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The morphological and haemodynamic findings in the vessels of the forearm and hand in 21 patients with progressive scleroderma are described. In these patients, brachial arteriograms have been carried out before instituting fibrinolytic therapy. Injections were carried out before and after intra-arterial Priscolin and the results were compared. Obliterative changes in the digital arteries are already present during the oedematous stage. Between the oedematous and advanced stages, there are vascular changes of progressive severity. In the sclerotic stage, the changes may be less marked, but more often consist of advanced obliterative vascular disease; this cannot be distinguished from the atrophic stage. The haemodynamics of the digital arteries can be influenced by Priscolin and this provides some information regarding the arterial side of the dermal micro-circulation. Even during the oedematous stage one can observe contrast stasis which is irreversible and not influenced by Priscolin.

Modern concepts on the classification and prognosis of cutaneous T-cell lymphomas are discussed in this paper. The full spectrum of cutaneous T-cell lymphomas is not yet known. A new classification of histomorphological types of mycosis fungoides and Sézary's syndrome in correlation with prognostic features is proposed.

The case of a 10-year-old girl with an infrequently observed lipid dermatoarthritis is reported. This is a systemic disease of unknown etiology characterized by a nodular eruption of the skin, mucosa and synovia, resulting in destructive arthritis and disfigurement of the facies. Biopsy of a nodule, whether from skin or synovia, discloses a cellular infiltrate consisting of histiocytes and multinucleated giant cells with lipid inclusions. No effective treatment is known.

The basis for this review forms a series of 20 new cases of clear cell acanthomas and the literature on this subject. The clinical and histopathological characteristics of this not too rare skin tumor and newer histochemical and electron microscopical findings are discussed. Particular attention will be paid to the question of the position of the clear cell acanthomas within the group of intraepidermal acanthomas and the "clear-celled" tumors of the skin. Presently, the clear cell acanthoma can be classified as a benign epidermal tumor of unknown etiology. It is assumed that the clear cell acanthoma arises through a special disturbance of the differentiation of keratinocytes.

This report draws attention to pitfalls that may be encountered in histologic diagnosis of early stages of pemphigus vulgaris. A man is described who had clinical and histologic features of bullous pemphigoid to begin with and later typical features of pemphigus vulgaris. Intercellular antibodies were demonstrable by direct immunofluorescence from the beginning.

We investigated 46 cases of cutaneous lymphoma and pseudolymphoma by immunohistochemical methods using a panel of monoclonal antibodies. Of the cutaneous T cell lymphomas, 2 did not show the classic helper phenotype but revealed a predominance of suppressor cells in one case and of immature thymocytes in the other. Cutaneous B cell lymphomas of low-grade malignancy were characterized by the presence of completely developed T zones between the B cell areas. B cell lymphomas of high-grade malignancy revealed an immunohistologically homogeneous infiltrate. Cutaneous pseudolymphomas can be classified in T cell pseudolymphomas (lymphocytic infiltration, lymphomatoid papulosis) and B cell pseudolymphomas. Lymphadenosis cutis benigna with germinal center cell differentiation was clearly distinguishable from other B cell pseudolymphomas, which are considered to comprise mainly peripheral B lymphocytes. Immunohistological methods are obviously useful in the classification of lymphoproliferative diseases of the skin and can make a contribution to increasing our understanding of them.