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SUMMARY.— A significant increase of the mean IgA globulin value was noted in 105 patients with ordinary psoriasis whereas the mean IgG and IgM globulin levels remained normal. Thirty-two of these patients received u.v. light therapy which resulted in resolution of the skin lesions. At this stage the IgA levels fell to the normal range. The possibility of the skin eruption influencing the IgA serum levels is discussed.

Thirty four sera from: 12 patients with Systemic Lupus Erythematosus (SLE), 9 with Subacute Cutaneous Lupus Erythematosus (SCLE) and 13 with Discoid Lupus Erythematosus (DLE) (disseminatus 3, localised 10) were tested for the presence of: (a) anti-thyroglobulin and anti-microsomal autoantibodies (b) anti-Sm/RNP, anti-doublestranded. DNA (anti-ds. DNA), anti-single-Stranded. DNA (anti-ss. DNA), anti-cardiolipin (anti-Cl), anti-SSA, anti-SSB, Antinuclear Antibodies (ANA). T3, T4, TSH levels were also determined. Five patients with SLE (41.6%), 4 with SCLE (44.4%), and 2 with DLE (15.3%) had thyroid autoantibodies and only three of the 41 controls (7.3%). Five patients (14.7%), especially from SLE and SCLE groups, had biochemical hypothyroidism whereas only one had hyperthyroidism. Statistical evaluation for the possible coexistence of thyroid autoantibodies with a panel of lupus characteristic autoantibodies, revealed highly significant correlations with anti-Sm/RNP, IgG (p = 0.003) and anti-ds. DNA, IgM (p = 0.012). It may be concluded, that not only SLE but also SCLE predisposes to autoimmune thyroid disease and the prevalence of the latter is related to a great extent to the subset of the LE spectrum. From these results and from the inhibition experiments, it seems that some of the specific mono- or polyclonal autoantibodies may be multiple organ reactive.

Background Attempts to elucidate the pathophysiology of chronic urticaria and its relation with stress have implicated many factors among which the increased activity of the opioid system seems to be particularly interesting. Material and Methods We determined the β-endorphin serum levels in 14 patients with chronic urticaria and 15 healthy members of the medical staff of comparable age. Results The mean β-endorphin levels of our patients (15.95 ± 2.75 pmol/l) were statistically elevated (P < 0.001) compared to those of controls (8.53 ± 2.53 pmol/l). Conclusions It is suggested that the opioid system of patients with chronic urticaria is strongly activated in the chronic stage of the disease.

The objective of the present study was an extensive analysis of the autoantibody profile in the most common subsets of cutaneous lupus erythematosus (LE), acute and subacute cutaneous lupus erythematosus (ACLE, SCLE) as well as discoid lupus, localized or disseminatus (DLE loc, DLE dis). Antibodies (Abs) against glomerular extracts, actin. myosin and cardiolipin were examined in the various cutaneous lupus subgroups, in addition to ANA and Abs against DNA, ENA and IgG (rheumatoid factor). Abs against glomerular extracts were detected mainly in ACLE and SCLE, whereas Abs against actin, myosin and cardiolipin were found in all cutaneous lupus subsets. The detailed record of the autoantibody profile helped in the serological differential diagnosis of the various cutaneous lupus subsets, suggesting also that SCLE and DLE dis are distinct subsets in the spectrum of cutaneous LE. Finally, correlations between autoantibodies of the same isotype were carried out, providing implications for regulation of autoantibody production. Copyright © 1994, Wiley Blackwell. All rights reserved

Thirty four sera from: 12 patients with Systemic Lupus Erythematosus (SLE), 9 with Subacute Cutaneous Lupus Erythematosus (SCLE) and 13 with Discoid Lupus Erythematosus (DLE) (disseminatus 3, localised 10) were tested for the presence of: (a) anti-thyroglobulin and anti-microsomal autoantibodies (b) anti-Sm/RNP, anti-doublestranded. DNA (anti-ds. DNA), anti-single-Stranded. DNA (anti-ss. DNA), anti-cardiolipin (anti-Cl), anti-SSA, anti-SSB, Antinuclear Antibodies (ANA). T3, T4, TSH levels were also determined. Five patients with SLE (41.6%), 4 with SCLE (44.4%), and 2 with DLE (15.3%) had thyroid autoantibodies and only three of the 41 controls (7.3%). Five patients (14.7%), especially from SLE and SCLE groups, had biochemical hypothyroidism whereas only one had hyperthyroidism. Statistical evaluation for the possible coexistence of thyroid autoantibodies with a panel of lupus characteristic autoantibodies, revealed highly significant correlations with anti-Sm/RNP, IgG (p = 0.003) and anti-ds. DNA, IgM (p = 0.012). It may be concluded, that not only SLE but also SCLE predisposes to autoimmune thyroid disease and the prevalence of the latter is related to a great extent to the subset of the LE spectrum. From these results and from the inhibition experiments, it seems that some of the specific mono- or polyclonal autoantibodies may be multiple organ reactive.

A 53-year-old female patient with pemphigus vulgaris under continuous immunosuppressive therapy for about 2 years presented a superficial spreading malignant melanoma on a pre-existing melanocytic naevus. After surgical removal of the inguinal lymph node group, a diffuse low-grade polymorphous immunocytoma was proved both histologically and immunocytochemically. The possible induction mechanisms are discussed.

One hundred tumors of epidermal origin were studied by means of indirect immunofluorescence technique with sera from patients with proven pemphigus and bullous pemphigoid. We found that in tumors of epidermal origin, there was a loss of antigenicity of the intercellular substance and basement membrane; this was minimal for benign tumors, greater for premalignant tumors, and very clear for malignant tumors. We also found a gross correlation between the histologically proven malignancy of squamous cell carcinoma and the grade of antigenic loss; both for the intercellular substances and for the basement membrane antigens. However, this did not yeild definite results in the group with basal cell carcinoma. With regard, especially, to the intercellular substance antigen, it seemed to be completely independent of histologic type of basal cell carcinoma. We found that the duration of the epidermal tumor did not correlate with the percentage of intercellular substance and basement membrane antigenic loss. This suggested that the antigenic loss was an early feature of neoplastic behavior. The deeper parts of the malignant tumors in the dermis showed a lower percentage of antigenicity for both antigens.

In 2 patients with anhidrotic ectodermal dysplasia, we were able to show that the hypoplastic eccrine glandular elements may give rise to normal eccrine glands both anatomically and functionally, after repeated local application of acetylcholine. The perspectives of our findings for the therapeutic management of the anhidrotic ectodermal dysplasia are discussed and special attention is paid to the genetic background of the defect as well as the possible mode of action of acetylcholine.

An immunohistochemical study has been undertaken on 25 biopsy specimens taken from lichen planus lesions, using antisera against human fibrin, immunoglobulins IgG, IgA, IgM and C3 (BjC/BjA) complement component. The findings of the present research are discussed and evaluated in relation to the problem of the etiopathogenesis of the disease.

We studied sweat gland distribution, density and activity in thirteen cases of granuloma annulare and ten cases of necrobiosis lipoidica, using a combination of the plastic impression and starch-iodine methods. The pattern of sweat gland disturbance in the two diseases was entirely different. In necrobiosis lipoidica an intense and uniform hypohidrosis was detected throughout the lesion, whereas in granuloma annulare the disturbance followed the morphology of the lesion (the papular border showed complete anhidrosis, whereas the flat central part of the lesion showed only moderate hypohidrosis or normal sweating). The method assigns numerical values to the 'relative density' and the 'relative activity' of the functioning sweat glands compared with normal skin, thus permitting statistical evaluation of the results. Br J Dermatol

In this study, the in situ immunological typing of cell populations in lichen planus was attempted. T lymphocytes and suppressor/cytotoxic subsets, B lymphocytes, macrophages, immunocytes and Langerhans’ cells were studied by one or more technical parameters and semiquantitative assessment of T cell populations were carried out. A critical evaluation of assays for T cell characterization was also attempted. T cells were found predominant in lichen planus infiltrate but macrophages were also many. Langerhans’ cells were increased in the epidermis compared to normal skin and contact dermatitis.

During the topical treatment of 45 patients, who had extensive forms of alopecia areata, with the allergen diphencyprone, 3 of them (6.7%) developed vitiligo. Two were females and 1 male aged 53, 19 and 28 years respectively. None of these patients had a personal or family history of vitiligo. Vitiligo appeared 3–5 months after the onset of treatment and was localized only to the areas of topical application in the younger woman and the man. In the older woman, vitiligo extended to several areas apart from those where the medicament was applied. After the end of diphencyprone treatment, vitiligo had a spontaneous significant improvement only in the man. Mitochondrial autoantibodies were found in the older woman only. To our knowledge, vitiligo due to diphencyprone has not been previously reported.

Summary A case of herpes gestationis with multiple attacks is reported. These attacks occurred over five years during and after three successful pregnancies, during and after three pregnancies which resulted in miscarriages, and during menstruation. The three living children did not have any skin problems. The diagnosis was substantiated, histologically and immunohistochemically. The patient was HLA DR3 positive. She was Rhesus−ve (Rh−ve) and the two first children were Rh+ve while the third one was Rh−ve. The investigative data are discussed in relation to the possible pathogenetic factors for the diseases.

Of 85 patients with condylomata acuminata treated topically with Solcoderm, the lesions were apparently eradicated in all but 11 (12.9%), and recurrences were noted in 6 during a 3-month follow-up. Only 1 treatment was required in 55 (64.7%) of the treated subjects.

The term " atopic dermatitis " was given by Wise and Sulzberger (1933) to those inflammatory dermatoses which are intimately associated with other allergic manifestations with a strong hereditary influence, such as hay-fever and asthma, described by Coca and Cooke (1923) as atopic. Patients suffering" from atopic conditions have a high incidence of circulating antibodies of a particular type. These antibodies, known as reagins, are responsible for positive immediate-type hypersensitivity reactions when the patient is skin-tested with a wide range of naturally occurring antigens. These antibodies cannot be demonstrated by in vitro techniques. However, their presence can be shown by the passive transfer technique of Prausnitz and K?stner (1921). They also differ from other circulating antibodies by having a high affinity for skin and being heat-labile. In June 1964 a committee of the World Health Organization defined proteins of animal origin with known antibody activity as immunoglobulins. The human immunoglobulins have been divided into three major groups. Two groups of molecular weight -^150,000 were called IgG (previously y, 7Sy, yss, or y2) and IgA (previously ?2A or YiO The third group consists of the macroglobulins of molecular weight r?900,000 and is called IgM (previously Yi*_ P^m, or 19Sy). Most circulating antibodies occur in the IgG fraction, though the IgM fraction contains red-cell iso-antibodies, saline anti-D (rhesus) antibodies, and immune antibodies directed against the somatic antigens of Salmonella spp. Until recently many workers considered reagin-type anti bodies to be immunoglobulins of the type IgA. However, more recently there has been evidence to suggest that the concept has been somewhat oversimplified, and in fact molecules of the class of IgG might be involved. As there is no doubt that reagin type antibodies are readily demonstrated in patients with atopic eczema, the present study was undertaken to determine the levels of immunoglobulins in patients with atopic eczema as compared with those with other skin conditions, including other patterns of eczema. Until recently this has not been possible because of the lack of a simple quantitative technique for deter mining accurately the levels of these different forms of immunoglobulins (Fahey and McKelvey, 1965). Previous work has been of a semi-quan?i?ative type either by the use of scanning of electrophoresis strips (Tickner, McCabe, and Mier, 1959), or, more recently, by the arbitrary assessment of the degree of precipitation in immunoelectrophoresis (K?lder, 1965).