a higher level of sebum excretion, but aged women have a much lower level of sebum excretion than aged References 1. Supplied as Delatestryl by E. R. Squibb & Sons (each ml. contains 200 mgm. testosterone enanthate) 2. Supplied as Delalutin by E. R. Squibb & Sons (each ml. contains 125 mg. hydroxyprogesterone caproate). 3. Aron-Brunetière, R.: An Attempt at a Physiological Explanation of Seborrhea and Acne Vulgaris: Therapeutic Results , Brit. J. Dermat. 65:157-164 ( (May) ) 1953.Crossref 4. Brun, R.: Recherches sur la sécrétion sudorale et la secretion sébacée , Archives des Sciences 7:243-304, 1954. 5. Brun, R.; Enderlin, K., and deWeck, A.: Variations de la couche sébacée de l'avant suivant l'age et le sexe , Acta dermat.-venereol. 35:311-317, 1955. 6. Brun, R.; Enderlin, K., and Kull, E.: A propos de Sebum-tests , Dermatologica 106:165-170, 1953.Crossref 7. Brun, R., and Grasset, N.: Contribution à l'étude de la pathogénie de l'acné vulgaire , Dermatologica 116:416-419, 1958.Crossref 8. Butcher, E. O., and Parnell, J. P.: The Distribution and Factors Influencing the Amount of Sebum on the Skin of the Forehead , J. Invest. Dermat. 10:31-38 ( (Jan.) ) 1948. 9. Emanuel, S.: Quantitative Determinations of Sebaceous Glands' Functions, with Particular Mention of the Method Employed , Acta dermat.-venereol. 17:444-456 ( (Sept.) ) 1936. 10. Enderlin, K., and Brun, R.: Nouvelles Experiences sur la sécretion sébacée , Dermatologica 108:235-256, 1954.Crossref 11. Hamilton, J. B.: Male Hormone Substance: a Prime Factor in Acne , J. Clin. Endocrinol. 1:570-592 ( (July) ) 1941.Crossref 12. Haskin, D.; Lasher, N., and Rothman, S.: Some Effects of ACTH, Cortisone, Progesterone, and Testosterone on Sebaceous Glands in the White Rat , J. Invest. Dermat. 20:207-212 ( (March) ) 1953. 13. Herrmann, F., and Prose, P. H.: Studies on the Ether-Soluble Substances on the Human Skin: I: Quantity and "Replacement Sum," J. Invest. Dermat 16:217-230 ( (April) ) 1951. 14. Kirk, E.: Quantitative Determinations of the Skin Lipid Secretion in Middle-Aged and Old Individuals , J. Gerontol. 3:251-266 ( (Oct.) ) 1948.Crossref 15. Kirk, J. E., and Chieffi, M.: The 20-Minute Rate of Sebaceous Secretion in the Forehead , J. Invest. Dermat. 27:15-17 ( (July) ) 1956.Crossref 16. Kligman, A. M., and Ginsberg, D.: Immunity of the Adult Scalp to Infection with Microsporum audouini , J. Invest. Dermat. 14:345-358 ( (May) ) 1950. 17. Kligman, A. M., and Shelley, W. B.: An Investigation of the Biology of the Sebaceous Gland . J. Invest. Dermat. 30:99-125 ( (March) ) 1958. 18. Kvorning, S. A.: Investigations into the Pharmocology of Skin Fats and of Ointments: II. On the Occurrence and Replenishment of Fat on Skin in Normal Individuals , Acta pharmacol. et toxicol. 5:262-269, 1949.Crossref 19. Lasher, N.; Lorincz, A. L., and Rothman, S.: Hormonal Effects on Sebaceous Glands in the White Rat: II. The Effects of the Pituitary-Adrenal Axis , J. Invest. Dermat. 22:25-31 ( (Jan.) ) 1954.Crossref 20. Lasher, N.; Lorincz, A. L., and Rothman, S.: Hormonal Effects on Sebaceous Glands in the White Rat: III. Evidence for the Presence of a Pituitary Sebaceous Gland Tropic Factor , J. Invest. Dermat. 24:499-505 ( (May) ) 1955.Crossref 21. Lorincz, A. L., and Lancaster, G.: Anterior Pituitary Preparation with Tropic Activity for Sebaceous Preputial and Harderian Glands , Science 126:124-125 ( (July 19) ) 1957.Crossref 22. Miescher, G., and Schönberg, A.: Untersuchungen über die Funktion der Talgdrüsen , Bull. schweiz, Akad. med. Wissensch. 1:101-114, 1944. 23. Rony, H. R., and Zakon, S. J.: Effect of Androgens on the Sebaceous Glands of Human Skin , Arch. Dermat. & Syph. 48:601-604 ( (Dec.) ) 1943. 24. Rothman, S. et al.: Physiology and Biochemistry of the Skin , Chicago, The Univ. Chicago Press, 1954, Chap. 12 , Sebaceous Gland Excretion, pp. 284-308. 25. Rothman, S., and Schaaf, F.: Chemie der Haut , in J. Jadassohn, Handb. der. Haut.-u. Geschlechtskrankheiten , 1/2:161-377, Berlin, Springer-Verlag, 1929. 26. Savard, K.: Personal communication to author. 27. Savard, K.; Dorfman, R. I.; Baggett, B., and Engel, L. L.: Biosynthesis of Androgens from Progesterone by Human Testicular Tissue in Vitro , J. Clin. Endocrinol. 16:1629-1630 ( (Dec.) ) 1956. 28. Slaunwhite, W. R., Jr., and Samuels, L. T.: Progesterone as a Precursor of Testicular Androgens , J. Biol. Chem. 220:341-352 ( (May) ) 1956. 29. Spoor, H. J.: Measurements of Emolliency and Emollient Penetration , Drug and Cosmetic Industry 81:42 ( (July) ) 1957. 30. Suzuki, S.: Zur Physiologie und Pathologie der Talgsekretion, besonders bei Lues , Jap. J. Dermat. & Urol. 40:203-212 ( (Dec. 20) ) 1936. 31. Zeligman, I., and Hubener, L. F.: Experimental Production of Acne by Progesterone , A.M.A. Arch. Dermat. 76:652-658 ( (Nov.) ) 1957.

DOMONKOS, ANTHONY N.

1959 A.M.A. Archives of Dermatology

doi: 10.1001/archderm.1959.01560240024003pmid: 13817430

Abstract In 1888, Hutchinson1 ascribed arsenic as the cause of epitheliomas and keratoses occurring in patients with a history of ingestion of potassium arsenite solution (Fowler's solution) for medicinal purposes. Since then, sufficient quantitative data has not been available to evaluate the etiologic significance of the actual amount of arsenic contained, not only in the arsenical epitheliomas, but also in keratoses and normal skin. This study was undertaken to determine the amount of arsenic found in normal skin, epitheliomas, and keratoses in patients with a history of arsenic ingestion and to compare these amounts with those found in normal skin, epitheliomas, and keratoses occurring in patients with no arsenic history. With the results of these findings it was anticipated that there would be further elucidation as to whether there is an increased amount of arsenic in arsenical epitheliomas in comparison to that of the adjacent References 1. Hutchinson, J.: On Some Examples of Arsenic-Keratoses of the Skin and of Arsenic-Cancer , Tr. Path. Soc. London 39:352, 1888. 2. Billeter, O., and Marfurt, E.: De le Teneur Normale en Arsenic dans le Corps Humain , Helvet. Chimica Acta. 6:780-784 ( (Aug.) ) 1923.Crossref 3. Osborne, E. D.: Microchemical Studies of Arsenic in Arsenical Pigmentation and Keratoses , Arch. Dermat. & Syph. 12:773-788 ( (Dec.) ) 1925. 4. Osborne, E. D.: Microchemical Studies of Arsenic in Arsenical Dermatitis , Arch. Dermat. & Syph. 18:37-49 ( (July) ) 1928. 5. Montgomery, H.: Arsenic as an Etiologic Agent in Certain Types of Epithelioma , Arch. Dermat. & Syph. 32:218-236 ( (Aug.) ) 1935. 6. Montgomery, H., and Waisman, M.: Epithelioma Attributable to Arsenic , J. Invest. Dermat. 6:365-383 ( (Oct.) ) 1941. 7. Scott, A.: The Retention of Arsenic in the Late Cutaneous Complications of its Administration , Brit. J. Dermat. 70:195-200 ( (June) ) 1958.

JILLSON, OTIS F.;CURWEN, WILLIAM L.

1959 A.M.A. Archives of Dermatology

doi: 10.1001/archderm.1959.01560240030004pmid: 14407286

Abstract Heat, cold, trauma, and light are the physical agents concerned in the production of physical hypersensitivity. Physical hypersensitivity to light is the most important and the most common of the dermatoses caused by these physical agents. Light is the etiologic agent in polymorphic light eruptions, solar urticaria, contact photodermatitis, and endogenous photochemical dermatitis. Light is a major precipitating factor in certain cases of skin diseases associated with porphyria, psoriasis, pityriasis rubra pilaris, keratosis follicularis, pellagra, lupus erythematosus, acne rosacea, herpes simplex, xeroderma pigmentosum, keratosis, cancer, and keratoacanthoma. For over a century the diseases produced by light have been studied, with a marked surge of interest over the last decade or two. Because of this, there are now certain fundamentals available, as well as basic equipment, for the study of light hypersensitivity. Application of these essentials, however, has not become routine office procedure for prac References 1. Epstein, S.: Photoallergy and Primary Photosensitivity to Sulfanilamide , J. Invest. Dermat. 2: 43, 1939.Crossref 2. Sams, W. M.: Contact Photodermatitis , A.M.A. Arch. Dermat. 73:142, 1956.Crossref 3. Blum, H. F.; Watrous, W. G., and West, R. J.: On the Mechanism of Photosensitization in Man , Am. J. Physiol. 113:350, 1935. 4. Blum, H. F.: Studies of Photosensitivity Due to Sulfanilamide , J. Invest. Dermat. 4:159, 1941.Crossref 5. Epstein, S.: Urticaria Photogenica , Ann. Allergy 7:443, 1949. 6. Epstein, S.: Studies in Abnormal Human Sensitivity to Light: II. Light Sensitivity in Purigo Æstivalis, Eczema Solare, and Urticaria Photogenica , J. Invest. Dermat. 5:225, 1942.Crossref 7. Kesten, B. M.: Urticaria Solare (4200 to 4900 A.) , Arch. Dermat. & Syph. 64:221, 1951. 8. Kesten, B. M.: Photosensitivity in Various Dermatoses, Lupus Erythematosus, Urticaria Due to Light, and Polymorphic Light Eruptions , A.M.A. Arch. Dermat. 74:40, 1956. 9. Epstein, S.: Studies in Abnormal Human Sensitivity to Light: IV. Photoallergic Concept of Prurigo Æstivalis , J. Invest. Dermat. 5:289, 1942. 10. Sulzberger, M. B., and Baer, R. L.: Studies in Hypersensitivity to Light , J. Invest. Dermat. 6: 345, 1945. 11. Cahn, M. M.; Levy, E. J., and Shaffer, B.: Polymorphous Light Eruption: The Effect of Chloroquine Phosphate in Modifying Reactions to Ultraviolet Light , J. Invest. Dermat. 26:201, 1956. 12. Levy, E. J.; Cahn, M. M., and Shaffer, B.: Polymorphous Light Eruption: Some Unusual Reactions in Ultraviolet Light Test Sites , J. Invest. Dermat. 28:147, 1957. 13. Bachem, A.: Time Factors of Erythema and Pigmentation, Produced by Ultraviolet of Different Wave Lengths. J. Invest. Dermat. 25:215, 1955. 14. Bachem, A.: Special Review: Ultraviolet Action Spectra. Am. J. Phys. Med. 35:177, 1956. 15. Kesten, B. M., and Slatkin, M.: Diseases Related to Light Sensitivity , A.M.A. Arch. Dermat. & Syph. 67:284, 1953. 16. Epstein, J. H.; Brunsting, L. A.; Peterson, M. C., and Schwarz, B. E.: A Study of Photosensitivity Occurring with Chlorpromazine Therapy , J. Invest. Dermat. 28:329, 1957. 17. Epstein, S., and Rowe, R. J.: Photoallergy and Photocross-Sensitivity to Phenergan , J. Invest. Dermat. 29:319, 1957. 18. Kesten, B. M.: The Effects of Sunlight on the Skin , J.A.M.A. 161:1565, 1956. 19. DeEds, F.; Wilson, R. H., and Thomas, J. O.: Photosensitization by Phenothiazine , J.A.M.A. 114:2095, 1940. 20. Sidi, E.; Hincky, M., and Gervais, A.: Allergic Sensitization and Photosensitization to Phenergan Cream , J. Invest. Dermat. 24:345, 1955. 21. James, A. P. R.: Sensitivity of the Skin to Fluorescent Light , Arch. Dermat. & Syph. 44:256, 1941. 22. Bresler, R. R.: Cutaneous Burns Due to Fluorescent Light , J.A.M.A. 140:1334, 1949. 23. Lamb, J. H.; Jones, P. E.; Rebell, G., and Alston, H. D.: Sensitivity to Fluorescent (Blue-Green) Light , A.M.A. Arch. Dermat. 77:519, 1958. 24. Rothman, S., and Henningsen, A. B.: The Sunburn Protecting Effect of PABA , J. Invest. Dermat. 9:307, 1947. 25. Lamb, J. H.; Jones, P. E., and Maxwell, T. B.: Solar Dermatitis , A.M.A. Arch. Dermat. 75: 171, 1957. 26. Lamb, J. H.: The Effects of Sunlight on the Skin , New York J. Med. 59:59, 1959. 27. Lamb, J. H.; Shelmire, B.; Cooper, Z.; Morgan, R. H., and Keaty, C.: Solar Dermatitis , Arch. Dermat. & Syph. 62:1, 1950. 28. Blum, H. F.: Photodynamic Action and Diseases Caused by Light , American Chemical Society Monograph Series No. 85, New York, Reinhold Publishing Corporation, 1941. 29. Gilfillan, W.: Clinical Note: Rasch's Polymorphic Light Eruption , Brit. J. Dermat. 49:241, 1937. 30. Cahn, M. M.; Levy, J. E., and Shaffer, B.: Lupus Erythematosus and Polymorphic Light Eruptions: An Experimental Study on Their Possible Relationship . J. Invest. Dermat. 21:375, 1953. 31. Knox, J. M.; Lamb, J. H.; Shelmire, B., and Morgan, R. J.: Light Sensitive Eruptions Treated with Atabrine and Chloroquine , J. Invest. Dermat. 22:11, 1954. 32. Woodburne, A. R.; Philpott, O. S., and Philpott, J. A., Jr.: Quinacrine (Atabrine) in Treatment of Solar Dermatitis , A.M.A. Arch. Dermat. & Syph. 70:116, 1954. 33. Robinson, R. C., and Smith, G. C.: Triquin in the Treatment of Discoid Lupus Erythematosus and Light Sensitive Eruptions , Bull. School Med. Univ. Maryland 43:97, 1958. 34. Schulz, K. H.; Wiskemann, A., and Wulf, K.: Clinical and Experimental Investigations on Photodynamic Effects of Phenothiazine Derivatives, Particularly Chlorpromazine , Arch. klin. u. exper. Dermat. 202:285, 1956. 35. Burckhardt, W.; Burckhardt, K., and Schwarz-Speck Kant, M.: Photoallergic Dermatitis Due to Nadisan , Schweiz. med. Wchnschr. 87:954, 1957. 36. Curwen, W. L., and Jillson, O. F.: Light Hypersensitivity: II. A Simplified Office Procedure for Diagnosis of Contact Photodermatitis , to be published in the Journal of Investigative Dermatology.

HAEBERLIN, JOHN B.;FOX, JACK M.

1959 A.M.A. Archives of Dermatology

doi: 10.1001/archderm.1959.01560240042005pmid: 13830789

Abstract The importance of primary irritation of the skin in producing an eczematous dermatitis by itself, as well as influencing the engendering of an allergic eczematous contact dermatitis is well documented. The recent literature is replete with articles adding to the fund of observations on mechanisms of pathogenesis of the eczematous sensitization and various aspects of dermatitis and eczema, but relatively few references are found under the heading of primary irritation as such. At present much of this information is found under such topics as contact dermatitis due to specific agents, thermal injuries, industrial dermatitis, and eczemas of various sorts, and it is inseparably linked with studies on allergic reactions in the skin. This is quite understandable since the need for such a term arose from the introduction of the concept of allergy which called for a designation to distinguish allergic from nonallergic forms References 1. Sulzberger, M. B.: Dermatologic Allergy , Charles C Thomas, Springfield, Ill., 1940, p. 512. 2. Rostenberg, A., Jr.: Primary Irritant and Allergic Eczematous Reactions , A.M.A. Arch. Dermat. 75:547-558 ( (April) ) 1957.Crossref 3. Dixon, W. J., and Massey, F. J.: An Introduction to Statistical Analysis , New York, McGraw-Hill Book Company, Inc., 1951. 4. Wilcoxon, F.: Some Rapid Approximate Statistical Procedures, American Cyanamid Company, Stamford, Conn. 5. Miescher, G.: Das Problem des Lichtschutzes und der Lichtgewöhnung , Strablentherapie , 35:403-443, 1930. 6. Pinkus, H.: Examination of the Epidermis by the Strip Method: I. Observations on Thickness of the Horny Layer and on Mitotic Activity After Stripping , J. Invest. Dermat. 16:383-386, 1951.

NELSON, LAWRENCE M.;McNIECE, KENNETH J.

1959 A.M.A. Archives of Dermatology

doi: 10.1001/archderm.1959.01560240052006pmid: 14426466

Abstract The effects of adrenal hypercorticism on bacterial infections are well recognized. The effects of hypercorticism on mycotic infections are not as widely appreciated. The following case warrants reporting because the patient shows dramatically the effect of hyperadrenocorticism on a Trichophyton rubrum infection. The steroid assays on this patient with adrenal hyperplasia and adenomas were within the levels usually found in adrenal malignancy. Report of a Case A white married engineer, aged 30, was seen at the Clinic in June, 1954, because of progressive weakness of six months' duration, obesity, known hypertension, and a dermatitis which had first appeared in September of 1953. Pertinent physical findings at that time were moderate obesity (height 72 in., weight 220 lb.), a blood pressure of 200/140 (which dropped rapidly to 140/100 on bed rest and reserpine), and electrocardiographic evidence of early left ventricular hypertrophy. Erythematous, scaling plaques, more active at References 1. Bratlund, H., and Holten, C.: Moniliasis of the Mucous Membrane and the Lungs as a Complication of Treatment with Antibiotics Corticotropin, and Cortisone , Danish M. Bull. 1:79 ( (June) ) 1954. 2. Burns, R. E.: Fungous Disease as a Complication of Steroid Therapy , A.M.A. Arch. Dermat. 77:686 ( (June) ) 1958.Crossref 3. Cremer, G.: The Influence of Adrenocortical Hormones on Dermatomycoses, Especially in the Cushing Syndrome , Dermatologica 111:285 ( (Nov.) ) 1955.Crossref 4. Curth, H. D.: In discussion of Newcomer et al.13 5. Engleman, E. P., Krupp, M. A., and Molyneaux, M. G.: Clinical Experiences with Cortisone (Coccidioidomycosis) in U.S. Veterans Administration Conference on Cortisone Research, August, 1950 , Rahway, N.J., Merck & Co., Inc., 1951, 28-30. 6. Fergusson, A. G.; DeWar, W. A., and Milne, J. A.: Steroid Therapy in Reticulosis of the Skin with Special References to Exfoliative Dermatitis , Brit. J. Dermat. 70:58 ( (Feb.) ) 1958.Crossref 7. Jadassohn, W., Mach, R. S., and Nardin, J.: Effet de la cortisone sur la mycose expérimentale du cobaye , Acta endocrinol. 6:351, 1951. 8. Jahn, J. P., et al: The Combination of ACTH-Cortisone-Hydrocortisone with Antibiotics in the Management of Overwhelmingly Severe Infections , J. Pediat. 44:640 ( (June) ) 1954.Crossref 9. Jawetz, E.: Effect of Cortisone on Therapeutic Efficacy of Antibiotics in Experimental Infections , A.M.A. Arch. Int. Med. 93:850 ( (June) ) 1954.Crossref 10. Kass, E. H.: Adrenocortical Steroids and the Management of Infectious Diseases , A.M.A. Arch. Int. Med. 102:1 ( (July) ) 1958.Crossref 11. Kass, E. H., and Finland, M.: Mechanisms Involved in Decreased Resistance to Infection , Ann. Rev. Microbiol. 7:377, 1953.Crossref 12. Levan, N. E., and Einstein, H. E.: Cortisone in Coccidioidomycosis , California Med. 84: 193 ( (March) ) 1956. 13. Newcomer, V. D., Wright, E. T., Tarbet, J. E., Winer, L. H., and Sternberg, T. H.: The Effect of Cortisone on Experimental Coccidioidomycosis , J. Invest. Dermat. 20:315 ( (April) ) 1953. 14. Pillsbury, D. M., and Jacobson, C.: Cushing's Syndrome Complicated by Generalized Trichophyton Rubrum Infection , A.M.A. Arch. Dermat. & Syph. 67:436 ( (April) ) 1953. 15. Reiss, F., and Caroline, L.: The Influence of ACTH and Cortisone upon Experimental Achorian Quinckeanum Infection and upon Anaphylaxis in Guinea Pigs , J. Invest. Dermat. 19:365 ( (Nov.) ) 1952. 16. Rothman, S.: Systemic Disturbances in Recalcitrant Trichophyton Rubrum (Purpureum) Infections , A.M.A. Arch. Dermat. & Syph. 67:239 ( (March) ) 1953. 17. Scheer, G. H.: The Effects of Cortisone on the Course of Systemic Moniliasis in Mice , Mycopath. et mycol. appl. 6:325, 1953. 18. Shields, T. L.: Observation on Steroid Therapy for Kerion, The Schoch Letter, Dec. 1958. 19. Silverman, F. N., Schwarz, J., Lahey, M. E., and Carson, R. P.: Histoplasmosis , Am. J. Med. 19:410 ( (Sept.) ) 1955. 20. Smith, F. P., and Cleve, E. A.: Infections Complicating Cortisone Therapy , New England J. Med. 256:104 ( (Jan. 17) ) 1957.

CANIZARES, ORLANDO;SHATIN, HARRY;KELLERT, ALBERT J.

1959 A.M.A. Archives of Dermatology

doi: 10.1001/archderm.1959.01560240057007pmid: 13807440

Abstract Introduction Cushing's syndrome, whether it reflects primary adrenal cortical hyperfunction, or hypercorticalism secondary to pituitary basophilism, is a rare disease. A review of the records at the Bronx Veterans Administration Hospital for the period 1948—1958 produced a total of only eight such cases. During this period the hospital was averaging approximately 9,300 admissions annually, underlining the rarity of this syndrome. Extensive mycotic cutaneous infection due to Trichophyton rubrum is uncommon in a temperate climate such as that of the northeastern United States. We are referring to the widespread infection rather than the localized variety of dermatomycosis, which may have started as a tinea cruris or tinea pedis and spread to involve the adjoining buttocks or feet. One probably does not see more than one or two new cases a year of a generalized T. rubrum infection in a New York City dermatologic center. The rarity of References 1. Burns, R. E.: Fungous Disease as a Complication of Steroid Therapy , A.M.A. Arch. Dermat. 77:686, 1958.Crossref 2. Cremer, G.: The Influence of Adrenocortical Hormones on Dermatomycoses, Especially in the Cushing Syndrome , Dermatologica 111:285, 1955.Crossref 3. Delamater, E. L.: in discussion on Newcomer, V. D., et al.9 4. Farrell, R. L.; Cole, C. R.; Prior, J. A., and Saslaw, S.: Experimental Histoplasmosis: Methods for Production of Histoplasmosis in Dogs , Proc. Soc. Exper. Biol. & Med. 84:51, 1953. 5. Jadassohn, W.; Mach, R. S., and Nardin, J.: The Effect of Cortisone on Experimycosis in the Guinea Pig , Acta endocrinol. 6:351, 1951. 6. Kass, E. H.; Kendrick, M. I., and Finland, M.: Effects of Corticosterone, Hydrocortisone and Corticotropin on Production of Antibodies in Rabbits , J. Exper. Med. 102:767, 1955. 7. Kligman, A. M.; Baldridge, G. D.; Rebell, G., and Pillsbury, D. M.: The Effect of Cortisone on the Pathologic Responses of Guinea Pigs Infected Cutaneously with Fungi, Viruses and Bacteria , J. Lab. & Clin. Med. 37:615, 1951. 8. Levan, N. E., and Einstein, H. E.: Cortisone in Coccidiomycosis , California Med. 84:193, 1956. 9. Lewis, G. M.; Hopper, M. E., and Scott, M. J.: Generalized Trichophyton Rubrum Infection Associated with Systemic Lymphoblastoma: Report of Three Cases , A.M.A. Arch. Dermat. & Syph. 67:247, 1953. 10. Mankowski, Z. T.: Influence of Hormonal Conditions on Experimental Fungus Infection , in Therapy of Fungus Diseases , edited by T. A. Sternberg and V. D. Newcomer, Boston, Little, Brown & Company, 1955. 11. Mountain, I. M.: Antibody Production by Spleen in Vitro: I. Influence of Cortisone and Other Chemicals , J. Immunol. 74:270, 1955. 12. Newcomer, V. D.; Wright, E. T.; Tarbet, J. E.; Winer, L. H., and Sternberg, T. H.: The Effects of Cortisone on Experimental Coccidiomycosis , J. Invest. Dermat. 20:315, 1953. 13. Pillsbury, D. M., and Jacobson, C.: Cushing's Syndrome Complicated by Generalized T. Rubrum Infection , A.M.A. Arch. Dermat. 67:436, 1953. 14. Reiss, F.: Steroid Hormones: Their Fungistatic and Genestatic Effect on Pathogenic Fungi , Arch. Dermat. & Syph. 59:405, 1949. 15. Reiss, F., and Caroline, L.: The Influence of ACTH and Cortisone upon Experimental Achorion Quinckeanum Infection and upon Anaphylaxis in Guinea Pigs , J. Invest. Dermat. 19: 365, 1952. 16. Reiss, F.; Rosenbaum, E. M., and Caroline, L.: The Course of Trichophyton Gypseum Infection in Rabbits Previously Infected with Trichophyton Purpureum: The Effect of ACTH on the Trichophytin Test , J. Invest. Dermat. 21:191, 1953. 17. Seligmann, E.: Virulence Enhancement of Candida Albicans by Antibiotics and Cortisone , Proc. Soc. Exper. Biol. & Med. 83:778, 1953. 18. Silverman, F. N.; Schwarz, J.: Lahey, M. E., and Carson, R. P.: Histoplasmosis , Am. J. Med. 19:410, 1955. 19. Smith, F. P., and Cleve, E. A.: Infections Complicating Cortisone Therapy , New England J. Med. 256:104, 1957. 20. Sulzberger, M. B.: Dermatologic Allergy , Springfield, Ill., Charles C Thomas Publisher, 1940. 21. Thomas, L.: Cortisone and Infection , Ann. New York Acad. Sc. 56:799, 1953. 22. Torack, R. M.: Fungus Infections Associated with Antibiotic and Steroid Thearpy , Am. J. Med. 22:872, 1957. 23. Weidman, F.: in discussion on Lewis, G. M., et al.9

EPSTEIN, JOHN H.;EPSTEIN, NORMAN N.;GREENLEE, MAX

1959 A.M.A. Archives of Dermatology

doi: 10.1001/archderm.1959.01560240065008pmid: 13820497

Abstract Epidermolysis bullosa is generally considered an inherited process beginning early in life, characterized by bulla formation and by erosions of the skin secondary to minor trauma. Occasionally this symptom complex begins in adulthood with no pertinent familial background. A few of these cases of the so-called tardive or acquired form apparently follow severe drug reactions.1,2 More commonly, however, the syndrome is found with porphyria cutanea tarda.3-5 The differentiation of the idiopathic acquired variety and that associated with porphyria may lead to some diagnostic confusion. We have recently had an opportunity to study concurrently a case of idiopathic epidermolysis bullosa acquisita with no associated familial or toxic background, and a patient with porphyria cutanea tarda. It is the purpose of our report to compare these two patients, not only to establish differentiating features, but if possible to shed some light on the mechanism or mechanisms References 1. These studies were carried out by Michael Hrenoff in the Spectrographic Laboratory of the University of California, San Francisco Medical Center, under the direction of Louis A. Strait, Professor of Biophysics. 2. Bloom, D.: Epidermolysis Bullosa Due to Sulfonamides , New York J. Med. 53:1077-1081, 1953. 3. Siemens, H. W.: Zur klinischen und histologischen Kenntnis einer richterblichen Form der sog. Epidermolysis: Bullosis mechanica toxica ex usu arseni , Arch. Dermat. u. Syph. 149:71-75, 1925.Crossref 4. Hoo, T. T.: The Differential Diagnosis between Epidermolysis Bullosa Hereditaria and Porphyria Cutanea Tarda , Dermatologica 115: 112-119, 1957.Crossref 5. Zeligman, I., and Baum, M.: Porphyric Bullous Dermatosis , Arch. Dermat. & Syph. 58: 357-371, 1948. 6. Brunsting, L. A., and Mason, H. L.: Porphyria with Epidermolysis Bullosa: Report of a Case of the Tardive Congenital Type with Demonstration of Latent Porphyria in a Sister of the Patient , J.A.M.A. 132:509-514, 1946. 7. Strait, L. A.; Bierman, H. R.; Eddy, B.; Hrenoff, M., and Eiler, J. J.: Relationship of Body Weight and Urinary Coproporphyrin Excretion , J. Appl. Physiol. 4:699-708, 1952. 8. Watson, C. J., and Schwartz, S.: A Simple Test for Urinary Porphobilinogen , Proc. Soc. Exper. Biol. & Med. 47:393-394, 1941. 9. Talman, E. L.: Porphyrins in Urine , in American Association of Clinical Chemists: Standard Methods of Clinical Chemistry , Vol. 2: New York, Academic Press, 1958, pp. 137-146. 10. Holti, G.; Rimington, C.; Tate, B. C., and Thomas, G.: An Investigation of "Porphyria Cutanea Tarda," Quart. J. Med. 27:1-18, 1958. 11. Vallee, B. L.; Wacker, W. E.; Bartholomay, A. F., and Hoch, F. L.: Zinc Metabolism in Hepatic Dysfunction: II. Correlation of Metabolic Patterns with Biochemical Findings , New England J. Med. 257:1055-1065, 1957. 12. Bolgert, M., and Canivet, J.: Cutaneous Porphyria in the Adult , Brit. J. Dermat. 66:312-317, 1954. 13. Feldaker, M.; Montgomery, H.; and Brunsting, L. A.: Histopathology of Porphyria Cutanea Tarda , J. Invest. Dermat. 24:131-137, 1955. 14. Brunsting, L. A.: Observations on Porphyria Cutanea Tarda , A.M.A. Arch. Dermat. & Syph. 70:551-564, 1954. 15. Rothman, S., et al.: Physiology and Biochemistry of the Skin , Chicago, University of Chicago Press, 1954, pp. 699-701. 16. Cooper, J. H.: Microanatomical and Histochemical Observations on the Dermal-Epidermal Junction , A.M.A. Arch. Dermat. 77:18-22, 1958. 17. Wise, F., and Lautman, M. F.: Epidermolysis Bullosa Beginning in Adult Life: The Acquired Form of the Disease, with the Report of a Case and a Review of the Literature , J. Cutan. Dis. 33:441-462, 1915. 18. Allen, A. C.: Survey of Pathologic Studies of Cutaneous Diseases During World War II , Arch. Dermat. & Syph. 57:19-56. 1948. 19. Peters, H. A.; Woods, S.; Eichman, P. L., and Reese, H. H.: The Treatment of Acute Porphyria with Chelating Agents: A Report of 21 Cases , Ann. Int. Med. 47:889-899, 1957. 20. Vallee, B. L.: The Metabolic Role of Zinc , J.A.M.A. 162:1053-1057, 1956. 21. Wacker, W. E. C.; Ulmer, D. D., and Vallee, B. L.: Metalloenzymes and Myocardial Infarction: II. Malic and Lactic Dehydrogenase Activities and Zinc Concentrations in Serum , New England J. Med. 255:449-456, 1956. 22. Strait, L.: Personal communications to the authors. 23. Lowry, P.: Personal communication, cited by Smith, N. G.24 24. Hausmann, W.: Über die sensibilisierende Wirkung tierischer Farbstoffe und ihre physiologische Bedeutung , Biochem. Zschr. 14:275-278, 1908. 25. Smith, N. G.: Porphyria Cutanea Tarda and Photosensitivity , presented at the University of Minnesota Hospitals Staff Meeting, March 9, 1956 . 26. Schwartz, S.: Clinical Aspects of Porphyrin Metabolism , Veterans Admin. Tech. Bull. , TB 10-94, 6:1-19, (Dec. 1) , 1953. 27. Beerman, A., and Pastras, T.: The Porphyrias: A Discussion of Some Current Concepts , Am. J. M. Sc. 235:471-483, 1958.Crossref 28. Wells, G. C., and Rimington, C.: Studies on a Case of Porphyria Cutanea Tarda , Brit. J. Dermat. 65:337-351, 1953.Crossref 29. Winer, M. N., and Orman, J. M.: Epidermolysis Bullosa, A Suggestion as to Possible Causation , Arch. Dermat. & Syph. 52:317-321, 1945. 30. Sonnenschein, R. R., and Bernstein, M.: Relation to the Central Nervous System of Neural Pathways Mediating Histamine Flare and Nicotine Sweating , J. Appl. Physiol. 11:481-485, 1957. 31. Müller, A. H.: Beitrag zur Kenntnis der Porphyria congenita Günther , Ztschr. klin. Med. 127:460-479, 1934. 32. Turner, W. J., and Obermayer, M. E.: Studies on Porphyria: II. A case of Porphyria Accompanied with Epidermolysis Bullosa, Hypertrichosis and Melanosis , Arch. Dermat. & Syph. 37:549-572, 1938. 33. Leoni, A.: Recherches sur le mécanisme de formation des bulles dans l'épidermolyse bulleuse simple , Ann. dermat. et syph. 10:501-517, 1950. 34. Williams, D. I.: Epidermolysis Bullosa in Father and Son (Case Report) , Brit. J. Dermat. 60-61:133-134, 1948-1949. 35. Waldenström, J.: The Porphyrias as Inborn Errors of Metabolism , Am. J. Med. 22:758-773, 1957.

CAWLEY, EDWARD P.;MOWRY, ROBERT W.;LUPTON, CHARLES H.;WHEELER, CLAYTON E.

1959 A.M.A. Archives of Dermatology

doi: 10.1001/archderm.1959.01560240077009

Abstract The importance of those remarkable cytological units, the tissue mast cells, has soared in recent years. This paper reviews briefly some of the newer concepts of these cells and reports on the author's experience with histological techniques for the study of mast cell acid polysaccharides in the cutaneous lesions of urticaria pigmentosa. Some Newer Concepts of Tissue Mast Cells Although the distribution of mast cells varies from species to species, their characteristic location in warm-blooded vertebrates is the loose fibrillary tissue which surrounds small blood vessels and underlies epithelial, serous and synovial membranes.1,13 In general, parenchymatous organs are poor in mast cells, a noteworthy exception being the widespread distribution of mast cells throughout the parenchyma of the dog's liver.1 Urticaria pigmentosa, the lesions of which are featured by agglomerations of mast cells, has been known for many years. Only recently, however, References 1. Solution used: Aqueous formalin (10%). 2. Riley, J. F.: The Riddle of the Mast Cells , Lancet 1:841, 1954.Crossref 3. Fawcett, D. W.: An Experimental Study of Mast Cell Degranulation and Regeneration , Anat. Rec. 121:29, 1955.Crossref 4. Fulton, G. P.; Maynard, F. L.; Riley, J. F., and West, G. B.: Humoral Aspects of Tissue Mast Cells , Physiol. Rev. 37:221, 1957. 5. Waters, W. J., and Lacson, P. S.: Mast Cell Leukemia Presenting as Urticaria Pigmentosa , Pediatrics 19:1033, 1957. 6. Asboe-Hansen, G.: The Mast Cell: Cortisone Action on Connective Tissue , Proc. Soc. Exper. Biol. & Med. 80:677, 1952. 7. Benditt, E. P.; Wong, R. L.; Arase, M., and Roeper, E.: 5-Hydroxytryptamine in Mast Cells , Proc. Soc. Exper. Biol. & Med. 90:303, 1955. 8. Hedbom, A., and Snellman, O.: Isolation and Analysis of the Large Cytoplasmic Granules of Tissue Mast Cells , Exper. Cell. Res. 9:148, 1955. 9. Julen, C.; Snellen, O., and Sylven, B.: Cytological and Fractionation Studies on the Cytoplasmic Constituents of Tissue Mast Cells , Acta physiol. scandinav. 19:289, 1950. 10. Smith, D. E.: Dynamics of Release of Histamine from Tissue Mast Cell , Science 128:207, 1958. 11. Barnett, R. J.; Hagen, P., and Lee, F. L.: Mast Cell Granules, Containing 5-Hydroxytryptamine, Histamine and Heparin, Morphologically and Biochemically Distinct from Mitochondria , Biochem. J. 69:36P, 1958. 12. Ottoson, R.; Kahn, K., and Glick, D.: Dry Mass of Mast Cells Measured by Interference Microscopy and X-ray Absorption , Exper. Cell. Res. 14:567, 1958. 13. Pollak, O. J.: Mast Cells in the Circulatory System of Man , Circulation 16:1084, 1957. 14. Riley, J. F.: Pharmacology and Functions of the Mast Cells , Pharmacol. Rev. 7:267, 1955. 15. Mowry, R. W.: Improved Procedure for the Staining of Acid Polysaccharides by Muller's Colloidal (Hydrous) Ferric Oxide and Its Combination with the Feulgen and Periodic-Acid-Schiff Reactions , Lab. Invest. 7:566, 1958. 16. Devitt, J. E.; Samuels, P. B.; Pirozynski, W. J., and Webster, D. R.: Morphology of Tissue Mast Cells: The Frequency of Artifacts and the Influence of Certain Biologic Agents , Am. J. Path. 30:391, 1954. 17. Saal, J. R., and Riek, R. F.: Studies on Bovine Mast Cells: I. The Effect of Formalin Fixation , Stain Technol. 33:123, 1958. 18. Nickel, W. R.: Urticaria Pigmentosa: Mastocytosis; a Consideration of Various Manifestations , A.M.A. Arch. Dermat. 76:476, 1957. 19. Mowry, R. W.: Personal communication to the authors. 20. Jeanloz, R. W.: Structure of Heparin , Fed. Proc. 17:1082, 1958. 21. Orkin, M., and Schwartzmann, R. M.: A Comparative Study of Canine and Human Dermatology: II. Cutaneous Tumors; the Mast Cell and Canine Mastocytoma , J. Invest. Dermat. 32: 451, 1959.

BECKER, FREDERIC T.;COVENTRY, WILLIAM D.;TUURA, JAMES L.

1959 A.M.A. Archives of Dermatology

doi: 10.1001/archderm.1959.01560240083010pmid: 13798085

Abstract Recurrent skin and mucous membrane infections, occurring at regular intervals, should alert the clinician to the possibility of an unusual hematologic disorder known as cyclic or periodic neutropenia. This disease is characterized by a cyclic depression of neutrophils, occurring at intervals of 12 to 30 days (average 21 days) lasting from 5 to 8 days and accompanied by fever, malaise, and infections occurring in the skin and mucous membranes. The neutrophils in the peripheral blood regularly fall to low levels or disappear at this time. Between the periods of depression, the neutrophils increase but seldom rise to above 50% of the total. The leukocyte count is usually in the low normal range (4,000 to 5,000). The literature describing this rare disorder will be reviewed in this paper, and three cases will be reported. These cases are of particular interest, since a long period of observation (10 and References 1. Leale, M.: Recurrent Furunculosis in an Infant Showing an Unusual Blood Picture , J.A.M.A. 54:1854, 1910.Crossref 2. Rutledge, R. H.; Hansen-Pruss, O. C., and Thayer, W. S.: Recurrent Agranulocytosis , Bull. Johns Hopkins Hosp. 46:360, 1930. 3. Thompson, W. P.: Observations on the Possible Relationship Between Agranulocytosis and Menstruation with Further Studies on a Case of Cyclic Neutropenia , New England J. Med. 210: 176, 1934.Crossref 4. Sutton, R. L.: Periadenitis Mucosa Necrotica Recurrens , J. Cutan. Dis. 29:65, 1911. 5. Doan, C. A.: The Neutropenic State: Its Significance and Therapeutic Rationale , J.A.M.A. 99:194, 1932.Crossref 6. Embleton, D.: Rhythmical Agranulocytosis , Brit. M.J. 2:1258, 1936Crossref 7. Proc. Roy. Soc. Med. 30:908, 1936-1937. 8. Imerslund, O.: A Case of Agranulocytosis , Acta Paediat. ( (Supp. 1) ) 30:232, 1942.Crossref 9. Barsby, B. E., and Close, H. G.: Recurrent Neutrophil Agranulocytosis , Lancet 1:99, 1942.Crossref 10. Vahlquist, B.: Cyclic Agranulocytosis: Report of a Case with a Short Survey of the Disease , Acta med. scandinav. , (Supp. 170) , p. 531, 1946. 11. Reznikoff, P.: Cyclical Neutropenia: A Case Study with Bone Marrow Findings Before and After Splenectomy , Tr. A. Am. Physicians 59:276, 1946. 12. Barling, B.: Chronic Cyclic Granulopenia , Proc. Roy. Soc. Med. 61:653, 1948. 13. Loffler, W., and Maier, C.: Über einen Fall von Fettyschem Syndrom mit cyclischer Agranulocytose: Augleich ein Beitrag zur Auflassung des infektiosen Rheumatismus als Ausdruck der individuellen Reaktion , Cardiologia 12:195, 1947-1948. 14. Owren, P. A.: Cyclic Agranulocytosis , Acta med. scandinav. 134:87, 1949.Crossref 15. Fullerton, H. W., and Duguid, H. L. D.: A Case of Cyclical Agranulocytosis with Marked Improvement Following Splenectomy , Blood 4:269, 1949. 16. Erf, L. A., and Fry, K. E.: Primary Splenic Neutropenia , Am. J. Clin. Path. 19:48, 1949. 17. Reimann, H. A., and deBerardinis, C. T.: Periodic (Cyclic) Neutropenia, an Entity: A Collection of 16 Cases , Blood 4:1109, 1949. 18. Cobet, R., and Schilling, V.: Recurrent Agranulocytosis , Folia haemat. 70:286, 1951. 19. Borne, S.: Cyclic Neutropenia in an Infant , Pediatrics 4:70, 1949. 20. Rolland, C. F., and Davidson, L. S. P.: A Case of Cyclic Neutropenia , Edinburgh M.J. 57:205, 1950. 21. Sandella, J. F.: Cyclic Acute Agranulocytosis: Report of a Case with Improvement After Splenectomy , Ann. Int. Med. 35:1365, 1951.Crossref 22. Moncrieff, A.: Recurrent Neutropenia , Arch. Dis. Childhood 26:438, 1951.Crossref 23. Monto, R. W.; Shafer, H. C.; Brennan, M. J., and Rebuck, M. W.: Periodic Neutropenia Treated by Adrenocorticotrophic Hormone and Splenectomy , New England J. Med. 246:893, 1952.Crossref 24. Siguier, F., and Sebaoun, J.: Maladie périodique avec crises de sialhorrhée et neutropénie cycliques , Bull. et mém. Soc. méd. hôp. Paris 70:976, 1954. 25. Good, R. A., and Varco, R. L.: A Clinical and Experimental Study of Agammaglobulinemia , Journal-Lancet 75:245, 1955. 26. Duane, G. W.: Periodic Neutropenia , A.M.A. Arch. Int. Med. 102:462, 1958.Crossref 27. Magnin, G. E.; Suits, J. J.; Wenzel, F.: Cyclic Neutropenia , Wisconsin Med. J. 56:192, 1957. 28. Hahnemann, B. M., and Alt, H. L.: Cyclic Neutropenia in a Father and Daughter , J.A.M.A. 168:270 ( (Sept.) ) 1958.Crossref 29. Chaiken, B. H.: Effect of ACTH in Periodic (Cyclic) Neutropenia , Blood 9:83, 1954. 30. Plum, P.: Clinical and Experimental Investigation in Agranulocytosis, Dissertation, Copenhagen, 1940, p. 410. 31. Natelson, R. P.: Cyclic Neutropenia with Giant Follicular Lymphoblastoma and Lymphosarcoma , Blood 8:923, 1953. 32. Jackson, J.; Merill, D., and Duane, M.: Agranulocytic Angina Associated with Menstrual Periods , New England J. Med. 210:175, 1934.Crossref 33. Coventry, W. D.: Cyclic Neutropenia , J.A.M.A. 153:28, 1953.Crossref 34. Page, A. R., and Good, R. A.: Studies on Cyclic Neutropenia , A.M.A. J. Dis. Child. 94:623, 1957.Crossref 35. Kohlenbrener, R. M.; Boehm, J. J., and Falk, A. B.: Pyoderma Gangrenosum , A.M.A. J. Dis. Child. 96:741, 1958.Crossref 36. Dausset, J.; Nenna, A., and Brecy, M.: Presence d'une leuko-agglutinine dans 3 serums de malades leucopeniques , Sang 24:410, 1953.