PALMAR AND PLANTAR SEED KEEATOSES AND INTEENAL MALIGNANCY

Summary— In a survey of 500 patients over the age of 40 years attending the skin clinic, 62% were found to have "seed" keratoses on their palms or their soles. No statistically significant association was found between the presence of these keratoses and internal malignancy.
The proportion of patients with keratoses was higher in those with basal cell epitheliomata but the excess was not statistically significant.     

HLA AND LEPROSY: SEGREGATION AND LINKAGE STUDY

Background. The presence of a genetic factor in the determination of leprosy has long been debated. This study tests whether the HLA-linked control of susceptibility to leprosy and/or for the types of leprosy could be confirmed. Materials and Methods. In 15 multicase families, the method of DeVries et al., 1976, was used to detect nonrandom segregation of parental HLA haplotypes in their affected and healthy siblings. Linkage analyses, for two and three alleles were performed by the computer program LIPED. Results. For the affected siblings, the segregations of the parental HLA haplotype were significantly nonrandom from the healthy parents and random from the affected parents, indicating that affected siblings were sharing their HLA haplotypes (segregated from the healthy parents) more than expected. The segregations to the healthy siblings from both the healthy and affected parents were random. Healthy siblings inherited the haplotypes shared among the leprosy siblings randomly as expected. There were excess DR₂/DR₂ homozygote individuals among tuberculoid siblings. The highest lod score was achieved when we considered our suggested three-alleles model for the susceptibility to the different types of leprosy. Conclusions. A closely HLA-linked gene on chromosome number 6 with multiple alleles (3 or more) in recombination fraction between 0.05 and 0.1 with 70 to 100% penetrance may be responsible for the susceptibility to the different types of leprosy, whereas the susceptibility to leprosy per se maybe the responsibility of non-HLA linked gene/s. DR₂/DR₂ homozygote individuals may be relatively at high risk of developing leprosy or tuberculoid leprosy.     

PATTERNS AND INTENSITY OE AUTOFLUORESCENCE AND ITS RELATION TO MELANIN IN HUMAN EPIDERMIS AND HAIR

The skin of 41 patients including 16 blacks, 15 Caucasians, and 10 Hispanics, was observed using a fluorescent microscope. Three patterns of autofluorescence were observed: intercellular, cytoplasmic, and a combination of intercellular and cytoplasmic. The hair of 75 subjects, including 18 Negroes and 55 Caucasians, was observed. Two patterns were found: medullar and at the cortex. Skin form black patients was associated with the cytoplasmic pattern of autofluorescence. Compared to lighter skin, black skin was also significantly associated with increased intensity of autofluorescence, indicating that autofluorescence of the epidermis parallels the clinical degree of pigmentation. In the hair of 75 subjects, similar results were obtained: Negro hair exhibited more fluorescence than Caucasian hair, and darker hair (brown to black) exhibited more fluorescence than lighter hair (blond). This may be related to melanin and it breakdown products.     

PSORIASIS AND PREGNANCY: HORMONE AND IMMUNE SYSTEM INTERACTION

Background. Various hormonal states are known to be associated with the waxing and waning of psoriasis. Patients with psoriasis commonly experience changes in their cutaneous disease during pregnancy or post partum. Objective. We evaluated 100 women with psoriasis by questionnaire and interview. The women had been seen at the Baylor Psoriasis Center, Dallas, and had experienced a pregnancy while having psoriasis. The answers were sorted and tabulated. In addition, we reviewed the literature to ascertain possible causes of clinical changes in psoriasis during pregnancy. Results. Ninety questionnaires were completed. Sixty-nine women (76.7%) described a change In their psoriasis during pregnancy with 57 (63.3%) noting improvement. Seventy-nine patients (87.7%) had a postpartum flare, most within 4 months of delivery. Conclusions. The majority of women with psoriasis, who become pregnant, experience a change, usually an improvement, in their cutaneous disease. Pregnancy is associated with hormonal changes in estrogens and progesterone resulting in a state of altered immune surveillance.     

MALIGNANT MELANOBLASTOMAS SOME USUAL AND UNUSUAL ASPECTS AND VAGAEIES

Malignant melanoblastomas (commonly referred to as melanomas or melanoblastomas) may arise from clinically normal looking skin or in other lesions, the commonest of which is the soft pigmented nevus (Melanocytoma or mole). In the latter case they commonly arise from junction navy or the functional component of a compound naevus, but very rarely from purely dermal naevi. The lesions with which they are more likely to be confused clinically are listed but all lesions concerned in the differential diagnosis of a squalors carcinoma may have to be considered, particularly for amelanotic lesions. Diagnosis is either made or confirmed by the microscope, and even here, certain difficulties (which are mentioned) may be encountered. To date, no certain evidence has been produced that malignancy has been initiated in a mole by performing a partial biopsy. Twenty-two clinical signs of developing or present malignancy are listed.     

CONFLUENT AND RETICULATE PAPILLOMATOSIS (GOUGEROT-CARTEAUD) AND PITYROSPORUM ORBICULARE

SUMMARY.— A patient whose lesions satisfied the clinical and histological criteria for the diagnosis of confluent and reticulate papillomatosis (C.R.P.) is described. Many of the lesions showed yellow fluorescence and were heavily colonized by Pityrosporum orbiculare but no evidence was found of filament formation as in Malassezia furfur. Treatment with 10% sodium thiosulphate and with selenium sulphide resulted in virtual eradication of P. orbiculare and complete clearance of the eruption. The possibility is discussed that C.R.P. may represent a peculiar host reaction to heavy colonization by P. orbiculare.