The fatty acid composition of skin and plasma lipids in Refsum's disease

The fatty acid composition of the skin and plasma lipids is described in a patient severely affected by Refsum's disease whose plasma phytanic acid concentration was very high (3.1 mg/ml). In the epidermal lipids, especially in the phospholipid fraction, phytanic acid tended to replace linoleic acid and to some extent arachidonic acid. In some respects the changes in the skin in Refsum's disease resemble those of essential fatty acid deficiency.

Dermo-epidermal relationships in pyogenic granulomata

The epidermis of pyogenic granulomata is presented with an unusual problem of distorted dermoepidermal relationships. In this study we have attempted to delineate the problem and have studied the way in which the epidermis copes with its difficulties. Sixteen pyogenic granulomata with (where possible) paralesional skin (and for comparison ten Campbell de Morgan spots) were studied by cell kinetic techniques. High labelling indices were found in the epidermis and in the endothelium in the pyogenic granulomata (contrasting strikingly with the findings in the Campbell de Morgan spots). A variable morphological response was found ranging from hyperplasia with parakeratosis to epidermal thinning and atrophy. Possible mechanisms for the epidermal changes are discussed and it is suggested that the data produced from this and similar studies may aid the understanding of dermo-epidermal interaction in a variety of common skin disorders including psoriasis.

Dermatitis herpetiformis--a skin manifestation of a generalized disturbance in immunity

Detailed investigations on 42 patients with dermatitis herpetiformis (DH) are presented, emphasis being placed on the presence of other disorders having a prominent immunopathogenic basis. These patients and 42 age and sex matched controls were submitted to an extensive clinical and investigative search for the presence of disorders with an immunological basis including the atopic disorders. The findings provided further evidence supporting the association of dermatitis herpetiformis with thyroid disease and pernicious anaemia. A statistically increased incidence of Raynaud's phenomenon and atopy was found in the patients with dermatitis herpetiformis compared to the control group. In addition, of the patients with dermatitis herpetiformis, two had rheumatoid arthritis, two had ulcerative colitis, one had systemic lupus erythematosus and four had splenomegaly. The possible basis for these associations is discussed and it is suggested that dermatitis herpetiformis may be part of a wider spectrum of disease. Genetic linkage and the formation of immune complexes following exposure to a dietary antigen may both be responsible for the disorders associated with DH.

Epidermal metabolism in heredopathia atactica polyneuritiformis (Refsum's disease)

The epidermal metabolic activity of a patient with a marked generalized ichthyosis associated with heredopathia atactica polyneuritiformis has been investigated. Both the in vivo labeling index and the in vitro rates of incorporation of radioactively labeled thymidine, proline, histidine and acetate were increased relative to normal indicating a high rate of epidermopoiesis. Thin-layer chromatographic analysis of 14C-acetate containing lipid extracts revealed qualitative changes compared with normal. In particular, altered proportions of radioactivities were incorporated into the triglyceride and phospholipid moieties. However, as abnormal patterns of lipogenesis are also seen in autosomal dominant ichthyosis, these changes are probably a reflection of disordered keratinization.

Epidermal abnormalities in Refsum's disease

A female patient with severe Refsum's disease is described. She had striking ichthyosis and detailed investigations into the structure of the epidermis were performed. Light microscopy and transmission electron microscopy revealed lipid-containing vacuoles in the epidermis. Scanning electron microscopy of the stratum corneum showed disruption and the presence of microvilli on individual horn cells consistent with a high output state of epidermal cell production.

Evolution of the lesion of discoid lupus erythematosus: a comparison with lichen planus

The tissue processes leading to the development of the epidermal changes in the lesion of discoid lupus erythematosus have been studied. Typical lesions in fifteen patients have been examined using cell kinetic and immunofluorescence techniques. The results suggest that a very active repair mechanism is operative within the epidermis with heightened epidermopoiesis and epidermal cell migration. The findings have been contrasted with those of previous similar studies of lichen planus. It is suggested that a major difference between the gross and microscopic appearance in the two diseases may be partially on the basis of differing patterns of immunoprotein deposition.

Is there a relationship between lupus erythematosus and lichen planus?

Three patients showing features of both lupus erythematosus and lichen planus are described together with their histological, immunofluorescence and other investigative findings. The similarities between lupus erythematosus and lichen planus are discussed and it is suggested that these may be the result of common pathophysiological pathways.

Pemphigus in a patient treated with penicillamine for generalized morphea

A 56-year-old woman with generalized morphea was treated with penicillamine. Four months after commencing treatment, she developed an eruption clinically, histologically, and immunopathologically consistent with pemphigus. The eruption disappeared following withdrawal of the drug. It is suggested that penicillamine initiated epidermal damage.

Simultaneous systemic lupus erythematosus and dermatitis herpetiformis

In April 1973, a 28-year-old woman had an eruption that was subsequently found to be dermatitis herpetiformis. In March 1974, she developed polyarthralgia and mriteria for each diagnosis were present. The concurrence of these two diseases has not been previously recorded, but we present reasons for believing that the two disorders may have similarities in pathogenesis based on disturbances in immune mechanisms.

An investigation of hydrolytic techniques for the amino acid analysis of foodstuffs

A survey of hydrolytic methods for the amino acid analysis of foods is presented and the advantages and disadvantages of the methods are discussed. Amino acids were determined after hydrolysis of the proteins with hydrochloric acid, sulphuric acid, perchloric acid, p‐toluene sulphonic acid and sodium hydroxide. The results are shown graphically using as examples a pure protein (casein) and a potential food protein of microfungal origin (Fusarium graminearum). The addition of some cation exchange resin to acids catalysed the hydrolysis of some peptide bonds containing aspartic acid, threonine, serine, glutamic acid, valine and isoleucine. Whilst several methods gave close agreement for the analysis of a pure protein, hydrolysis with 6 N‐hydrochloric acid gave the largest yield of most amino acids in food proteins. With the exception of extracted soya meal, protection of cystine prior to hydrolysis gave higher values than direct hydrolysis.