Archives of Dermatology

Muller, Sigfrid A.

1974 Archives of Dermatology

doi: 10.1001/archderm.1974.01630080009001

Abstract Members of the Genetics Task Force of the Division for Research of the National Program for Dermatology recognized early in the development of its programs that there was little association between clinical dermatologists and the relatively few individuals working or interested in the area of medical genetics and basic genetics. The pioneering monograph of Cockayne1 on genodermatoses and McKusick's2 text listing genetic disorders with dermatologic manifestations were clear proof—if any were needed—that knowledge of genetics was an absolute essential to the clinical practice and medical progress of dermatology. Just as we have long recognized the crucial involvement of dermatology in internal medicine, we are convinced that genetics should have an equal place and that it is likely to have increasing importance in the future. Replies to Questionnaire We were frequently asked by residents what dermatologists needed to know about genetics and how such information could be integrated into References 1. Cockayne EA: Inherited Abnormalities of the Skin and Its Appendages . London, Oxford University Press, 1933. 2. McKusick VA: Mendelian Inheritance in Man: Catalogs of Autosomal Dominant, Autosomal Recessive, and X-Linked Phenotypes , ed. 2. Baltimore, Johns Hopkins Press, 1968. 3. Johnson ML: National program for dermatology . Arch Dermatol 100:521-522, 1969.Crossref

1974 Archives of Dermatology

doi: 10.1001/archderm.1974.01630080010002

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract In the article "Dermatitis Herpetiformis With Discoid Lupus Erythematosus: Occurrence of Sulfone-Induced Discoid Lupus Erythematosus," published in the July Archives (110:95-98, 1974), the surname of coauthor Robert E. Jordon, MD, was misspelled.

1974 Archives of Dermatology

doi: 10.1001/archderm.1974.01630080010003

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract In the article, "IgG and Complement-Fixing Pseudointercellular Antibodies After Thermal Injury," published in the June Archives (109:887-888, 1974), an error of placement occurred in the Table on page 888. The two subheadings under "Pseudo-IC†," comprising the headings for table-columns 3 and 4, should have been "IgG" and "C′3 (β1C/β1A)§," respectively.

Pope, F. Michael

1974 Archives of Dermatology

doi: 10.1001/archderm.1974.01630080011004

Abstract Recent clinical examination of 140 British patients with pseudoxanthoma elasticum (PXE) showed both autosomal and recessive inheritance. Fifty-seven recessive families were studied and showed two disease patterns. Patients with type 1 recessive PXE had flexurally distributed rash, moderately severe retinal disease, and a particular predisposition to gastrointestinal bleeding. Type 2 recessive disease is much rarer and affects the entire skin which is loose-fitting, lax, and extensively infiltrated with degenerated elastic fibers. Pooled data for these two groups clearly support an autosomal recessive pattern of inheritance. References 1. Cockayne EA: Inherited Abnormalities of the Skin and Its Appendages . London, Oxford University Press, 1933, pp 312-319. 2. McKusick VA: Pseudo-xanthoma elasticum , in Inherited Disorders of Connective Tissue , ed 4. St. Louis, CV Mosby Co, 1972, pp 475-520. 3. Pope FM: Autosomal dominant variants of PXE . Br J Hum Genet , to be published. 4. Pope FM: A study of PXE in England and Wales, thesis. University of Wales, 1973. 5. McMillan DC, Vickers HR: Pseudo-xanthoma elasticum and a bleeding defect: Case report . Br J Dermatol 84:183, 1971. 6. Goldschmidt E: On the aetiology of Myopia: An epidemiological study . Acta Ophthalmologica , (suppl 98) , 1968. 7. Bernstein F, quoted by Levitan M, Montagu M: Ueber die Ermittlung und Prüfung von Gen Hypothesen aus Vererbungsbeobachtungen am Menschen und über die Unzulässigkeit der Weinbergschen Geshcwister Methode als Korrektur der Auslesewirkung . Archiv Rassen Gesselschaft Biol 22:241-249, 1929. 8. Levitan M, Montagu M: Textbook of Human Genetics . London, Oxford University Press, 1971, pp 424-429.

Jones, Henry E.;Reinhardt, Jeffrey H.;Rinaldi, Michael G.

1974 Archives of Dermatology

doi: 10.1001/archderm.1974.01630080015005

Abstract Subjects extensively and chronically infected with dermatophytes were shown to be atopic by demonstration of multiple immediate skin test sensitivities and elevated levels of serum IgE. Three atopic men with no evidence of prior dermatophyte infection were experimentally infected (forearm) with Trichophyton mentagrophytes var granulare. All of the subjects developed cell-mediated immunity (CMI). In two of the subjects, the infections healed spontaneously. In the third subject, who, in addition, developed type I humoral immunity (T-I-HI), the infection did not heal and it spread to his feet. A local antagonism between T-I-HI and CMI was demonstrated. Chronic dermatophytosis develops in most individuals due to immunologic factors, including a local functional, if not actual, defect in CMI. Atopic individuals are predisposed to chronic dermatophytosis because of T-I-HI antagonism of CMI, and the rapid development of CMI tolerance. References 1. Lewis GM, Hopper ME, Scott MD: Generalized Trichophyton rubrum infections associated with systemic lymphoblastoma . Arch Dermatol Syphilol 67:247-262, 1953.Crossref 2. Nelson LM, McNeice KJ: Recurrent Cushing's Syndrome with Trichophyton rubrum infection . Arch Dermatol 80:700-704, 1959.Crossref 3. Canizares 0, Shatin H, Kellert AJ: Cushing's Syndrome and dermatomycosis . Arch Dermatol 80:705-712, 1959.Crossref 4. Wilson JW: Cushing's Syndrome and dermatomycosis: Discussion . Arch Dermatol 80:709-710, 1959. 5. Wilson JW, Plunkett OA: The Fungus Diseases of Man . Berkeley, Calif, University of California Press, 1965, pp 232-233. 6. Rothman S: Systemic disturbances in recalcitrant Trichophyton rubrum infections . Arch Dermatol Syphilol 67:239-246, 1953.Crossref 7. Jolly HW, Carpenter CL: Oral glucose tolerance studies in recurrent Trichophyton rubrum infections . Arch Dermatol 100:26-28, 1969.Crossref 8. Jones HE, Reinhardt JH, Rinaldi MG: A clinical, mycological and immunological survey for dermatophytosis . Arch Dermatol 108:61-65, 1973.Crossref 9. Jones HE, Reinhardt JH, Rinaldi MG: Acquired immunity to dermatophytes . Arch Dermatol , to be published. 10. Jones HE, Reinhardt JH, Rinaldi MG: Model dermatophytosis in naturally infected subjects . Arch Dermatol , to be published. 11. Jones HE, et al: Atopic disease and serum immunoglobulin-E . Br J Dermatol , to be published. 12. Hanifin JM, Ray LF, Lobitz WC: Immunologic reactivity in dermatophytosis . Br J Dermatol , to be published. 13. Jillson OF, Huppert M: The immediate wheal and the 24-48 hour tuberculin type edematous reactions to trichophytin . J Invest Dermatol 12:179-185, 1949. 14. Lewis GM, et al: An Introduction to Medical Mycology , ed 4. Chicago, Year Book Publishers Inc, 1958, pp 228-230. 15. Bloch BR, Labouchere A, Schaaf FR: Versuche einer chemischen Charakterisierung and Reindarstellung des Trichophytins (des aktiven, antigenen Prinzips pathogener Hautpilze) . Arch Derm Syph 149:413-424, 1925.Crossref 16. Jadassohn W, Schaaf F, Sulzberger MB: Der Schultz-Delesche versuch mit trichophytin . Klin Wochenschr 11:857-860, 1932.Crossref 17. Basarab O, How MJ, Cruickshank CND: Immunological relationships between glycopeptides of Microsporum canis, Trichophyton rubrum, Trichophyton mentagrophytes and other fungi . Sabouraudia 6:119-126, 1968.Crossref 18. Hegyi E, et al: Die spezifitat der Mykine und ihre bedentung fur die Diagnostik der Dermatomykosen . Allerg Asthmaforsch 13:164-174, 1967. 19. Wilson JW: Some observations on fungus diseases in 1959 . Med Clin N Am 43:857-867, 1959. 20. Brostoff J, Roitt IM: Cell-mediated (delayed) hypersensitivity in patients with summer hayfever . Lancet 27:1269-1272, 1909. 21. Marcussen PV: Relationship of the urticarial to the inflammatory reaction to trichophytin . Arch Dermatol Syphilol 36:494-514, 1937.Crossref 22. Grappel SF, Blank F, Bishop CT: Circulating antibodies in dermatophytosis . Dermatologica 144:1-11, 1972.Crossref 23. Lorincz AL, Priestly JO, Jackobs PH: Evidence for a humoral mechanism which prevents growth of dermatophytes . J Invest Dermatol 31:15-17, 1958.Crossref 24. Carlisle DH, et al: Significance of serum dermatophyte inhibitory factor in dermatophytosis . J Invest Dermatol , to be published. 25. Salvin SB: Contact hypersensitivity, circulating antibody and immunologic unresponsiveness . Fed Proc 24:40-44, 1965. 26. Perlman F: Arthropod sensitivity , in Criep LO (ed): Dermatologic Allergy . Philadelphia, WB Saunders Co, 1967, pp 222-244. 27. Pepys J: Allergic hypersensitivity to fungi . Postgrad Med J 35:436-440, 1959.Crossref 28. Jones HE, et al: Apparent cross reactivity of air-borne molds and the dermatophytic fungi . J Allergy Clin Immunol , to be published. 29. Palacios J, Fuller EW, Blaylock WK: The immunologic capabilities of patients with atopic dermatitis . J Invest Dermatol 47:484-490, 1966.Crossref 30. Rajka G: Delayed dermal and epidermal reactivity in atopic dermatitis (prurigo Besnier) . Acta Derm Venereol 47:158-162, 1967. 31. Lobitz WB Jr, Honeyman JF, Winkler NW: Suppressed cell-mediated immunity in two adults with atopic dermatitis . Br J Dermatol 86:317-328, 1972.Crossref 32. Jones HE, Lewis CW, McMarlin SL: Allergic contact sensitivity in atopic dermatitis . Arch Dermatol 167:217-222, 1973.Crossref

Barranco, Vincent P.

1974 Archives of Dermatology

doi: 10.1001/archderm.1974.01630080023006

Abstract Two patients had vesiculobullous dermatoses that combined features of dermatitis herpetiformis (DH) and either pemphigus vulgaris or pemphigus foliaceus. Both patients responded to treatment with sulfones. The literature contains similar reports, as well as reports of cases of vesiculobullous dermatoses that combine features of DH and bullous pemphigoid (BP). There is evidence that a similar immune mechanism exists for DH, pemphigus, and BP. The presence of indeterminate or hybrid cases and their similar immunopathological features suggest that these three diseases may be related clinically and immunologically. Such hybrid or indeterminate cases may be referred to as "mixed bullous disease." References 1. Beutner EH, Jordon RE: Demonstration of skin antibodies in sera of pemphigus vulgaris patients by indirect immunofluorescent staining . Proc Soc Exp Biol Med 117:505-510, 1964.Crossref 2. Jordon RE, et al: Basement zone antibodies in bullous pemphigoid . JAMA 200:751-756, 1967.Crossref 3. Beutner EH, Jordon RE, Chorzelski TP: The immunopathology of pemphigus and bullous pemphigoid . J Invest Dermatol 51:63-80, 1968.Crossref 4. Sams WM Jr: Bullous pemphigoid . Arch Dermatol 102:485-497, 1970.Crossref 5. Chorzelski TP, Joblonska S: Immunopathologische Untersuchungen bei der durhingschen Krankheit und Pemphigoid . Dermatol Wochenschr 153:558-561, 1967. 6. Meer JB van der: Granular deposits of immunoglobulins in the skin of patients with dermatitis herpetiformis: An immunofluorescent study . Br J Dermatol 81:493-503, 1969.Crossref 7. Holubar K, Doralt M, Eggerth G: Immunofluorescence patterns in dermatitis herpetiformis . Br J Dermatol 85:505-510, 1971.Crossref 8. Chorzelski TP, et al: Immunofluorescence studies in the diagnosis of dermatitis herpetiformis and its differentiation from bullous pemphigoid . J Invest Dermatol 56:373-380, 1971.Crossref 9. Seah PP, et al: Tissue antibodies in dermatitis herpetiformis and adult coeliac disease . Lancet 1:834-836, 1971.Crossref 10. Floden CH, Gentele H: A case of clinically typical dermatitis herpetiformis (Duhring) presenting acantholysis . Acta Derm Venereol 35:128-131, 1955. 11. Winkelmann RK, Roth HL: Dermatitis herpetiformis with acantholysis or pemphigus with response to sulfonamides . Arch Dermatol 82:385-390, 1960.Crossref 12. Doepfmer R von: Ueber eine nosologisch ungeklärte bullose Dermatose (Pemphigus chronicus vulgaris oder Dermatitis herpetiformis Duhring . Hautarzt 12:452-456, 1961. 13. Emmerson RW, Wilson-Jones E: Eosinophilic spongiosis in pemphigus . Arch Dermatol 97:252-257, 1968.Crossref 14. DeMento FJ, Grover RW: Acantholytic herpetiform dermatitis . Arch Dermatol 107:883-887, 1973.Crossref 15. Honeyman JF, et al: The enigma of bullous pemphigoid and dermatitis herpetiformis . Arch Dermatol 106:21-25, 1972.Crossref 16. Barranco VP: Inhibition of lysosomal enzymes by diaminodiphenylsulfone . Arch Dermatol , to be published. 17. Thomas L, et al: Comparison of the effects of papain and vitamin A on cartilage-1: The effect in rabbits . J Exp Med 111:705-718, 1960.Crossref 18. Winkelmann RK, Ditto WB: Cutaneous and visceral syndromes of necrotizing or "allergic" angiitis: A study of 38 cases . Medicine 43:59-89, 1964.Crossref 19. Wells GC: Allergic vasculitis (tri-symptom of Gougerot) treated with dapsone . Proc R Soc Med 62:665-666, 1969. 20. Kalkoff KW: Zur Behandlung des Erythema elevatum diutinum mit 3-sulfanilamido-6-methoxy-pyridazin (Lederkyn) . Dermatol Wochenschr 142:788-800, 1960. 21. Vollum DI: Erythema elevatum diutinumvesicular lesions and sulphone response . Br J Dermatol 80:178-183, 1968.Crossref 22. Cream JJ, Levene GM, Calnan CD: Erythema elevatum diutinum: An unusual reaction to streptococcal antigen and response to dapsone . Br J Dermatol 84:393-399, 1971.Crossref 23. Stringa SG, et al: Allergic vasculitis Gougerot-Ruiter syndrome . Arch Dermatol 95:23-27, 1967.Crossref

Poh-Fitzpatrick, Maureen B.;Piomelli, Sergio;Young, Patricia;Hsu, Helen;Harber, Leonard C.

1974 Archives of Dermatology

doi: 10.1001/archderm.1974.01630080027007

Abstract The rapid quantitative microfluorometric assay for free erythrocyte porphyrins can be applied in the diagnosis of erythropoietic protoporphyria. The advantages of this assay are speed, accuracy, reproducibility, and lower cost, as compared with other biochemical methods now in use. When local facilities permit, this assay can be done on a wet blood specimen. Otherwise, drops of blood from the finger can be collected on filter paper that can be submitted by regular mail to a laboratory for quantitative analysis by this assay. References 1. Magnus IA, et al: Erythropoietic protoporphyria: New porphyrin syndrome with solar urticaria due to protoporphyrinaemia . Lancet 2:448-451, 1961.Crossref 2. Rimington C, Cripps DJ: Biochemical and fluorescence microscopy screening for erythropoietic protoporphyria . Lancet 1:624-626, 1965.Crossref 3. Perterka ES, Runge WJ, Fusaro RM: Erythropoietic protoporphyria: III. Photohemolysis . Arch Dermatol 94:282-285, 1966.Crossref 4. Wranne L: Free erythrocyte copro- and protoporphyria: Methodological and clinical study . Acta Paediatr 49( (suppl 124) ):1-78, 1960.Crossref 5. Piomelli S, et al: The FEP (free erythrocyte porphyrins) test: A screening micromethod for lead poisoning . Pediatrics 51:254-259, 1973. 6. Piomelli S: A micromethod for free erythrocyte porphyrins: The FEP test . J Lab Clin Med 81:932-940, 1973. 7. Piomelli S, Young P, Gay G: Field screening of children for lead poisoning with the FEP test , abstracted. Pediatric Res 7:350, 1973. 8. Mathews-Roth MM, et al: Beta-carotene as a photoprotective agent in erythropoietic protoporphyria . N Engl J Med 282:1231-1234, 1970.Crossref 9. vanKamper EJ, Zijlstra WG: Standardization of hemoglobinometry: II. The hemoglobin cyanide method . Clin Chim Acta 6:538, 1961.Crossref 10. Günther H: Die Haematoporphyrie . Dtsch Arch Klin Med 105:89-146, 1911. 11. Goldberg A, Rimington C, Lochhead AC: Hereditary coproporphyria . Lancet 1:632-636, 1967.Crossref 12. Heilmeyer L, Clotten R: Congenital erythropoietic coproporphyria . Ger Med Mon 9:353-357, 1965. 13. Dean G: The Porphyrias: A Story of Inheritance and Environment . London, Sir Issac Pitman & Sons Ltd, 1963.

Tromovitch, Theodore A.;Stegeman, Samuel J.

1974 Archives of Dermatology

doi: 10.1001/archderm.1974.01630080033008

Abstract A variation of Mohs' technique, that is, microscopically controlled surgical excision is presented. The use of fresh tissue eliminates the need for zinc chloride paste. This substantially decreases the discomfort of the procedure and shortens the time necessary for extirpation of difficult tumors. A series of 102 basal cell carcinomas occurring in 85 patients was treated by this method. With a minimum follow-up of three years and a maximum of eight years there have been only three recurrences. We believe that this method retains the high cure rate previously experienced with the standard Mohs' technique, but offers important advantages. References 1. Menn H, et al: The recurrent basal epithelioma . Arch Dermatol 103:628-631, 1971.Crossref 2. Mohs FE: Chemosurgery in Cancer, Gangrene and Infections . Springfield, Ill, Charles C Thomas Publisher, 1956, pp 116-117. 3. Tromovitch TA, Beirne G, Beirne C: Mohs' technique (cancer chemosurgery): Treatment of recurrent cutaneous carcinomas . Cancer 19:867-868, 1966.Crossref

Tindall, John P.;Whalen, Robert E.;Burton, E. Edward

1974 Archives of Dermatology

doi: 10.1001/archderm.1974.01630080035009

Abstract One hundred two patients with Raynaud syndrome have been treated with intra-arterial injections of reserpine. Two thirds of them had good or excellent responses when they were reevaluated after one month. Benefits continued in some patients for many months. There was no important difference in the clinical responsiveness between those with Raynaud disease (50 patients) and those with Raynaud phenomenon (52 patients). Some patients with vascular problems of the lower extremities, other than Raynaud syndrome, likewise benefited from the treatment. Side effects were mild in degree and patient acceptance of the procedure was good. References 1. Raynaud AGM: Del's Axphyxie Locale et de la Gangrene Symetrique des Extremities . Paris, Rignoux, 1862, pp 6, 9. 2. Hutchinson J: Raynaud's phenomenon , abstracted. Med Press Circ 72:403-405, 1901. 3. Allen EV, Brown CE: Raynaud's disease: A critical review of minimum requisites for diagnosis . Am J Med Sci 183:187-200, 1932.Crossref 4. Laws JW, et al: Arteriographic appearance in rheumatoid arthritis and other disorders . Br J Radiol 36:477-493, 1963.Crossref 5. Marshall TR, et al: Hand arteriography . Radiology 86:299-304, 1966.Crossref 6. Roy P: Peripheral angiography in ischemic arterial disease of the limbs . Radiol Clin N Am 5:467-496, 1967. 7. Willerson JT, et al: Reserpine in Raynaud's disease and phenomenon . Ann Int Med 72:17-27, 1970.Crossref 8. Gifford RW Jr: The clinical significance of Raynaud's phenomenon and Raynaud's disease . Med Clin N Am 42:963-970, 1958. 9. Wilson RH, et al: Occupational acro-osterolysis . JAMA 201:577-581, 1967.Crossref 10. Olin R: Arterial occlusion caused by jobs that are hard on the hands . Med Times 99:178-192, 1971. 11. White fingers, editorial . JAMA 215:631, 1971.Crossref 12. Birnstingl M: The Raynaud syndrome . Postgrad Med J 47:297-312, 1971.Crossref 13. Abboud FM, et al: Preliminary observations on the use of intra-arterial reserpine in Raynaud's phenomenon . Circulation 36:49, 1967. 14. Kontos HA, Wasserman AJ: Effect of reserpine in Raynaud's phenomenon . Circulation 39:259-266, 1969.Crossref 15. Romeo SG, et al: Intra-arterial administration of reserpine . Arch Intern Med 125:825-830, 1970.Crossref 16. Raynaud M: On Local Asphyxia and Symmetrical Gangrene of the Extremities (1862), and New Researches on the Nature and Treatment of Local Asphyxia of the Extremities (1874) . Barlow (trans), London, New Sydenham Society, 1888. 17. Lewis T: Experiments relating to the peripheral mechanism involved in the spasmodic arrest of the circulation in the fingers: A variety of Raynaud's disease . Heart 15:7-10, 1929. 18. Fox RH: Effects of cold on the extremities . Proc R Soc Med 61:785-789, 1968. 19. Downey JA, et al: Thermoregulation and Raynaud's phenomenon . Clin Sci 40:211-219, 1971. 20. Jamieson GG, et al: Cold hypersensitivity in Raynaud's phenomenon . Circulation 44:254-264, 1971.Crossref 21. Peacock JH: Peripheral venous blood concentration of epinephrine and norepinephrine in primary Raynaud's disease . Circ Res 7:821-827, 1959.Crossref 22. De la Lande IS, et al: The peripheral dilator action of reserpine in man . Aust J Exp Biol Med Sci 38:313-320, 1960.Crossref 23. Sapira JD, et al: Studies of endogenous catecholmaines in patients with Raynaud's phenomenon secondary to progressive systemic sclerosis (scleroderma) . Am J Med 52:330-337, 1972.Crossref 24. Mendlowitz M, Naftchi N: The digital circulation in Raynaud's disease . Am J Cardiol 4:580-584, 1959.Crossref 25. Kleckner MS Jr, et al: The effect of local application of glyceryl trinitrate (nitroglycerine) on Raynaud's disease and Raynaud's phenomenon: Studies on blood flow and clinical manifestations . Circulation 3:681-689, 1951.Crossref 26. Hall KV, Hillestad LL: Raynaud's phenomenon treated with sympathectomy . Angiology 11:186, 1960.Crossref 27. Johnston ENM, et al: Prognosis in Raynaud's phenomenon after sympathectomy . Br Med J 1:962-964, 1965.Crossref 28. De Takatas G, Fowler EF: Raynaud's phenomenon . JAMA 179:1-8, 1962.Crossref 29. Holti G: The effect of intermittent low molecular weight dextran infusions upon the digital circulation in systemic sclerosis . Br J Dermatol 77:560-568, 1965.Crossref 30. Lane P: Low molecular weight dextran infusions in systemic sclerosis with Raynaud's phenomenon: A report of nine cases . Br Med J 4:657-659, 1970.Crossref 31. Friend DG, Edwards EA: Use of "Dibenzyline" as a vasodilator in patients with severe digital ischemia . Arch Intern Med 92:928-937, 1954.Crossref 32. Wilson JL, Quash ET: Intra-arterial and oral priscoline: A clinical report . Am J Surg 81:336-340, 1951.Crossref 33. Van Itallie TB, Clark LW Jr: The effect of priscoline on peripheral blood flow in normal subjects and patients with peripheral vascular disease . Circulation 3:820-829, 1951.Crossref 34. Lippman HI: Intra-arterial priscoline therapy for peripheral vascular disturbances . Angiology 3:69-97, 1952.Crossref 35. Creery RDG, et al: Raynaud's disease treated with griseofulvin . Arch Dis Child 43:344-346, 1968.Crossref 36. Giordano M: Griseofulvin for scleroderma . Lancet 2:260, 1967.Crossref 37. Allen BR: Griseofulvin in Raynaud's phenomenon . Lancet 2:840-841, 1971.Crossref 38. Rubin AA: Coronary vascular effects of griseofulvin . JAMA 185:971-972, 1963.Crossref 39. Birk RE, Rupe CE: The treatment of systemic sclerosis with disodium EDTA, pyridoxine and reserpine . Henry Ford Hosp Med Bull 14:109-118, 1966. 40. Peacock JH: The treatment of primary Raynaud's disease of the upper limb . Lancet 2:65-69, 1960.Crossref 41. Alpers HS, Shore PA: Specific binding of reserpine: Association with norepinephrine depletion . Biochem Pharmacol 18:1363-1372, 1969.Crossref 42. Maass AR, et al: Studies on absorption, excretion, and metabolism of 3H-Reserpine in man . Clin Pharm Therap 10:366-371, 1969. 43. Burn JH, Rand MJ: Noradrenalin in artery walls and its dispersal by reserpine . Br Med J 1:903-908, 1958.Crossref 44. Von Euler UW, Lishajko F: Effect of reserpine on release of noradrenalin from transmitter granules in adrenergic nerves . Science 132:351-352, 1960.Crossref 45. Campos HA, et al: Subcellular sites of the catecholamine-depleting action of reserpine in the heart . J Pharmacol Exp Therap 153:448-454, 1966. 46. Coffman JD, Cohen AS: Total and capillary fingertip blood flow in Raynaud's phenomenon . N Engl J Med 285:259-262, 1971.Crossref

Burdick, Kenneth H.

1974 Archives of Dermatology

doi: 10.1001/archderm.1974.01630080040010

Abstract The standard vasoconstrictor assay has been of proven value in ranking the potencies of topically applied corticosteroids from alcoholic solutions. Shortening the time of application, omitting occlusion, and using multiple reading times has allowed valuable observations to be made on the effective delivery of corticosteroids from their vehicles. As with any biologic assay, substantial variation does occur. These inherent errors may be reduced by preselection of subjects and the use of sufficient numbers of subjects and sites. Interpretive errors can be reduced by using two independent readers, randomization of the test materials, the use of a patterned square site, and standard lighting conditions. References 1. Burdick KH, Poulsen BJ, Place VA: Extemporaneous formulation of corticosteroids for topical usage . JAMA 211:462-466, 1970.Crossref 2. Burdick KH: Corticosteroid bioavailability assays: A correlation with a clinical study . Acta Derm Venereol 52( (suppl 67) ):19-23, 1972. 3. Burdick KH, et al: Corticosteroid ointments: Comparison by two human bioassays . Curr Ther Res , to be published. 4. McKenzie AW, Stoughton RB: Method for comparing percutaneous absorption of steroids . Arch Dermatol 86:608-610, 1962.Crossref 5. Stoughton RB: Bioassay system for formulations of topically applied glucocorticosteroids . Arch Dermatol 106:825-827, 1972.Crossref 6. Coldman MF, Lockerbie L, Laws EA: The evaluation of a novel corticosteroid formulation, fluocinonide in "FAPG" base, in the blanching test . Br J Dermatol 85:573-576, 1971.Crossref 7. Moore-Robinson M, Christie GA: Vasoconstrictor activity of topical corticosteroids—methodology and results . Br J Dermatol 82( (suppl 6) ):86-92, 1970.Crossref 8. Ortega E, et al: The croton oil inflammation suppression assay as a measure of topical corticosteroid potency . Acta Derm Venereol 52( (suppl 67) ):95-97, 1972. 9. Dumas KJ, Scholtz JR: The psoriasis bio-assay for topical corticosteroid activity . Acta Derm Venereol 52:43-48, 1972. 10. Burdick KH: Evaluation of a new corticosteroid, fluocinonide in a scientifically designed base . Acta Derm Venereol 52( (suppl 67) ):24-27, 1972. 11. Coldman MF, Lockerbie L: Placebo ointment response in the blanching test . Br J Dermatol 85:398-399, 1971.Crossref 12. Barry BW, Woodford R: Placebo response to white soft paraffin/propylene glycol in skin blanching test . J Pharm Pharmacol 24( (suppl 24) ):174-175, 1972.Crossref 13. Place VA, Giner-Velasquez J, Burdick KH: Precise evaluation of topically applied corticosteroid potency: Modification of the Stoughton-McKenzie assay . Arch Dermatol 101:531-537, 1970.Crossref 14. Evans DP, Hossack M, Thomason DS: Inhibition of contact sensitivity in the mouse by topical application of corticosteroids . Br J Pharmacol 43:403-408, 1971.Crossref 15. Sutton PM, Feldmann RJ, Maibach HI: Vasoconstrictor potency of corticoids: Intradermal injection . J Invest Dermatol 57:371-376, 1971.Crossref 16. Poulsen BJ, Burdick K, Bessler S: Paired comparison vasoconstrictor assays: A comparison of methods for the determination of relative vasoconstrictor potency of topically applied corticosteroids . Arch Dermatol 109:367-371, 1974.Crossref 17. Ostrenga JA, Steinmetz C: Estimation of steroid solubility: Use of fractional molar attraction constants . J Pharm Sci 59:414-416, 1970.Crossref 18. Sarkany I, Hadgraft JW: The influence of formulation on topical corticosteroid activity . Br J Dermatol 81( (suppl 4) ):98-102, 1969.Crossref 19. Coldman MF, Poulsen BJ, Higuchi T: Enhancement of percutaneous absorption by the use of volatile: Nonvolatile systems as vehicles . J Pharm Sci 58:1098-1102, 1969.Crossref

Burket, John M.

1974 Archives of Dermatology

doi: 10.1001/archderm.1974.01630080045011

Abstract This is the first report, to my knowledge, of physiologic verification of neural alteration in patches of alopecia mucinosa. The patient had a loss of the triple response of Lewis, loss of histamine flare, and loss of sweat response to methacholine chloride in the areas of alopecia mucinosa. References 1. Johnson WC, Higdon R, Helwig E: Alopecia mucinosa . Arch Dermatol 79:395-406, 1959.Crossref 2. Fereira-Marques J: Sensory imbalance in alopecia mucinosa . Arch Dermatol 84:302-305, 1961.Crossref 3. Arnold HL: Dysesthesia in alopecia mucinosa, a possible diagnostic sign . Arch Dermatol 85:409-410, 1962.Crossref 4. Rothman S: Physiology and Biochemistry of the Skin . Chicago, University of Chicago Press, 1961, pp 163-172. 5. Eyster WH Jr, Roth GM, Kierland RR: Studies on the peripheral vascular physiology of patients with atopic dermatitis . J Invest Dermatol 18:37-45, 1952.Crossref 6. Lobitz WC, Campbell CJ: Physiologic studies in atopic dermatitis (disseminated neurodermatitis) . Arch Dermatol 67:575-589, 1953. 7. Burn JH: Relation of motor and inhibitor effects of local hormones . Physiol Rev 30:177-193, 1950. 8. Papa C, Kligman A: Mechanisms of eccrine anhidrosis . J Invest Dermatol 47:1-9, 1966.Crossref 9. Gordon B, Maibach H: On the mechanism of the inactive eccrine human sweat gland . Arch Dermatol 97:66-68, 1968.Crossref 10. Fan J, Chang H, Ma B: Alopecia mucinosa simulating leprosy . Arch Dermatol 95:354-356, 1967.Crossref

Emmett, Edward A.

1974 Archives of Dermatology

doi: 10.1001/archderm.1974.01630080047012

Abstract A case of photoallergic dermatitis to a topically applied diphenhydramine preparation was observed, and the diagnosis was confirmed by photopatch testing. This diphenhydramine photoallergy appears to differ from most other forms of photoallergies in that it is elicited by ultraviolet light in the 290 to 320-nm range (termed UV-B) instead of by the more usual 320- to 400-nm range (termed UV-A). This may be related to the photochemical properties of diphenhydramine, which absorbs In the UV-B but not in the UV-A, the UV-B absorption being associated with a distinctive fluorescence. It is noted that the cases of UV-B photoallergy described to date have certain clinical features In common. References 1. Vickers CFH: Dermatitis medicamentosa . Br Med J 1:1366-1367, 1961.Crossref 2. Epstein E: Allergy to dermatologic agents . JAMA 198:103-106, 1966.Crossref 3. Kauppinen K: Cutaneous reactions to drugs with special reference to severe bullous mucocutaneous eruptions and sulphonamides . Acta Derm Venereol 52( (supp 68) ):5-83, 1972. 4. Schreiber MM, Naylor LZ: Antihistamine photosensitivity . Arch Dermatol 86:106-110, 1962.Crossref 5. Newill, RGD: Photosensitivity caused by promethazine . Br Med J 2:359-360, 1960.Crossref 6. Stevanovic DV: Photosensitivity due to certain drugs . Br J Dermatol 73:233-237, 1961.Crossref 7. Sidi E, Hincky M, Gervais A: Allergic sensitization and photosensitization to phenergan cream . J Invest Dermatol 24:345-352, 1955.Crossref 8. Epstein S, Rowe RJ: Photoallergy and photocross-sensitivity to phenergan . J Invest Dermatol 28:319-326, 1957.Crossref 9. Duperrat B, Lamberton JN: Allergie à la phenothiazine . Bull Soc Franc Dermat et Syph 67:941-946, 1960. 10. Schulz KH, Wiskemann A, Wulf K: Klinische und experimentelle Untersuchungen über die photodynamische Wirksamkeit von Phenothiazinderivaten insbesondere von Megaphen . Arch Klin Exp Dermatol 202:285-298, 1956.Crossref 11. Wilkinson DS, et al: Terminology of contact dermatitis . Acta Derm Venereol 50:287-292, 1970. 12. Jung EG: Photoallergie durch triacetyldiphenolisatin (TDI): I. Kasuistik . Arch Klin Exp Dermatol 229:170-173, 1967.Crossref 13. Jung EG: Photoallergie durch triacetyldiphenolisatin (TDI): II. Photochemische Untersuchungen zur Pathogenese . Arch Klin Exp Dermatol 231:39-49, 1967.Crossref 14. Jagger J: Introduction to Research in Ultraviolet Photobiology . Englewood Cliffs, NJ, Prentice Hall Inc, 1967. 15. Harber LC, Baer RL: Pathogenic mechanisms of drug-induced photosensitivity . J Invest Dermatol 58:327-342, 1972.Crossref 16. Cripps DJ, Enta T: Absorption and action spectra studies on bithionol and halogenated salicylanilide photosensitivity . Br J Dermatol 82:230-242, 1970.Crossref 17. Harber LC, Targovnik SE, Baer RL: Contact photosensitivity patterns to halogenated salicylanilides: In man and guinea pigs . Arch Dermatol 96:646-653, 1966.Crossref

1974 Archives of Dermatology

doi: 10.1001/archderm.1974.01630080050013

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Nishikai, Masahiko;Funatsu, Yuzo;Homma, Mitsuo

1974 Archives of Dermatology

doi: 10.1001/archderm.1974.01630080051014

Abstract A 66-year-old Japanese man with systemic sclerosis had benign monoclonal gammopathy. Penicillamine therapy resulted in a hypersensitivity state, with marked eosinophilia. Later he developed polymyositis. Remission of the polymyositis and a decrease in the monoclonal immunoglobulin followed prednisolone therapy. Immunological disorders may play an important role in the pathogenesis of polymyositis. References 1. Hällén J: Discrete gammaglobulin (M-) components in serum . Acta Med Scand 179( (suppl 462) ):1-127, 1966. 2. Zawadzki Z, Edwards GA: Dysimmunoglobulinemia in the absence of clinical features of multiple myeloma and macroglobulinemia . Am J Med 42:67-88, 1967.Crossref 3. Michaux JL, Heremans JF: Thirty cases of monoclonal immunoglobulin disorders other than myeloma or macroglobulinemia: A classification of diseases associated with the production of monoclonal-type immunoglobulins . Am J Med 46:562-579, 1969.Crossref 4. Ogryzlo MA, et al: The serum proteins in health and disease: Filter paper electrophoresis . Am J Med 27:596-616, 1959.Crossref 5. Gothoni G, Wassastjirna C, Jeglinsky B: Macroglobulinaemia: Primary (Waldenström) and symptomatic in rheumatoid arthritis . Acta Med Scand 177:263-273, 1965. 6. McFarlane H, Nwokolo C: Waldenström type macroglobulinemia in a Nigerian with rheumatoid arthritis . J Clin Pathol 19:603-605, 1966.Crossref 7. Jensen K, et al: Characterization of M-components in a large municipal hospital . Dan Med Bull 16:165-170, 1969. 8. Kawai T: Serum Protein . Tokyo, Igaku Shoin, 1969, p 582. 9. Zawadzki ZA, et al: Rheumatoid arthritis terminating in heavy-chain disease . Ann Intern Med 70:335-347, 1969.Crossref 10. Rhomberg W: Beitrag zur Kenntnis der sogenannten rudimentären Paraproteinämien . Schweiz Med Wochenschr 98:568-574, 1968. 11. Scheurlen PG: Atypische Gamma-Globuline bei nichthaematologischen Erkrankungen . Verh Dtsch Ges Inn Med 69:451-456, 1963. 12. Epstein WV, Tan M: Bence Jones proteinemia associated with systemic lupus erythematosus . Arthritis Rheum 7:733-734, 1964. 13. Abramson N, Shattil SJ: M-components . JAMA 223:156-159, 1973.Crossref 14. Starobinski-Sirman JH: Periarterite noueuse et macroglobulinémie . Schweiz Med Wochenschr 93:669-675, 1963. 15. Linquette M, et al: Un cas de peraprotéinémie avec sclerodermie . Lille Med 12:1346-1350, 1967. 16. Lindström FD: Urinary immunoglobulins in rheumatoid arthritis and other connective tissue diseases . Ann Clin Res 3:39-45, 1971. 17. Klein H, Block M: Bone marrow plasmacytosis . Blood 8:1034-1041, 1953. 18. Clark H, Muirhead EE: Plasmacytosis of bone marrow . Arch Intern Med 94:425-432, 1954.Crossref 19. Porter DD, Dixon FJ, Larsen AE: The development of a myeloma-like condition in mink with Aleutian disease . Blood 25:736-742, 1965. 20. Sheard C Jr: Dermatomyositis . Arch Intern Med 88:640-658, 1951.Crossref 21. Wedgewood RJP, Cook CD, Cohen J: Dermatomyositis: Report of 26 cases in children with a discussion of endocrine therapy in 13 . Pediatrics 12:447-466, 1953. 22. Mackie B: Dermatomyositis induced by drugs . Aust J Dermatol 8:249-251, 1966. 23. Hyman I, Arbesman CE, Terplan KL: Dermatomyositis following penicillin injections . Neurology 6:63-67, 1956.Crossref 24. Petera V, Hula M: Lupusovy exantem po lecebe penicillaminem u nemocne s lupoidni diathezou . Cas Lek Cesk 106:784-786, 1967. 25. Harpey JP, et al: Lupus-like syndrome induced by D-penicillamine in Wilson's disease . Lancet 1:292, 1971.Crossref 26. Schraeder PL, Peters HA, Dahl DS: Polymyositis and penicillamine . Arch Neurol 27:456-457, 1972.Crossref 27. Nishikai M, Homma M: Anti-myoglobin antibody in polymyositis . Lancet 2:1205-1206, 1972.Crossref

Kolton, Bruce;Pedersen, James

1974 Archives of Dermatology

doi: 10.1001/archderm.1974.01630080054015

Abstract Metastatic calcinosis cutis occurred in a patient with chronic renal failure. Prompt clinical clearing of the lesions was noted after treatment with phosphorus-binding antacids and the subsequent lowering of the serum phosphorus level. References 1. Miller LM, Krane SM: Calcification and ossification of the skin and subcutaneous tissues in Fitzpatrick TB, et al (eds): Dermatology in General Medicine . New York, McGraw-Hill Book Co Inc, 1971, pp 1204-1211. 2. Virchow R: Kalkmetastasen . Arch Path Anat Physiol 8:103-113, 1855.Crossref 3. Parfitt AM: Soft tissue calcification in uremia . Arch Intern Med 124:544-556, 1969.Crossref 4. Thomas WS, in discussion, Weidman FD, Schaffer LW: Calcification of the skin, including the epiderm, in connection with extensive bone resorption . Arch Dermatol Syphilol 14:503-532, 1926.Crossref 5. Platt R, Owen TK: Renal dwarfism associated with calcification of arteries and skin . Lancet 7:135-137, 1934.Crossref 6. Soffer LJ, Cohn C: Primary and secondary hyperparathyroidism . Arch Intern Med 71:630-649, 1943.Crossref 7. Wibley JEM, Hunter D: Calcinosis in a case of chronic nephritis with secondary hyperparathyroidism . Proc R Soc Med 38:141, 1945. 8. Putkonen T, Wangel GA: Renal hyperparathyroidism with metastatic calcification of the skin . Dermatologica 118:127-144, 1959.Crossref 9. Jackson R, Munkittrick R: Secondary hyperparathyroidism in chronic renal disease with metastatic skin calcification . Can Med Assoc J 87:745-751, 1962. 10. Posey RE, Ritchie EB: Metastatic calcinosis cutis with renal hyperparathyroidism . Arch Dermatol 95:505-508, 1967.Crossref 11. Eisenberg E, Bartholow PV: Reversible calcinosis cutis . N Engl J Med 268:1216-1220, 1960.Crossref 12. Hamper CL, Katz AL, Merril JR: Calcium metabolism and osteodystrophy after renal transplantation . Arch Intern Med 124:282-291, 1969.Crossref 13. Parfitt M, et al: Disordered calcium and phosphorus metabolism during maintenance hemodialysis . Am J Med 51:319-330, 1971.Crossref 14. Ball JH, et al: The many facets of secondary hyperparathyroidism . Arch Intern Med 131:746-749, 1973.Crossref

Petrozzi, John W.;Warthan, T. Lynn

1974 Archives of Dermatology

doi: 10.1001/archderm.1974.01630080056016

Abstract Malignant external otitis represents a severe, progressive Pseudomonas infection. Although it begins locally in the external auditory canal, it may invade soft tissues and bone and lead to parotitis, mastoiditis, cranial nerve palsies, meningitis, and death. Elderly diabetics appear most vulnerable, but it is thought that any impairment of host resistance may predispose to this disease. Early diagnosis with prompt administration of antibiotics and surgical intervention can prove lifesaving. References 1. Chandler JR: Malignant external otitis . Laryngoscope 78:1257-1294, 1968.Crossref 2. Wilson DF, Pulec JL, Linthicum FH: Malignant external otitis . Arch Otolaryngol 93:419-422, 1971.Crossref 3. Dinapoli RP, Juergen E: Neurologic aspects of malignant external otitis: Report of three cases . Mayo Clin Proc 46:339-344, 1971. 4. Chandler JR: Pathogenesis and treatment of facial paralysis due to malignant external otitis . Ann Otol Rhinol Laryngol 81:648-658, 1972. 5. McGonigle JJ, Jillson OF: Otomycosis: An entity . Arch Dermatol 95:45-46, 1967.Crossref 6. Saltzman M: Otitis externa: Clinical aspects and bacteriologic studies . Clin Med 70:559-570, 1963. 7. Mowat AG, Baum J: Chemotaxis of polymorphonuclear leukocytes from patients with diabetes mellitus . N Engl J Med 284:621-627, 1971.Crossref 8. Perry ET: The Human Ear Canal , Illinois, CC Thomas, 1957, pp 49-50. 9. Hall JJ, et al: Pseudomonas aeruginosa in dermatology . Arch Dermatol 97:312-324, 1968.Crossref 10. Ervasti E: Frostbites of the extremities and their sequelae . Acta Chir Scand , (Supp 299) , pp 1-69, 1962. 11. Mendlowitz M, Abel HA: Quantitative blood flow measured calorimetrically in the human toe in normal subjects and in patients with residua of trench foot and frostbite . Am Heart J 39:92-98, 1950.Crossref 12. Blair JR, Schatzki R, Orr KD: Sequelae to cold injury in one hundred patients . JAMA 169:1203-1208, 1957.Crossref 13. Fisher JK: Case of chronic cellulitis of left ear . Arch Dermatol 100:505-506, 1969.Crossref 14. Ballenger JJ: Diseases of the Nose, Throat, and Ear , ed 11. Philadelphia, Lea & Febiger, 1969. 15. Jackson C, Jackson CL: Diseases of the Nose, Throat, and Ear , ed 2. Philadelphia, WB Saunders, 1959, p 351.

Dorfman, Maurice L.;Hershko, Chaim;Eisenberg, Shlomo;Sagher, Felix

1974 Archives of Dermatology

doi: 10.1001/archderm.1974.01630080059017

Abstract Two sisters and two unrelated patients with an ichthyosiform dermatosis resembling nonbullous ichthyosiform erythroderma were found to have lipid accumulations in the granulocytes of the peripheral blood, in the granulocyte precursors in the bone marrow, and in the liver. In each case, the blood anomaly was readily detected on examining a peripheral smear. One patient showed many of the features seen in Refsum syndrome. This association of findings in four patients may constitute another neurocutaneous lipidosis. References 1. Refsum S, Salomonsen L, Skatvedt M: Heredopathia atactica polyneuritiformis in children . J Pediatr 35:335-343, 1949.Crossref 2. Sjögren T, Larsson T: Oligophrenia in combination with congenital ichthyosis and spastic disorders: A clinical and genetic study . Acta Psychiatr Scand 32( (suppl 113) ):1-112, 1957. 3. Netherton EW: A unique case of trichorrhexis nodosa-"bamboo hairs." Arch Dermatol 78:483-487, 1958.Crossref 4. Reed WB: Congenital cutaneous diseases associated with central nervous system disorders . Postgrad Med 41:527-536, 1967. 5. Sever RJ, Frost P, Weinstein G: Eye changes in ichthyosis . JAMA 206:2283-2286, 1968.Crossref 6. Goyer RA, et al: Hereditary renal disease with neurosensory hearing loss, prolinuria, and ichthyosis . Am J Med Sci 256:166-179, 1968.Crossref 7. Reed WB: Classification of ichthyosiform dermatoses . Arch Dermatol 101:620, 1970.Crossref 8. Tay CH: Ichthyosiform erythroderma, hair shaft abnormalities, and mental and growth retardation . Arch Dermatol 104:4-13, 1971.Crossref 9. Giroux JM, Barbeau A: Erythrokeratodermia with ataxia . Arch Dermatol 106:183-188, 1972.Crossref 10. Steinberg D, et al: The enzymatic defect in Refsum's disease . J Clin Invest 46:1120, 1967.Crossref 11. Rozenszajn L, et al: Jordans' anomaly in white blood cells . Blood 28:258-265, 1966. 12. Jordans GH: The familial occurrence of fat-containing vacuoles in the leucocytes diagnosed in two brothers suffering from progressive muscular dystrophy (Erb) . Acta Med Scand 145:419-423, 1953.Crossref 13. Schnyder UW: Inherited ichthyoses . Arch Dermatol 102:240-252, 1970.Crossref 14. Heycock JB, Wilson J: Diabetes mellitus in a child showing features of Refsum's syndrome . Arch Dis Child 33:320-322, 1958.Crossref 15. Nehlil J: Multinévrite a rechutes associée a des manifestations osseuses cutanées et cardiaques: Affection apparentée à la maladie de Refsum ou maladie autonome? Presse Med 73:2081-2084, 1965. 16. Rubin E, et al: Hepatic injury in chronic hypervitaminosis A . Am J Dis Child 119:132-138, 1970. 17. Muenter MD, Perry HO, Ludwig J: Chronic vitamin A intoxication in adults . Am J Med 50:129-136, 1971.Crossref 18. Vandersteen PR, Muller SA: Lamellar ichthyosis: An enzyme, histochemical, light and electron microscopic study . Arch Dermatol 106:694-701, 1972.Crossref 19. Frost P, et al: Ichthyosiform dermatoses: III. Studies of transepidermal water loss . Arch Dermatol 98:230-233, 1968.Crossref 20. Bettley FR: Lipomelanic lymphadenopathy . Acta Derm Venereol 31:111-116, 1951. 21. Lever WF: Histopathology of the Skin , ed 4. Philadelphia, JB Lippincott Co, 1967, p 109. 22. Craddock CG: Production, distribution, and fate of granulocytes , in Williams WJ, Beutler E, Erslev AJ, Rundles RW (eds): Hematology . New York, McGraw-Hill Book Co Inc, 1972, pp 607-618.

Mikhail, George R.

1974 Archives of Dermatology

doi: 10.1001/archderm.1974.01630080065018

Abstract Four patients with a primary histological diagnosis of Bowen disease of the nail bed were treated by the Mohs chemosurgery technique. The presence of invasive squamous cell carcinoma was disclosed during chemosurgery in three cases. The fourth case had already progressed to invasive squamous cell carcinoma before treatment. It is urged that biopsies be performed in all cases of persistent and recurrent disease of the nail bed so that an early diagnosis may be made and treatment instituted before the development of invasive carcinoma. Mohs chemosurgery permits adequate excision of the tumor with maximal preservation of normal tissue and function. References 1. Bowen JT: Precancerous dermatoses . J Cutan Dis 30:241-255, 1912. 2. Pardo-Castello V, Pardo OA: Diseases of the Nail . Springfield, Ill, Charles C Thomas Publisher, 1960, pp 88-91. 3. Coskey RJ, Mehregan A, Fosnaugh R: Bowen's disease of the nail bed . Arch Dermatol 106:79-80, 1972.Crossref 4. Dieteman DF: Bowen's disease of the nail bed . Arch Dermatol 108:577-578, 1973.Crossref 5. Mohs FE: Chemosurgery in Cancer, Gangrene and Infections . Springfield, Ill, Charles C Thomas Publisher, 1956. 6. Graham JH, Helwig EB: Premalignant cutaneous and mucocutaneous diseases , in Graham JH, Johnson WC, Helwig EB (eds): Dermal Pathology . Hagerstown, Md, Harper & Row Publishers Inc, 1972, pp 581-597. 7. Bowen JT: Precancerous dermatoses . J Cutan Dis 33:787-802, 1915. 8. Pinkus H, Mehregan AH: A Guide to Dermatohistopathology . New York, Appleton-Century-Crofts Publisher, 1969, pp 406-408. 9. Jansen GT, Dillaha CJ, Honeycutt WM: Bowenoid conditions of the skin: Treatment with topical 5-fluorouracil . South Med J 60:185-188, 1967.Crossref 10. Klein E, et al: Tumors of the skin. XII: Topical 5-fluorouracil for epidermal neoplasms . J Surg Oncol 3:331-349, 1971.Crossref 11. Belisario JC: Topical use of 5-fluorouracil . Med J Aust 2:91, 1973. 12. Zala L: Histologische Befunde bei Behandlung von Hautneoplasm mit 5-Fluorouracil-Salbe . Dermatologica 145:326-333, 1972.Crossref 13. Boyes JH: Carcinoma of the nail , in Bunnell's Surgery of the Hand . Philadelphia, JB Lippincott Co, 1970, pp 702-703. 14. Campbell CJ, Keokarn T: Squamous-cell carcinoma of the nail bed in epidermal dysplasia . J Bone Joint Surg 84A:92-99, 1966. 15. Mineiro LEG, Salter JJ, Orduna CC: Squamous cell carcinoma of the nail bed . Arch Surg 100:6-7, 1970.Crossref 16. Eichenholtz SN, De Angelis C: Squamous-cell carcinoma of nail bed . JAMA 191:1080-1082, 1965.Crossref 17. Nelson MN, Hamilton CF: Primary carcinoma of the nail bed . Arch Dermatol 101:63-67, 1970.Crossref 18. Eibel P: Squamous-cell carcinoma of the nail bed . Clin Orthop 74:155-160, 1971.Crossref 19. Guides to the Evaluation of Permanent Impairment . Chicago, Ill, American Medical Association, 1971, pp 4-5.

Goette, Detlef K.

1974 Archives of Dermatology

doi: 10.1001/archderm.1974.01630080069019

Abstract Erythroplasia of Queyrat in a 72-year-old patient was successfully treated with 5% fluorouracil cream topically in four weeks without any discomfort. The course of involution of the lesion and the pretreatment and posttreatment biopsy specimens are pictorially presented. References 1. Queyrat L: Erythroplasie du gland . Bull Soc Fr Dermatol Syphiligr 22:378-382, 1911. 2. Tarnovsky VM: Congres des Medicins Russes, Moscow, Jan 19,1891 . Ann Dermatol Syphiligr 2:410-411, 1891. 3. Fournier A, Darier J: Epithelioma benin syphiloide de la verge . Bull Soc Fr Dermatol Syphiligr 4:324-328, 1893. 4. Sulzberger MB, Satenstein DL: Erythroplasia of Queyrat . Arch Dermatol Syphilol 28:798-806, 1933.Crossref 5. McCrea LE: Erythroplasia of Queyrat: Report of a case . J Urol 60:776-779, 1948. 6. Friedman S: Queyrat's erythroplasia with carcinomatous invasion: Report of an unusual case . J Urol 69:813-814, 1953. 7. McAninch JW, Moore CA: Precancerous penile lesions in young men . J Urol 104:287-290, 1970. 8. Blau S, Hyman AB: Erythroplasia of Queyrat . Acta Derm Venereol 35:341-378, 1955. 9. Graham JH, Johnson WC, Helwig EB (eds): Premalignant cutaneous and mucocutaneous disease , in Dermal Pathology . Harper & Row, Hagerstown, Md, 1972, p 597. 10. Carteaud A, Meyer JJ, Lebron F: Erythroplasie vulvaire . Bull Soc Fr Dermatol Syphiligr 57:321-323, 1950. 11. MacDonald WI: Erythroplasia of Queyrat in a female . Arch Dermatol Syphilol 43:919, 1941. 12. Touraine A, Solente G: L'erythroplasie . Presse Med 44:1830-1833, 1936. 13. Klinger ME, Northrup RU: The erythroplasia of Queyrat: Two case reports . J Urol 63:173-175, 1950. 14. Jansen GT, Dillaha CJ, Honeycutt WM: Bowenoid conditions of the skin: Treatment with topical 5-fluorouracil . South Med J 60:185-188, 1967.Crossref 15. Lewis RJ, Bendl BJ: Erythroplasia of Queyrat: Report of a successfully treated patient with topical 5-fluorouracil . Can Med Assoc J 104:148-149, 1971. 16. Hall TB, Hoffman RL, Newman R: Erythroplasia of Queyrat . Urol Cut Rev 39:21-23, 1935. 17. Chargin L: Carcinoma of the penis (erythroplasia of Queyrat) . Arch Dermatol Syphilol 33:579-580, 1936. 18. Shapiro L, Boyarski S, Roberts TW: Carcinoma developing in Queyrat's erythroplasia . NY State J Med 62:2999-3001, 1962. 19. Hueser JN, Pugh RP: Erythroplasia of Queyrat treated with topical 5-fluorouracil . J Urol 102:595-597, 1969. 20. Dillaha CJ, Jansen GT, Honeycutt WM: Selective cytotoxic effects of topical 5-fluorouracil . Arch Dermatol 88:247-256, 1963.Crossref 21. Dillaha CJ, et al: Further studies with 5-fluorouracil . Arch Dermatol 92:410-417, 1965.Crossref

1974 Archives of Dermatology

doi: 10.1001/archderm.1974.01630080071020

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Grossman, Jay R.;Izuno, Gene T.

1974 Archives of Dermatology

doi: 10.1001/archderm.1974.01630080072021

Abstract A 65-year-old man had a primary mucinous tumor of the right side of the neck with distinctive histologic and histochemical features. Primary mucinous (adenocystic) carcinoma of the skin should be differentiated from the sweat gland carcinomas in general since their biologic reaction is characterized by a very low incidence of metastasis. References 1. Mendoza S, Helwig E: Mucinous (adenocystic) carcinoma of the skin . Arch Dermatol 103:68-78, 1971.Crossref 2. Stout AP, Cooley SGE: Carcinoma of sweat glands . Cancer 4:521-536, 1951.Crossref 3. Miller WL: Sweat gland carcinoma . Am J Clin Pathol 47:767-780, 1967. 4. Paret-Raymond G, Johnson W: Adenocarcinoma of the eccrine sweat gland . Arch Dermatol 107:44-46, 1973. 5. Johnson WC, Helwig EB: Adenoid squamous cell carcinoma (adenoacanthoma) . Cancer 19:1639-1650, 1966.Crossref 6. Montagna W, Chase HB, Tobitz WC: Histology and cytochemistry on human skin: IV. The eccrine sweat glands . J Invest Dermatol 20:415-523, 1953. 7. Norris HJ, Taylor HB: Prognosis of mucinous (gelatinous) carcinoma of the breast . Cancer 18:875-885, 1965.Crossref

1974 Archives of Dermatology

doi: 10.1001/archderm.1974.01630080075022

Abstract Rees B. Rees Tours Europe for AAD; Dome Lecturer Visits Four Countries Four countries were included in the overseas tour of the 1974 American Academy of Dermatology Dome Lecturer this summer. Rees B. Rees, M.D., San Francisco, California, was the 10th American dermatologist to be honored with the Academy's Dome Lectureship. Selection is made annually by the AAD's Committee on Education, based primarily on the recipient's contribution to dermatological education and original research. Dr. Rees is Clinical Professor of Dermatology and Radiology at the University of California, San Francisco. In a four-week period, the California dermatologist visited France, Bulgaria, Austria and England. The French leg of the educational tour included lectures at the Rothschild Foundation and at St. Louis Hospital, both in Paris. In Sofia, Bulgaria, Dr. Rees spoke at the Institute of Dermatology and Venerology Academy of Medicine. In Vienna, Austria, the Dome Lecturer was a guest Professor

Tuffanelli, Denny L.

1974 Archives of Dermatology

doi: 10.1001/archderm.1974.01630080078023

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract Malpractice and the Dermatologist The possibility of being sued, the cost of malpractice insurance, and the time spent considering the implications of malpractice are playing an increasingly important role in the practice of dermatology. In northern California, the number of yearly claims for all physicians rose from 11.8 per 100 physicians in 1968 to 21 per 100 physicians in 1969.The rise in the number of claims has been accompanied by a rapid rise in insurance premiums. In northern California, the average premium has risen 400% since 1968. In southern California, a 400% increase occurred between 1967 and 1969 alone. Recently, the rises have been even more spectacular. In California and New York, the major insurance carriers have decided to drop the medical malpractice insurance entirely. Medicolegal Organizations As the magnitude of the malpractice problem increases, organizational attempts to find solutions have also increased. In 1971, the secretary of the Department of Health, Education,

Catalano, Philip M.

1974 Archives of Dermatology

doi: 10.1001/archderm.1974.01630080082024

References 1. McDuffie FC: Serum complement levels in cutaneous diseases . Br J Dermatol 82( (suppl 5) ):20-23, 1970.Crossref 2. McDuffie FC, et al: Hypocomplementemia with cutaneous vasculitis and arthritis . Mayo Clin Proc 48:340-348, 1973.

Elias, Peter M.

1974 Archives of Dermatology

doi: 10.1001/archderm.1974.01630080083026pmid: 4852933

Abstract To the Editor.— Reid et al1 have admirably documented a case of staphylococcal toxic epidermal necrolysis (TEN) in an adult who had renal failure and impaired delayed hypersensitivity. As recently stated,2 the distinctive histologic features of drug-induced vs staphylococcal TEN allow rapid differentiation between these two entities, which can then be treated by appropriate therapy, pending results of culture studies. Isolation of group 2 organisms and demonstration of their exfoliative capacity in neonatal mice is usually much more time-consuming (and perhaps less reliable, since such organisms could be secondary invaders2).In seeking to explain the generalized TEN in their patient, Reid et al focused on the immunological defect discovered. The fact that in this case, as well as in the case reported earlier by Levine and Norden,3 the patients had renal insufficiency was not considered important per se. I suggest that while immune factors may have References 1. Reid LH, Weston WL, Humbert JR: Staph ylococcal scalded skin syndrome: Adult onset in a patient with deficient cell-mediated immunity . Arch Dermatol 109:239-241, 1974.Crossref 2. Elias PM, Arndt KA, Peck GL: Scalded skin syndrome in adults . N Engl J Med 288:582-583, 1973.Crossref 3. Levine G, Norden CW: Staphylococcal scalded skin syndrome in an adult . N Engl J Med 287:1339-1340, 1972.Crossref 4. Elias PM, et al: Experimental staphylococcal toxic epidermal necrolysis in adult humans and mice . Clin Res 22:158a, 1974. 5. Melish ME, Glasgow LA, Turner MD: The staphylococcal scalded-skin syndrome: Isolation and partial characterization of the exfoliative toxin . J Infect Dis 125:129-140, 1972.Crossref 6. Elias PM, et al: Staphylococcal toxic epidermal necrolysis: The expanded mouse model . J Lab Clin Med , to be published. 7. Rothenberg R, et al: Staphylococcal scalded skin syndrome in an adult . Arch Dermatol 108:408-410, 1973.Crossref

Golden, Theodore A.;McElveen, Fred J.;Jupia, James E.

1974 Archives of Dermatology

doi: 10.1001/archderm.1974.01630080083025

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract The intent of the Letters section is not only to remark about previously published manuscripts, but also to offer a new observation, a new technique, or to describe an interesting patient. An attempt is made to publish most letters that are received without subjecting them to multiple critical reviews, and proved scientific validity is not a prerequisite factor.—Eds. To the Editor.— We would like to report a case of hematuria following the administration of thiabendazole (Mintezol Suspension) since it has not, to our knowledge, been previously reported in the dermatologic literature.A 21-year-old man was first seen on Aug 13, 1973, with a foot eruption of several days' duration. Prior to the onset of the eruption, he had been walking barefoot at the local beach. Examination revealed numerous raised exudative serpiginous tracts on the plantar surfaces of both feet, and a diagnosis of larva cutaneous migrans was made. Treatment

Frankel, Edward B.

1974 Archives of Dermatology

doi: 10.1001/archderm.1974.01630080084028pmid: 4852780

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract To the Editor.— A 41-year-old white man has been followed up during the past year for multiple leiomyomas. The patient's lesions are scattered in a general and symmetrical distribution, sparse on the torso, slightly increased on the upper extremities, but almost confluent on the lower extremities. The patient came to me with a history of prior examination at University of California Los Angeles clinics; the treatment consisted of excision of painful nodules, desiccation and curettage, and amitriptyline hydrochloride (Elavil HCl) therapy, which brought intermittent relief of the pain.The major complaint was pain. The patient also indicated that pain could be brought on by a cool breeze and changes in temperature.Since, ethaverine HCl (Ethaquin) therapy produces smooth muscle relaxation affecting the larger blood vessels, I hoped that this therapy might lessen the pain, which I attributed to contraction of abnormal smooth muscle cells. The patient is being maintained on

Bentley-Phillips, Barry

1974 Archives of Dermatology

doi: 10.1001/archderm.1974.01630080084029

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract To the Editor.— I was most interested in the case presented at the San Francisco Dermatological Society meeting by Odom and Stein as given in the Archives (108:848, 1973), since my paper on this subject (S Afr Med J 48:810, 1974) has just been published. Three cases are described, all in black African hospital workers, and they are attributed to contact with an undiluted disinfectant, O'Syl (Lysol backwards!).Patient 1 is a male cleaner who did not dilute the disinfectant, patient 2 is a female nurse who "disinfects" her hands with concentrated O'Syl nightly, and patient 3 is another male cleaner who seems unaware of the existence of dilution techniques.My photographs are essentially similar to the one published in the Archives. However, an interesting clinical difference is that in my three patients, the depigmentation was entirely insidious in onset, whereas in Odom and Stein's case, the loss of color

Weston, William L.;Reid, Lawrence H.;Humbert, James R.

1974 Archives of Dermatology

doi: 10.1001/archderm.1974.01630080084027

Abstract To the Editor.— We thank Dr. Elias for his timely comments. We agree that in our case it is difficult to define whether deficient cell-mediated immunity or the metabolic disturbances of uremia were responsible for the development of the staphylococcal scalded skin syndrome (SSSS). However, the suggestion that normal adults may develop SSSS is open to question. In the case reported by Rothenberg et al1 and quoted by Dr. Elias, the evidence for normal immunity is scant. Their 64-year-old patient had staphylococcal septicemia, was a chronic alcoholic, had hypoalbuminemia, had treated advanced syphilis, and an atonic bladder, with chronic urinary tract infections. Furthermore, Rothenberg et al did not investigate cell-mediated immunity beyond performing a single skin test. It is difficult to classify their patient as a "normal" adult.Although uremia had been present in both our patient and the first adult in the case reported by Levine and Norden, References 1. Rothenberg R, et al: Staphylococcal scalded skin syndrome in an adult . Arch Dermatol 108:408-410, 1973.Crossref 2. Levine G, Norden CW: Staphylococcal scalded skin syndrome in an adult . N Engl J Med 287:1339-1340, 1972.Crossref 3. Norden CW, Mendelow H: Staphylococcal scalded skin syndrome in adults . N Engl J Med 290:577, 1974. 4. Hawley HB, Aronson MD: Scalded skin syndrome in adults . N Engl J Med 288:1130, 1973. 5. Tisman G, Herbert V: In vitro myelosuppression and immunosuppression by ethanol . J Clin Invest 52:1410-1414, 1973.Crossref 6. Elias PM, et al: Experimental staphylococcal toxic epidermal necrolysis in adult humans and mice , abstracted. Clin Res 22:158, 1974.

Chalmers, Derek

1974 Archives of Dermatology

doi: 10.1001/archderm.1974.01630080085032pmid: 4852939

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract To the Editor.— The article by Marples et al (Arch Dermatol 108:237, 1973) highlights a problem that has interested me for many years— namely, the importance of subclinical or "hidden" infection in common inflammatory dermatoses.The authors pose the question "We must then inquire how often dermatoses are complicated by infection? The literature supplies no answer ..."Dr. Selwyn and I carried out some research in Edinburgh on this very question (Br J Dermatol 77:349,1965). Not only did we point out that there was a high percentage of patients with important but clinically unapparent infections of their lesions, but we also highlighted the hazard of the dispersal of these bacteria into the atmosphere. This latter aspect of the paper covers the point made by the authors in their discussion of the public health aspects of dermatitic skin colonized by pathogens.Certainly in children and almost certainly in adults, eczema is commonly

Gordon, Hyman H.

1974 Archives of Dermatology

doi: 10.1001/archderm.1974.01630080085035

Abstract To the Editor.— In the Archives (109:70, 1974), Drs. DesGroseilliers and Brisson report on glutaraldehyde treatment of localized epidermolysis bullosa, or recurrent bullous eruption of the hands and feet (RBEHF). Their conclusions indicate three general shortcomings, though they note the beneficial effects of 10% buffered glutaraldehyde. I have reported the use of glutaraldehyde in hyperhidrosis1 and in herpes zoster and simplex2 and its theoretical benefits in the treatment of Pseudomonas infection.3 This, together with its use in verruca vulgaris, plantar and genital warts, and tinea, has given me considerable experience that suggests that glutaraldehyde as reported by DesGroseilliers and Brisson may be useful in epidermolysis bullosa with the following technique.The starting strength of buffered glutaraldehyde should be 2% for nightly use. Within one week, there should be adequate control, when it may be used every other night. If glutaraldehye is still effective at this schedule, References 1. Gordon HH: Hyperhidrosis: Treatment with glutaraldehyde . Cutis 9:375, 1972. 2. Gordon HH: Herpes zoster and simplex: Local therapy with glutaraldehyde . Cutis 12:918, 1973. 3. Gordon HH: Pseudomonas infections . Arch Dermatol 109:261, 1974.Crossref 4. London ID: Buffered glutaraldehyde solution for warts . Arch Dermatol 104:96, 1971.Crossref

Steele, Donald R.

1974 Archives of Dermatology

doi: 10.1001/archderm.1974.01630080085033

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract To the Editor.— Drs. Roenigk and Handel, in their article describing a case of gold vasculitis (Arch Dermatol 109:253, 1974) present an interesting observation. They fail, however, to give any evidence that would indicate that the gold leaf they employed in the patch testing was indeed absolutely pure gold. This leaves open to speculation a number of possibilities, including the presence of many other metals in trace to reasonably substantial amounts. Additionally, one must be concerned with the possibility that there was surface contamination of the gold leaf with organic or inorganic allergens.Was a neutron activation analysis performed on the metallic gold leaf? What techniques were used to exclude surface contamination by other materials? The answer to these questions must be evaluated prior to lending any credulence to their observation.

Roenigk, Henry H.;Taylor, James S.

1974 Archives of Dermatology

doi: 10.1001/archderm.1974.01630080085034

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract To the Editor.— The gold leaf employed to patch test the patient who had "gold vasculitis" was obtained from M. Swift & Sons, Inc, 10 Love Lane, Hartford, CT 06101. The company informs us that the gold used in the gold leaf is .9998% pure. If there is trace contamination, it would be with silver, lead, or iron. When the company processes this gold bullion, it uses 10 parts of silver per 500 parts of gold and 8 parts of copper per 500 parts of gold. Neutron activation analysis was not performed.The patient was tested for copper sensitivity, which was negative, but was not tested for silver sensitivity.I am not sure of the relevance of the statement about the possibility of surface contamination of the gold leaf with organic or inorganic allergens. Routine patch testing procedures limit the amount of contamination if proper precautions are taken. If there

Rahbari, Homayoon;Cordero, Alejandro A.;Mehregan, Amir H.

1974 Archives of Dermatology

doi: 10.1001/archderm.1974.01630080085031

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract To the Editor.— Dr. Ronald Goldner has brought to our attention his report of two cases of Zosteriform Porokeratosis of Mibelli. This report adds two more cases of linear porokeratosis that had been reported in the literature prior to the appearance of our article. We apologize for our failure to list Dr. Goldner's contribution in our review of the literature.

Goldner, Ronald

1974 Archives of Dermatology

doi: 10.1001/archderm.1974.01630080085030

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract To the Editor.— In the April issue of the Archives (109:526,1974), Dr. Rahbari and co-workers report on eight cases of linear porokeratosis. Their review of the literature produced only seven instances of this entity.I would like to call their attention to my article published in the Archives (104:425, 1971) entitled "Zosteriform Porokeratosis of Mibelli." I reported on two cases of linear porokeratosis in young girls and mentioned that one of Mibelli's original patients apparently had this form of distribution.I agree with the authors' conclusion that linear porokeratosis should be considered a distinct clinical variant and that it must be considered in the differential diagnosis of linear dermatoses, but it is unfortunate that they have mentioned that only seven cases had been reported previously.

Greenwald, Gerald

1974 Archives of Dermatology

doi: 10.1001/archderm.1974.01630080086037

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract To the Editor.— The simultaneous occurrence of uncommon diseases in a single patient is always fascinating, especially when the diseases are of dermatologic interest.The following report depicts the association of porphyria cutanea tarda (PCT) with lentigo maligna. This is an association that has not been reported previously to my knowledge. Report of a Case A 56-year-old white man with a two-year history of vesicles and bullae on his forehead and dorsal hands was proved to have PCT by appropriate testing.Examination also revealed an asymptomatic 2-cm tan and brown, sharply marginated, irregularly bordered macule on his right cheek, in an area uninvolved with the vesicles.Biopsy bore out my clinical impression of lentigo maligna.The case above demonstrates the simultaneous occurrence of two unusual entities in one patient.

1974 Archives of Dermatology

doi: 10.1001/archderm.1974.01630080086039

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract To the Editor.— As an avid reader of the medical literature and especially that related to dermatology, I would like to suggest that the format of the Archives be adapted to that recently adopted by a sister journal, JAMA, ie, placing the Letters to the Editor and possibly the Society Transactions in the front of the journal.My colleagues and I have found that many "pearls" of information are consistently found in these sections, and I think that they would be further appreciated when the reader is alert. This earlier reading of these sections would also "prime" the reader for the longer and more involved articles found later on in the journal.I also think that more review articles are needed to match the caliber of the excellent ones the Archives has published in the past.Maj Charles E. Reaves, MC, USAF Lackland Air Force Base, Tex

Frazier, Claude A.

1974 Archives of Dermatology

doi: 10.1001/archderm.1974.01630080086036pmid: 4852684

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract To the Editor.— Again, this year I am compiling case reports of allergic reactions to bites by insects such as mosquitoes, fleas, gnats, kissing bugs, bedbugs, chiggers, black flies, horseflies, sandflies, and deerflies. I am also interested in reactions to stings of the imported and southern fire ants.I would like physicians to supply me with case reports of those patients who have had reactions to such insects. The report should include the type of reaction and complications, if any; the age, sex, and race of the patient; the site of the bite(s); the season of the year; the immediate symptoms; the skin test results; desensitization results, if any; and any associated other allergies.Send this information to Claude A. Frazier, MD, 4-C Doctors' Park, Asheville, NC 28801.

Arnold, Harry L.

1974 Archives of Dermatology

doi: 10.1001/archderm.1974.01630080086038

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract To the Editor.— Identical 25-year-old twin sisters from Michigan presented themselves in my office with their fourth attack of polymorphous light eruption during a period of four years. They had a profuse, pink papular rash confined to sun-exposed surfaces, which began on the third day of a vacation in Waikiki. Previous attacks had occurred in Nassau, Florida, and Acapulco; this was the first attack they had experienced when both were in the same resort, however.There was no history of atopy, other skin problems, or recent medication. Time did not permit phototesting.

Epstein, Ernst

1974 Archives of Dermatology

doi: 10.1001/archderm.1974.01630080087042

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract To the Editor.— Shore and Shelley in the Archives (109:397, 1974) describe "contact dermatitis from stearyl alcohol and propylene glycol in fluocinonide cream" in a patient who developed intolerance to fluocinonide cream and showed positive patch tests to the propylene glycol and stearyl alcohol constituents of the fluocinonide cream. On the basis of positive patch tests to propylene glycol, and to commercial stearyl alcohol, they concluded that the patient showed irritation from propylene glycol, and had developed contact-type allergy to a contaminant in the stearyl alcohol.I would like to suggest that their data are compatible with the conclusion that both the propylene glycol and the stearyl alcohol patch tests represented irritant responses rather than that the positive stearyl alcohol tests constituted an allergic response. Distinguishing irritant tests from allergic patch tests on purely morphologic grounds is difficult and the literature is full of studies where experienced investigators have mistaken

Kim, Robert

1974 Archives of Dermatology

doi: 10.1001/archderm.1974.01630080087041pmid: 4852947

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract To the Editor.— During the past four years, I have treated six cases (Table) of Mycobacterium (balnei) marinum granuloma of the skin with tetracycline for 8 to 16 weeks with complete healing in all six cases. Positive cultures were obtained in each case and a few acid-fast bacilli were found in tissue in two cases. That involution was spontaneous in any of the cases cannot be ruled out. However, in five cases, the lesions were present for 6 to 36 months and were progressing until institution of tetracycline therapy. The initial dosage was 1.0 gm daily in all cases.Various forms of therapy have been used for M marinum skin infection, including antituberculosis drugs (isoniazid, aminosalicylic acid, ethambutol, and streptomycin), electrosurgery, cryosurgery, and surgical excision. In some cases, none of these modalities may be applicable or suitable due to drug intolerance, location or size of the lesion, or cost.

Stubbart, F. James

1974 Archives of Dermatology

doi: 10.1001/archderm.1974.01630080087040

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract To the Editor.— Formaldehyde present in clothing and sheets can produce allergic reactions. Most frequently, it is an irritant, especially to dry skin and areas exposed to increased friction or perspiration.Casein is an innocuous compound that, when added to formaldehyde, produces insoluble compounds used to make items, such as buttons, billiard balls, and water-proof adhesives. A small handful of nonfat dry milk added to the laundry rinse water precipitates free formaldehyde, this results in reduction of the skin irritation. This process also makes clothing and sheets feel softer. In some fabrics, the formaldehyde continues to be released, and after a few days the rinsing must be repeated.Excessive quantities of harsh laundry detergents may cause the same problem of itching.

Shore, Ronald N.;Shelley, Walter B.

1974 Archives of Dermatology

doi: 10.1001/archderm.1974.01630080088043

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract To the Editor.— Dr. Epstein has suggested that the data we presented are compatible with the conclusion that the patient's reactions to stearyl alcohol preparations represented irritant rather than allergic responses. Unfortunately, Dr. Epstein did not have either the advantage of viewing the patch test reactions directly or of following the patient before, during, and after the period of her contact dermatitis. Having had this opportunity, we were aware of several aspects that present strong evidence for the presence of contact allergy, and that may not have been sufficiently stressed in the original report.First, we agree that it may be extremely difficult to distinguish irritant from allergic patch test reactions in some situations. In the patient we observed, however, we found that patch testing with commercial stearyl alcohol in standard concentration (30% in petrolatum) produced an irregular, eczematous reaction characteristic of allergy. This was in sharp contrast to the

Constantine, Victor S.;Fuks, Zvi Y.

1974 Archives of Dermatology

doi: 10.1001/archderm.1974.01630080089045pmid: 4852753

Abstract To the Editor.— It was interesting to read about the two cases reported by Ackerman et al in the Archives (109:218, 1974) that had been initially diagnosed as mycosis fungoides (MF) based on certain histopathologic features but actually were not MF. The authors illustrate so well the old maxim that dermatologic disorders are diagnosed clinically and that the diagnosis is confirmed by the histopathologic findings.It was the final paragraph, however, that prompted us to write this letter. The authors state: "The diagnosis of mycosis fungoides will inevitably become apparent in time. Because no panacea has yet been demonstrated for MF there is no urgency for a hasty diagnosis or overly enthusiastic therapy." It is not certain what the authors mean by "apparent." Certainly, the most diagnostic clinical features of MF are the typical tumors. If one waits that long, however, it is too late. Average survival after the onset References 1. Fuks ZY, Bagshaw MA, Farber EM: Prognostic signs and the management of mycosis fungoides . Cancer 32:1385-1395, 1973.Crossref 2. Epstein EH, et al: Mycosis fungoides . Medicine 15:61-71, 1972.Crossref 3. Van Scott EJ, Kalmanson JD: Complete remissions of mycosis fungoides lymphoma induced by topical nitrogen mustard (HN2) . Cancer 32:18-30, 1973.Crossref

de Launey, Walter E.

1974 Archives of Dermatology

doi: 10.1001/archderm.1974.01630080089044

Abstract To the Editor.— The relationship between the jejunal changes in patients suffering from dermatitis herpetiformis (DH) and the enteropathy of celiac disease (CD) remains uncertain. Fry et al1 believe that in at least some patients with DH, a gluten-free diet modifies the course of the cutaneous disease. Others2 believe that the skin disease and the enteropathy behave independently, each responding to its appropriate treatment. There has been, to my knowledge, one report of a patient who developed DH after six years of gluten restriction for CD.3 I have recently encountered a similar case, which I believe should be recorded. Report of a Case A 48-year-old man was seen in May 1973, because of an intensely itching eruption that had been present for three months. Eight years previously, he had been investigated for diarrhea, with bulky, greasy stools. After jejunal biopsy, he was told he had CD and References 1. Fry L, et al: Clearance of skin lesions in dermatitis herpetiformis after gluten withdrawal . Lancet 1:288-291, 1973.Crossref 2. The gut and dermatitis herpetiformis, editorial . Br Med J 4:5, 1971. 3. McNeish AS, Fraser NG, Morley WN: Dermatitis herpetiformis in a treated coeliac child . Arch Dis Child 45:279-281, 1970.Crossref 4. Soter NA: Dermatitis herpetiformis . N Engl J Med 288:1020-1021, 1973.Crossref 5. Marks J, Shuster S: Dermatitis herpetiformis . Arch Dermatol 101:452, 1970.Crossref

Ackerman, A. Bernard

1974 Archives of Dermatology

doi: 10.1001/archderm.1974.01630080090046

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract To the Editor.— It has long been acknowledged that pretumorous lesions of mycosis fungoides, such as parapsoriasis en plaques and poikiloderma vasculare atrophicans, cannot always be diagnosed with certainty as mycosis fungoides, clinically or histologically. Our paper titled "Spongiotic Simulants of Mycosis Fungoides" told of another unsettling phenomenon, namely, of patients who did not have mycosis fungoides, but whose skin biopsy specimens showed spongiotic foci containing atypical mononuclear cells that were indistinguishable from Pautrier microabscesses. A corollary from this finding was that patients who do not have absolutely proven mycosis fungoides should not be treated with potentially harmful modalities. If the electron beam or topical mechlorethamine hydrochloride therapy, advocated by Drs. Constantine and Fuks for "early cases of mycosis fungoides," had been given to our patients with spongiotic simulants of mycosis fungoides, the lesions would have likely gone into complete remission, but at what a price! Our patients, in fact,

Berlin, Steven J.;Air, Bel

1974 Archives of Dermatology

doi: 10.1001/archderm.1974.01630080090047

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract To the Editor.— I have recently read Dr. Kenneth E. Greer's article titled "Epidermal Inclusion Cyst of the Sole" in the Archives (109:251,1974).In Dr. Greer's article, he mentions that these lesions are rare. I would like to state that these lesions are not rare and that they are frequently seen on the plantar surfaces of the foot. In 1971,I reported three cases in the Journal of the American Podiatry Association, and since then have had several other cases. There have also been several other cases reported in the podiatric literature.I would recommend that in the writing of future dermatology articles specifically involving the foot, authors should refer to some of the podiatric literature.

Greer, Kenneth E.

1974 Archives of Dermatology

doi: 10.1001/archderm.1974.01630080090048

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract To the Editor.— I am very grateful to Dr. Berlin for his comments. I can only report that I have checked with a number of experienced dermatologists, most of whom have never seen an epidermal inclusion cyst on the sole. Dermatopathology Symposium.— Dr. Rudolf L. Baer, George Miller MacKee Professor and Chairman of the Department of Dermatology at New York University's Postgraduate Medical School, announces a Dermatopathology Symposium to be held Oct 7-9, 1974.The symposium, which will be directed by Dr. A. Bernard Ackerman, Associate Professor of Dermatology and Pathology, is aimed at bringing a fresh approach to the understanding of dermatopathology.Several aspects of cutaneous pathology, including inflammations, neoplasias, malformations and deposits, will be examined at the symposium. Special emphasis will also be given to the mechanisms of skin diseases; the elucidation of concepts concerning pathological processes; and the importance of careful gross and microscopic pathological correlations.The

Lynfield, Yelva L.

1974 Archives of Dermatology

doi: 10.1001/archderm.1974.01630080091049

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract Lentigo Maligna. Presented by Dr. Laszlo Biro, Dr. Arnold Zimmerman (by invitation). An 88-year-old Italian man was found to have an asymptomatic pigmented macule on the right fifth fingertip in October 1972, during his physical examination on admission to the Brooklyn Veterans Administration Hospital for mental depression and chronic brain syndrome. The lesion had been present for more than 50 years, and it had become darker and somewhat raised during the past six months.Examination showed a hyperpigmented maculopapular lesion involving almost the entire distal phalanx of the right fifth finger, sparing the nail. The color ranged from tan to brown to black. Discussion Dr. Biro: Since this patient has been in the hospital for approximately nine months, we had an opportunity to observe this lesion on a day-to-day basis and to perform biopsies for light and electron microscopic studies. A skin biopsy specimen taken during October 1972 from a

Hadley, Terry P.

1974 Archives of Dermatology

doi: 10.1001/archderm.1974.01630080092050

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract Vitamin E Treatment in a Case of Epidermolysis Bullosa. Presented by Gundula Schaumburg-Lever, MD, Walter F. Lever, MD. A 25-year-old woman has had a blistering disease since birth. She spent the first six months of life in a hospital receiving massive doses of vitamin C and antibiotics. Beginning at age 11, she was treated intermittently with systemically administered corticosteroids. This was continued until 1971. In 1971, methotrexate therapy was begun, whereupon she underwent a remarkable remission. However, the methotrexate had to be discontinued after several months because of nausea. For the past four months, she has received 1,600 international units of vitamin E (Aquasol E) daily. There is no family history of a bullous disease.Examination of the skin revealed numerous bullae and denuded areas over the entire body. Fingernails were present only on the thumbs and right ring finger. Discrete scars were distributed over the entire body. Fingernails were

Arundell, Faye D.

1974 Archives of Dermatology

doi: 10.1001/archderm.1974.01630080093051

Abstract Lichen Nitidus of the Palms and Soles. Presented by Richard B. Odom, MD, Kenneth M. Stein, MD. A 50-year-old white woman has had crops of asymptomatic palmar lesions for many years. No other family members are affected. She has not had any malignant skin conditions. The palms and medial aspects of the soles are studded with multiple small depressed pits surrounded by discrete borders. X-ray films of the skull, jaw, and hand are normal. Discussion Dr. Odom: A search of the English literature revealed no other cases in which lichen nitidus is limited strictly to the palms and soles. The lesions have been present at least since early childhood. Six patients with involvement of the palms and soles also had other areas of the body that were involved: the wrists, elbows, fingers, back, knees, ankles, and genitalia (Arch Dermatol 104:538, 1971). Clinically, the lesions of the palms and soles may closely resemble References 1. Lynch FW, Goltz RW: Nevus lipomatosus cutaneus superficialis (Hoffman-Zurhelle) . Arch Dermatol 78:479-482, 1958.Crossref 2. Abel R, Dougherty JW: Nevus lipomatosus cutaneus superficialis (Hoffman-Zurhelle) . Arch Dermatol 85:524-526, 1962.Crossref

1974 Archives of Dermatology

doi: 10.1001/archderm.1974.01630080094052

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract Allergy Symposium.— A four-day medical symposium titled Recent Advances in Allergy will be held at the famous resort The Homestead in Hot Springs, Va, Aug 19-22, 1974. The medical seminars will be held from 8 until 10 AM each day. A golf and tennis tournament will be held in conjunction with this meeting, beginning each day at 10 AM. A wide variety of subject material will be presented by outstanding specialists that will be of interest to all physicians. For further information, contact Claude A. Frazier, MD, 4-C Doctors' Park, Asheville, NC 28801. West Coast Allergy Society Meeting.— The West Coast Allergy Society Annual Scientific Meeting will be held Oct 24-26, 1974, at the Hotel St. Francis, San Francisco. For further information, contact West Coast Allergy Society, Daniel K. Billmeyer, MD, Chairman, Program Committee, 2164 SW Park Place, Portland, OR 97205. Second European Meeting on Electron Microscopy Applied to Clinical