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Among inbred strains of rats, the Fischer 344 (F344) is commonly used in immunological and behavioral studies. However, little is known about patterns of sex hormones and corticosterone (CORT) secretion throughout the estrous cycle in this strain, which is characterized by a marked CORT response to stress and variable length of cycles. In the current study, using radioimmunoassays, we assessed serum levels of progesterone, estradiol, LH, testosterone, prolactin and CORT, at 1-h intervals throughout the estrous cycle in F344 female rats with 4- and 5-day cycles, as well as in males. Vaginal smears were obtained from 268 females for 15 consecutive days to determine individual length of the estrous cycle and the exact estrous phase upon blood withdrawal, which was conducted once in each rat on the 12th day of smearing. The results indicated that both 4- and 5-day cyclers have two distinct and marked surges of progesterone, one on proestrus day and the other on diestrous-1 day. Testosterone levels in 5-day cyclers peaked on diestrus-3, one day earlier than in 4-day cyclers. Daily peak levels of CORT gradually increased from estrus day to proestrous day, whereas daily nadir levels of CORT remained unchanged. To simulate the natural kinetics of specific sex hormones in ovariectomized females, different doses of estradiol, progesterone, testosterone, prolactin or CORT were injected s.c. or i.p., or 90-day sustained release pellets containing different doses of estradiol or progesterone were implanted. The findings indicated dose- and time-dependent effects, suggesting regimens for modeling the estrous cycle or replacement therapy.

Summary: The frequency of Pityrosporum orbiculare as a skin commensal among israeli population was studied. Out of 74 subjects studied 51 (68.9%) gave positive results. However, the frequency of positive cases was not equally shared by the different age groups studied. It was positive in 77.1% of people between 15 and 45 years, while the positive results among younger and older subjects were 50% and 64.2% respectively. No difference in frequency was observed between the two sex groups. Zusammenfassung: Untersuchung uber die Haufigkeit von P. orbiculare als kommensaler Hautkeim in einer israelischen Bevolkerungsgruppe. Von 74 untersuchten Personen zeigten 51 (68, 9%) ein positives Resultat. Die Verteilung der positiven Nachweise war in verschiedenen Altersgruppen ungleich. Am hochsten lagen die Werte in der Gruppe mit einem Alter zwischen 15 und 45 Jahren: 77, 1%. Jungere bzw. altere Probanden waren mit 50% hzw. 64, 2% seltener befallen. Zwischen den Geschlechtern bestand kein Unterschied in der Haufigkeit des Befalls.

Eosinophilic fasciitis is an additional clinical entity to many others manifested by sclerodermic changes in the skin. A case with this process is reported. It presents vast cutaneous sclerodermic changes associated with eosinophilia, signs of muscular exertion, and a massive inflammatory infiltrate involving the lower part of the dermis, subcutaneous tissue and the muscle fascia. Prednisone therapy was followed by rapid and marked improvement.

Aspects of lymphocyte function were investigated, in vitro, in nine patients with active Behçet’s disease. The rosette formation technique revealed a slight decrease in number of T lymphocytes and more so of B lymphocytes. In spite of their low number, the transformation of the T lymphocytes in response to mitogens did not show a significant difference from that of normal controls. This may indicate a hyperreactivity, and in two instances a spontaneous blastogenesis prior to addition of mitogens, was also noted. The immunoglobulins and complement levels in serum were within normal limits.

SUMMARY The mechanism of skin hyperreactivity (pathergy) in Behcet's disease is unknown. It has been suggested that the response is due to an Arthus-like reaction. In 18 patients with active Behcet's disease, pathergy was induced and the skin biopsied after 24 h. The histological reaction was that of mild to intense round cell infiltration, perivascular in type. Direct immunofluorescence failed in all 18 patients to demonstrate the local presence of immunoglobulins and complement at the site of lesion. A marked increase in the number of mast cells was observed at the site of reaction and scattered throughout the dermis, the role of which is to be further investigated. The study failed to demonstrate a humoral mechanism in the production of the cutaneous hyperreactivity.

The systemic manifestations of Behçet disease were evaluated retrospectively in 45 patients. Twenty-seven patients underwent radiographic examination. Twenty-two examinations (64.7%) showed positive but nonspecific findings, most of them involving the vascular tree. The roentgen diagnosis of Behçet disease will be influenced by the dermatologic and ophthalmologic findings.

Familial koilonychia involving 7 members in 3 generations is reported, one of them was complicated with an episode of bacterial infection of all fingernails. The familial distribution of the process in this report suggests an autosomal dominant transmission with high degree of penetrance.

10 of 16 (62.5%) patients with granuloma annulare presented microangiopathic changes in the skin. The incidence in control groups was 100% in diabetic patients, 40% in old-age patients not known as diabetics and 0 in young victims of road accidents. The frequency of the vascular findings does not seem to be shared equally by the two types of granuloma annulare, the generalized and the localized type. In the first, as in the diabetic group, microangiopathy was observed in all patients examined. Whereas, in the second it was detected in only 2 of the 8 patients. It is concluded, therefore, that from the point of view of their relation to a diabetic state, the two forms of the disorder differ from each other.

Disseminated Intravascular coagulation may be an important and determining factor in the pathophysiology of some of the cutaneous vascular manifestations. The use of heparin in this condition seems to be the therapy of choice and sometimes it is life saving. Hence, the importance of being aware of the possibility and polymorphism of this phenomenon. Three cases are described where the presenting symptoms of the disease were mainly dermatological.

Our experience with pemphigus vulgaris consists of 35 cases. The majority are Jews of Eastern European origin, with an average age of 49.3 years. A daily 40–60 mg of prednisone was effective to initiate remission in most of the cases. Substitution of prednisone by an equivalent dose of triamcinolone avoided further increasing in the dose in 11 of 14 cases. Other regimens of treatment, such as alternate-day therapy, addition of estrogen and of methotrexate, were utilized in some of the patients. They were effective in only a part of the cases and after the disease has been held in remission by the conventional daily therapy. Our data shows that it is adviseable to make allowances for individual reactions on determining the level of initial dosages and when utilizing the other modalities of treatment.

Two cases with circumscribed calcinosis of skin are described. One is an obvious case with scleroderma, whereas the second is apparently idiopathic. However, a striking clinical similarity is seen in both. This together with other noncontributory clinical and laboratory findings observed in the second case seem suggestive that idiopathic type of calcinosis may present a preceeding or presenting symptom of a subclinical underlying disease.

SUMMARY The carbohydrate tolerance was routinely investigated in fifty-two patients with granuloma annulare. Thirteen of the fifty-two cases presented the generalized type and the remaining thirty-nine had the localized form of the disorder. The results obtained in these patients were compared with those revealed in two control groups of patients. The same number of patients of the same sex, age and ethnic group with skin diseases other than granuloma annulare were similarly investigated as were 386 patients with conjunctival micro-aneurysms. Some degree of carbohydrate intolerance was detected in 36.5% of patients with both types of granuloma annulare. However, the incidence of this disturbance in patients with the localized form was no greater than in those with other skin diseases. The important finding in this study was the 76.9% incidence of carbohydrate intolerance in generalized granuloma annulare. This finding was supported by the histopathological changes in the small cutaneous blood vessels of these patients.

Solcoderm was used in the management of various epidermal growths in 372 patients with 1,002 lesions, including condyloma acuminatum, verruca plana, basal cell epithelioma, intradermal nevus, seborrheic and solar keratosis. No antiseptic precautions or local anesthesia were used during the treatment. The results seem promising and suggest that Solcoderm is a simple, safe, and efficient method for the management of these tumors. Cosmetic results were excellent. It is especially recommended when the lesions are in difficult to manage locations for surgical or other known chemical or physical methods, when the patient is not fit for surgical procedures, and when local anesthesia is contraindicated.

A patient with a cyclic premenstrual eruption, clearing spontaneously with the menstrual flow, is reported. Hypersensitivity to endogenous progesterone in this case was confirmed by positive intradermal and leukocyte migration inhibition tests. Treatment with conjugated estrogens was followed by remission of symptoms. The importance of awareness to the possibility of progesterone autoimmune mechanisms is emphasized.

This is a report of three cases of associated tuberculous and neoplastic processes. The first is a case of lymphosarcoma complicated by cutaneous tuberculosis. The remaining two are cases of cutaneous tuberculosis complicated by squamouse cell carcinoma. Due to clinical similarity, the diagnosis of the secondary process in these cases was evoked by its failure to respond to treatment of the primary disease.

Vaccinia of the vulva in a 32-year-old married woman is described. The vaccination was apparently due to a heteroinoculation from her husband during sexual contact. Clinically it presented as an indurated ulcer with a few isolated umbilicated vesicles and was associated with an acute biological false-positive serological reactions.

Leukocyte inhibitory factor (LIF) was investigated in 9 patients with localized granuloma annulare and 8 patients with the generalized form of the disease. The control group consisted of 10 matched, apparently healthy subjects. LIF values were significantly higher in patients with granuloma annulare of both groups than in controls (p less than 0.05 and 0.01). However, no significant difference was revealed between the two groups of patients. Though the results seem to speak for a cell-mediated immune response in granuloma annulare, they do not add a further support to the previously demonstrated differences between the two forms of granuloma annulare.

Thirteen patients with localized granuloma annulare and 19 with the generalized form of the disease were typed for HLA antigens. The control group consisted of 70 matched apparently healthy subjects. No significant difference in the frequencies of the 26 tested antigens was revealed between patients with localized granuloma annulare and controls. Patients with the generalized form of the disease showed a highly significant increase in the frequency of HLA-Bw35 as compared with both controls and patients with the localized form of the disorder (P = 0.001 and 0.01 respectively). The results seem suggestive of a possible different pathogenesis of the two forms of the disease.

One hundred patients with viral warts and 108 apparently healthy matched controls were typed for HLA-A and B antigens. No significant difference in the frequencies of antigens was revealed, which suggested that a possible genetic trend in warts is at least not related to A and B loci of the histocompatibility system.

Seborrheic keratosis (Leser-Trélat sign) and extensive florid papillomatosis of the skin and the mucous membranes of the nose, mouth, throat, and external genitalia were associated with adenocarcinoma of the breast in a 61-year-old woman.

Lymphocytes from seven patients with lymphoma cutis were cultured and stimulated by phytohemagglutinin. The lymphocytes of six patients behaved like those lymphocytes from normal donors. The lymphocytes of the seventh patient were anergic.

This is a report of 2 cases revealing photosensitivity in association with aminoaciduria. The first is a patient with psoriasis and the second, a patient with Ehlers-Danlos syndrome, mitis type. The display of the above combinations seems peculiar. The psoriatic lesions become confined mainly to the exposed surface and intermingled with those of photodermatitis forming lesions which are a mixture of the two processes. In the case with Ehlers-Danlos, the disease presented rupioid plaque-like erythematous oozing lesions which seem somewhat different from those of the photodermatosis yet known.

This is a report on two cases with pemphigus vulgaris effectively controlled by dapsone. In one, dapsone was added to the treatment after a failure of combined prednisone and methotrexate therapy to control the disease completely. It is suggested that dapsone may offer a means in an attempt to minimize adverse reactions met with during the long corticosteroid regimen required in pemphigus.

Histocompatibility antigens (HL-A) were studied in a family with Behçet's disease (BD). All who had symptoms or signs of BD had either HL-A B5 or BW35, or both. The increased number of families with BD recently reported supports the suggestion that positive family history may assist the diagnosis of BD.

Twenty-one patients with Behçet's disease were typed for HLA antigens. The controls were 50 subjects randomly chosen from a local population and 24 apparently healthy subjects of the same ethnic groupings as those of the patients. The study revealed significant differences in the frequencies of various antigens in the above three groups, the most obvious of them related to HLA-B5 and HLA-Bw35, HLA-B5 was demonstrated in 71% of the patients as compared with 18% in the local population group and 12.5% in the ethnically related healthy subjects. The incidences of HLA-Bw35 were 66.7%, 32% and 37.5% respectively. In 86% of the patients, at least one of these two antigens was present. It is suggested that besides contributing to the understanding of the disease process, the determining of associated specific antigens may constitute a further diagnostic acid in doubtful cases of Behçet's disease.

A 2-year old girl suffered from continuous pyogenic inflammation in the anogenital region probably enhanced by neurological alterations. In one episode, the inflammatory process presented multiple moist papillomatous growths on the labia majora and along the anal margin which are thought to have been caused by gonococcal infection.

Polymorphonuclear leucocyte function was investigated in 19 patients with active Behcet's disease. Spontaneous free leucocyte migration was found to be significantly reduced, yet after stimulation the leucocyte's chemotactic activity was considerably increase (p less than 0-05) when compared to control leucocytes. Control leucocytes migrated more rapidly when incubated in serum taken from patients with Behcet's disease (p less than 0-005). The enhanced chemotactic activity in Bechcet's disease appears to be due to both serum and intrinsic leucocyte factors. Spontaneous nitroblue tetrazolium reduction was found to be normal, although after stimulation leucocyte nitroblue tetrazolium reduction was lower than in the control group (P less than 0-025), as was leucocyte oxygen utilisation. It is suggested that the hyperreactive cellular inflammatory response that characterises Behcet's disease may be due to increased chemotactic activity and minor alterations in functional metabolic activity of leucocytes.

SUMMARY Thirth-five patients who received thirty-seven kidney transplants (two patients received live; the rest cadaver kidneys) were followed up for skin complications. There were thirty-nine instances of overt skin infection. In twenty-one instances we encountered fungal, in ten pyogenic and in eight viral infection. The course of these infections was more severe and more protracted than is usual in other patients. In nine instances, the skin infection contributed directly to the death of the patient. One patient developed Kaposi's sarcoma and another pyoderma gangrenosum. This study suggests that immunosuppressive treatment, which all our patients were continuously receiving, enhances their susceptibility to infection and to malignancy and may have been an aetiological factor in pyoderma gangrenosum.

Summary Clinical or chemical (latent) diabetes was discovered in 7 of 8 patients with generalized granuloma annulare; all were women. The average age of onset of their disease was 50 years. Treatment with chlorpropamide and low carbohydrate diet seemed to alleviate the skin manifestations in 6 of 7 patients so treated.

Alternate-day prednisone therapy was tried in 21 children, with rheumatic fever, 1 with nephrotic syndrome, and in 14 patients with pemphigus vulgaris. Ten of the latter were already treated by the conventional daily method and their lesions were well controlled by a carefully established daily maintenance dose. The additional 4 received the alternate-day treatment directly after their lesions were first controlled by the daily method. The follow-up of our cases revealed the following: (a) the adverse reactions to this regimen were comparatively mild and rare, and most of the already existing ones improved or disappeared totally, (b) the endogenous pituitary adrenal function was well preserved and in 3 it returned to normal following its depression by the daily method, (c) the treatment was apparently as effective as the daily devided doses regimen, (d) in 1 patient with pemphigus vulgaris the treatment failed to bring a primary remission, however, it was effective in maintaining the remission achieved by the daily method.