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A case of pili annulati in an eighteen year old woman is described. The hairs show bright spots along hair shafts when viewed in daylight. The transmission and scanning electron microscopy confirmed that the bright spots are due to small cavities into the cortex. The plasmatic measurement of copper, zinc and of the most important hormone, such as the dosage of plasmatic, urinary and hair aminoacids, allowed the Authors to exclude any influence of metabolic systemic alterations on the pathogenesis of pili annulati. Neither cutaneous nor internal anomalies were detected.

The unknown etiopathogenesis of psoriasis and its often unpredictable course, in spite of actual treatment, suggest the search of parameters correlated with the disease that could help to better define and treat these patients. The altered cell turnover of the psoriatic epidermis leads to hypothesize a disturbance or at least a modification of the cellular rhythm of the skin. In order to prove alterations of the circadian temporal structure in psoriasis, we have studied some easily detectable variables, registered at 3-h intervals, in both psoriatic and in healthy control subjects. The control subjects presented statistically significant circadian rhythms of oral temperature, arterial blood pressure, pulse, electrolytes, 17KS, 17-OHCS and uricemia. In the psoriatic group, only a few of these variables present a clearly reproducible circadian rhythm. Moreover these rhythms, when they are demonstrable in the patients, do not show the same circadian acrophases of the control subjects and they are also desynchronized inside the group itself. The alteration in these circadian urinary and haematic rhythms implies that in psoriasis not only the skin is involved: all the circadian structure seems to be perturbed and the cause of the disease should mot be searched only in the epidermis.

Authors describe a case of Hypohidrotic Ectodermal Dysplasia in a female carrier. This report give rise to a review of the clinical spectrum of the syndrome. An appraisal of diagnostic methods, associate abnormalities and mode of inheritance is detailed.

Patients with hyper IgE syndrome (HIES) have varying degree of immunological unbalance that account for deficiency of total T and OKT8 lymphocytes. To investigate the role of immunostimulating drugs in HIES, thymostimulin (TP1) and levamisole were given in highly controlled groups of patients after a wash out period with disodium-chromoglycate (DSCG). Both drugs do not modify clinical picture whereas they do modulate some laboratory parameters as T lymphocyte total number, IgE plasmatic concentration, neutrophil chemotaxis. Furthermore TP1 had a worsening clinical effect in 3 of our patients. In our opinion we feel that the therapies proposed and employed so far for this rare disease must be critically analyzed.

Activity of p53, H-ras, c-myc and c-fos in psoriatic lesions was studied using monoclonal antibodies (MoAbs) performing a sensitive immunohistochemical method on frozen sections. Normal skin from surgery was used as control. Reactivity of p53, H-ras and c-myc is remarkable in psoriatic plaques but, in contrast, c-fos expression does not show differences compared to control skin. These findings led us to speculate about the importance of cellular oncogenes in the pathogenesis of psoriasis.

Ten patients with vitiligo, either in the active (six cases) or static (four cases) phase, and twelve healthy control subjects were studied with a standard cytotoxicity assay to evaluate the circadian rhythm of natural killer cell activity from peripheral blood mononuclear cells. The natural killer cell activity was measured at the zero, sixth, twelfth, and eighteenth hours of the day. The results demonstrated that patients with vitiligo had significantly higher natural killer cell activity compared with normal controls. When patients with static and active vitiligo were compared, those with the static form had increased natural killer cell activity at all times except noon, whereas those with active form had increased natural killer cell activity only at 0600 and 1800. These changes shifted the acrophase of the circadian rhythm of each group. Indeed, by cosinor analysis, both patients with vitiligo and normal controls had similar circadian rhythms, but the acrophase was shifted from 0602 in control subjects to 0435 in the ten patients with vitiligo. The acrophase in the six patients with active vitiligo was found to be closest to that of normal controls (0508). These findings indicate that natural killer cell activity abnormalities are more marked in the static rather than in the active form of vitiligo.

Melatonin is synthesized and secreted by the pineal gland. A daily rhythm of melatonin secretion, with high plasma values during the dark period, has been found in all vertebrates studied so far. In psoriatics, several hormones, including GH and prolactin, have altered chronobiology, and some studies in humans suggest that melatonin affects the levels of GH and prolactin. We investigated circadian melatonin rhythm in 13 male psoriatics and 13 healthy males with an RIA specific for measuring the hormone in plasma. Samples were taken at 6 a.m., 8 a.m., 12.00, 4 p.m., 8 p.m. and 2 a.m. Differences in (mean +/- SD) plasma melatonin levels were analysed by Student's t-test. Our results show that psoriatic patients had lost the nocturnal peak and usual circadian rhythm of melatonin secretion. Levels of melatonin were significantly lower than in controls at 2 a.m., and higher at 6 and 8 a.m. and at 12 noon. Further investigations of this disorder of melatonin secretion in psoriasis are needed to understand its significance.

A 5 months old infant having "granuloma gluteale infantum" (G.G.I.) is reported. One or more tumorous red-purple nodules on gluteal or on genitocrural area are the usual cutaneus injuries of G.G.I. The histologic aspect resembles pyogenic granulomas. The exact pathogenesis of G.G.I. is still to be defined; nevertheless the use of plastic diaper covers and topical fluorinated steroid preparations seems to have great influence.