Immunological and chromosomal studies in a patient with Sézary syndrome

A patient with the small-cell variant of Sézary syndrome was studied before and during treatment with low-dose chlorambucil. He had depressed responses to phytohemagglutinin (PHA) and concanavalin A that returned to normal with clinical improvement. Spontaneously dividing cells were found in the peripheral blood by culturing lymphocytes without PHA for 24 hours. Seventy-two-hour PHA-stimulated lymphocyte cultures revealed predominantly hypodiploid chromosome numbers. Both abnormalities improved during treatment. Lymphocytes that were studied for sister chromatid exchanges had an increased number of exchanges per metaphase. Immunofluorescence studies revealed immunoglobulins and C at the dermoepidermal junction and in the dermal vessel walls. Our findings demonstrate that the depression of mitogen responsiveness that is sometimes seen in Sézary syndrome can be favorably affected by chemotherapy. Likewise, some chromosomal abnormalities may regress during successful therapy. These findings may provide a way of measuring the response to therapy.

Vasculitis in granuloma annulare: histopathology and direct immunofluorescence

Biopsy specimens from patients with granuloma annulare were studied by conventional light and immunofluorescence microscopy. In six of 20 patients, IgM was present in blood vessels of involved skin, and C3 was present in blood vessels in ten of 20 patients. In addition, IgM, C3, or fibrinogen were observed at the dermal-epidermal junction of eight patients. Necrobiotic areas contained fibrinogen. A retrospective histopathologic study of 38 biopsy specimens from other patients with granuloma annulare showed blood vessels with vessel wall necrosis, fibrinoid change, thickening, or occlusion in most specimens. Nuclear dust and extravasation of RBCs were also noted. These findings suggest that an immunoglobulin-mediated vasculitis may be involved in the pathogenesis of granuloma annulare.

Skin changes in graft-vs-host disease

In this review of the clinical and histopathologic manifestations of the graft-vs-host reaction, the characteristic changes in the skin are given particular emphasis, since they are among the earliest and most obvious signs of this syndrome. The acute and chronic forms of graft-vs-host disease are distinguished, with notation of their different dermatologic presentations. The distinctive histopathologic and immunopathologic findings of the graft-vs-host reaction in the skin are presented. Finally, the possible pathogenetic mechanisms which produce the clinical picuture of graft-vs-host disease are discussed. Both T cells and B cells apparently are involved, as are macrophages, but what is primary and what is secondary in the reaction remains to be delineated, as do the respective contributions of donor and host cells.

DNA-antibodies in sera from patients with systemic lupus erythematosus

DNA-antibody determinations using the Farr technique and LE cell tests were performed on single serum samples from 55 patients with SLE according to well defined criteria. It was found that the DNA-antibody test was just as sensitive as the LE cell test, and studies of sera from patients with questionable SLE, discoid LE, other connective-tissue diseases, psoriasis, and from healthy persons, indicated that the DNA-antibody test is highly specific for SLE. Neither the DNA-antibody test nor the LE cell test could discriminate between SLE patients with active and inactive disease as estimated by clinical criteria or by the serum concentrations of complement C3 and C4.

Ultrastructure of palmar and plantar pits in basal cell nevus syndrome

No abstract available

Generalized morphea with blisters. A case report

A patient suffering from generalized morphea developed blisters in the morpheic plaques on her buttocks. The plaques had an increased concentration of serum aminoterminal propertice of type III procollagen, an echo response and thickened skin on ultrasound scanning, and compact bundles of collagen fibrils with bimodal distribution of the diameters. The blisters appeared as an echo-free band in the subepidermal zone by ultrasound scanning. Electron microscopy revealed blisters in the upper papillary dermis, surrounded by degraded collagen fibrils.

Deposits of complement and immunoglobulins in vessel walls in pyoderma gangrenosum

Previous immunofluorescence studies on pyoderma gangrenosum (PG) proved negative. Biopsies from the ulcer edge of 8 patients with PG were examined by immunofluorescence microscopy. Deposits of complement C3 were seen in the vessel walls of all samples, IgM in three and IgA in one. Granular deposits of C3 were seen at the dermal--epidermal junction in 2 patients. Biopsies from clinically normal skin of 6 of the patients were negative. It is suggested that deposition of immune complexes in the dermal vessel walls may play a role in the pathogenesis of PG.