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An ultrastructural investigation of two patients suffering from acrodermatitis chronica atrophicans revealed in the small dermal vessels swelling of the endothelial cells, material of probably plasmatic origin accumulated in the subendothelial area, and sleeves of basement membrane-like material on a concentric perivascular layout.

Cardiac conducting tissue antibodies (CCTA) were detected, using indirect immunofluorescence, in 8 (25%) out of 32 sera from patients with progressive systemic sclerosis (PSS) and in 39 (35%) out of 110 with rheumatoid arthritis (RA). Conduction abnormalities, namely right bundle branch block, were present in 19 (59%) of the PSS patients and in 37 (32%) of the RA cases. No significant correlation was found between the prevalence of CCTA and conduction abnormalities in PSS patients, while this was present in RA patients (p less than 0.001). CCTA were always negative in 18 patients with systemic lupus erythematosus and were found in one out of 8 cases with Sjögren's syndrome, also positive for rheumatoid factor without clinical RA. These data suggest that CCTA are evoked when involvement of cardiac conducting tissue (as in RA) or working myocardium (as in PSS) is present. Whether CCTA should be mainly regarded as an expression of the immunological derangement underlying these pathological conditions or whether they are secondary to myocardial tissue damage, must still be clarified.

The Authors report the results of a study on the etiology of non-gonococcal urethritis (NGU) carried out on 180 male patients with NGU and on 50 healthy volunteers matched for age and sex. Chlamydia trachomatis infection was proven by culture in 54 (30%) of the NGU-patients and in none of the healthy controls. Ureaplasma urealyticum was recovered from men both with and without urethritis. Bacteria other than C. trachomatis were not found in NGU-patients in a significant percentage. All C. trachomatis-positive NGU-patients presented antibodies against C. trachomatis, by indirect fluorescence, while only 54% of C. trachomatis-negative NGU-patients and 22% of healthy volunteers, were positive. A further serological screening of 78 women with no history of urethritis or cervicitis and 44 children less than 10 years of age was carried out in order to investigate the prevalence of serum antibodies against C. trachomatis in groups of healthy population in Italy.

In pathological conditions, vascular modifications occur in various stages involving both vessel structure and adjacent extracellular matrix. The relationships between vascular cells and surrounding microenvironmental stroma are mediated by cytoskeleton. Our investigation showed a high number of vimentin- and actin-positive cells in the vascular cutaneous bed, mainly related to reactive vascularization phenomena, whereas vessel cells with a desmin-positive reaction were barely detectable. Furthermore, in newly formed vessels ultrastructure showed that basement membrane synthesis strictly depends on close contact between the endothelium and extracellular matrix. Our data give structural evidence of the close morphofunctional interactions existing between vascular cells and extracellular matrix.

A case of xanthelasma palpebrarum with extensive and disfiguring involvement of all four eyelids in a patient without abnormal serum lipid levels is reported.

Patients with Darier's disease have frequently been observed to develop severe bacterial and viral infections. Previous studies have indicated some derangement in the immune system, even though no consistent or specific abnormality has yet been demonstrated. We performed the results of immunologic studies in 10 patients with Darier's disease. In each patient humoral immunity and cell-mediated immunity (in vivo and in vitro) were evaluated and leukocyte chemotactic function was assayed. Humoral immunity was normal; as regards clusters of differentiation (CD), a slight increase in CD4 lymphocyte subpopulations was observed in 7 patients and of CD4/CD8 ratio in 1 case. The lymphocyte responses to phytohemagglutinin and concanavalin A were normal, whereas the response to pokeweed mitogen was decreased slightly, but not significantly. Normal random and chemotactic mobility was found in all the patients except one. The data obtained do not show important immunological alterations. Our patients did not have a high propensity to develop severe infections and this may explain the absence of significant immunological derangement. Our data confirm that no immunological derangement is associated with Darier's disease.