Palmar and plantar pustulosis elicited by Candida antigen

Intracutaneous injection of Candida albicans was done on the forearm of 30 patients with palmar and plantar pustulosis. This induced an aggravation of pustular eruptions on the palms and soles in 11 (37%) of the 30 patients. The aggravation occurred only in those patients who had a positive delayed skin reaction to the Candida antigen. It is suggested that a delayed hypersensitivity inflammatory reaction somewhere in the body is attended with an aggravation of palmar plantar pustulosis.

Follicular contact dermatitis due to formaldehyde

2 patients with textile contact dermatitis due to formaldehyde developed follicular, papular lesions. Histologically these papules showed eczematous changes in the follicular epidermis and mononuclear cell infiltrates in the dermis around the involved follicle. The skin between the papules was intact. It is suggested that the concept of "dermal" contact sensitivity does not fit for the explanation of papular dermatitis due to formaldehyde.

Atopic dermatitis and tuberculin reactivitiy

Transient suppression of already established tuberculin reactivity by a wide-spread, allergic contact dermatitis as well as by primary irritant contact dermatitis has been recently reported. Similar transient suppression of tuberculin reactivity by the eczematous inflammation of atopic dermatitis is now shown to occur. Thus, when the dermatitis is active, atopic dermatitis patients show diminished tuberculin reactivity. While they are in remission, however, a significant increase of their tuberculin reactivity occurs. Before the onset of dermatitis, their tuberculin reactivity was normal. Healed patients showed normal tuberculin reactivity. The presence of dermatitis may play an important role in the diminished cell-mediated immunity in atopic dermatitis.

Abnormal vascular reactions in atopic dermatitis

Vascular reactions to mechanical stroking, topical application of nicotinic acid ester, and methacholine chloride were examined in both the normal and abnormal skin of 100 patients with atopic dermatitis and 20 patients with allergic contact dermatitis. White dermographism, nicotinic acid blanching, and delayed blanch with methacholine consistently occurred in areas of skin with eczematous change of patients with atopic dermatitis and those with allergic contact dermatitis. Normal skin of atopic patients did not show the abnormal vascular reactions. It is suggested that white dermographism, nicotinic acid blanching, and delayed blanch with methacholine seen in atopic dermatitis are secondary phenomena that give no definite information concerning the diagnosis of this disease.

Patch test reactions to human dander in atopic dermatitis

Patch tests reactions to human dander were positive in 120 of 181 (66%) patients with atopic dermatitis, in two of 28 (7%) patients with allergic contact dermatitis, and in one of 31 (3%) normal controls. The frequency of positive reactions was significantly higher in patients with atopic dermatitis. The reactions consisted of erythema and papules, which histologically showed an eczematous change at the upper parts of hair follicles. There was significant correlation between patch test reactions to human dander and delayed intradermal reactions to the same substance in atopic patients. It is suggested that certain patients with atopic dermatitis exhibit contact hypersensitivity to human dander. Whether or not the hypersensitivity has any relationship to the pathogenesis of the dermatitis was not determined in this study.

Primary eruption of prurigo simplex subacuta

28 patients with typical picture of prurigo simplex subacuta were examined for the primary eruption. In all patients, the first visible lesion was a papule, at the top of which a vesicular element was never seen. 46 biopsy specimens of the initial eruption were serially sectioned. The histological changes were found in connection with hair follicles, which consisted of spongiosis and mononuclear cell migration at the follicular epidermis and perifollicular infiltrates of mononuclear cells.

Pustular patch test reactions in atopic dermatitis

Pustular patch test reactions to 5% nickel sulfate were regularly produced in patients with atopic dermatitis when patches were placed over areas of skin with (a) follicular papules, (b) erythema, (c) lichenification, and (d) minimal trauma. The pustular patch test reactions seldom occurred in the normal-appearing skin of these patients. However, if the skin was traumatized prior to the patch test, the reaction was produced in the normal-appearing skin of atopic as well as control individuals. No pustular reactions occurred in the follicular lesions of keratosis pilaris, supporting the view that follicular lesions of atopic dermatitis differ from keratosis pilaris. It is suggested that pustular patch test reactions are caused by primary irritation.

Sequence of events during germination of putrefactive anaerobe 3679 spores

The sequence of changes during germination of putrefactive anaerobe 3679h spores was studied under aerobic conditions in a solution containing l-alanine and sodium pyrophosphate. Evidence that specific changes occurred in two distinct regions of the spore is given by data on several criteria that were used to measure germination. During the initial stage of germination, the absorbancy decreased, dipicolinic acid was released, the spores lost their resistance to heat and toxic chemicals, and the spore periphery (cortex) darkened gradually under phase-contrast microscopy. The final stage of germination was characterized by changes in the central spore region (core), notably phase darkening of the spore center and stainability with mercurochrome, and by a slight additional absorbancy decrease.

Family background of respiratory atopy: a factor of serum IgE elevation in atopic dermatitis

The incidence of family history of atopic diseases in patients with atopic dermatitis (AD) was dependent upon the number of family members. In AD patients whose family had four persons or less, the diagnostic value of atopic family history was considerably diminished. To investigate if personal or family history of atopic respiratory disease (ARD) are implicated in elevating serum IgE in AD, serum IgE values were analyzed in 200 AD patients who had a family of five or more. AD patients who had a personal or family history of ARD showed significantly higher serum IgE than AD patients who lacked both personal and family ARD history. Patients with only AD and very high serum IgE commonly had a family ARD history. Patients with severe AD and normal serum IgE mostly lacked personal and family ARD history. It appears that about 40% of total AD patients do not have predisposition for ARD.

Clinical and histological features of dry skin in atopic dermatitis

Of 200 atopic dermatitis patients observed during cold months, 44 (22%) had ichthyosis vulgaris. Histologically, the dry skin in atopic dermatitis coexistent with ichthyosis demonstrated ichthyotic features which were frequently superimposed with eczematous changes. The dry skin in pure atopic dermatitis demonstrated the histology of mild eczema. Examinations using monoclonal antibodies showed that the dry skin in pure atopic dermatitis had increased numbers of OKT6-positive cells in epidermis. The lymphocytes in the dermal infiltrates consisted predominantly of LEU-3a-positive cells. It is concluded that the dry skin often seen in atopic dermatitis may be a mild eczematous lesion of atopic dermatitis, or a manifestation of concomitant ichthyosis, or a complex of these two changes.

Mast cell invasion of peripheral nerve in skin lesions of atopic dermatitis

To ascertain whether or not a spatial relationship between mast cells and peripheral nerves is present in skin lesions of atopic dermatitis, 10 biopsy specimens of the skin lesions were examined with both semi-thin and ultrathin serial sections. Mast cell invasion of peripheral nerves was observed in 9 out of the 10 biopsy specimens (4 subacute lesions, 3 lichenified lesions, and 3 prurigo lesions). The mast cells within peripheral nerves often showed degranulation, and the nerve fiber bundle showed conspicuous edema. The degranulation of mast cells within peripheral nerve bundles and edema of the nerve bundle may pay a role in provoking or aggravating itchiness of atopic dermatitis.