Contact sensitivity to Candida albicans--comparative studies in man and animal (guinea-pig).

We studied the elicitation of contact sensitivity to Candida albicans antigen in guinea-pigs with experimental cutaneous candidiasis and in humans, using commercially available potent 1:100 C. albicans antigen (Torii) by patch testing on abraded skin. In guinea-pigs, non-immune animals became patch test-reactive 4-5 days after topical application of viable C. albicans, either under occlusion or without occlusive dressings, concurrently with the demonstrability of delayed responses to intradermally injected 1:10 000 Candida antigen. In humans, all healthy adults who showed delayed hypersensitivity reactions to intradermally injected 1:10 000 C. albicans antigen demonstrated positive patch-test reactions to 1:100 C. albicans antigen. There was a significant correlation between the magnitude of responses to these tests. In contrast, no positive patch test reactions were elicited to the 1:100 C. albicans antigen on neonatal skin, emphasizing the lack of irritability of this test agent. These results also indicate that in humans contact sensitivity to Candida antigen occurs during later life because C. albicans is a ubiquitous organism. The practical value of this Candida patch test for evaluation of patients' immune function was assessed by a prospective study in patients with various skin disorders. The results obtained suggested some potential value of the test for evaluation of cell-mediated immune function of patients with regard to ubiquitous recall antigens.

Bullous pemphigoid, figurate erythema and generalized pigmentation with skin thickening in a patient with adenocarcinoma of the stomach.

A 52-year-old woman with bullous pemphigoid developed a bizarre figurate erythematous eruption and generalized pigmentation and velvety skin thickening. Later on, these cutaneous signs were found to be associated with an underlying adenocarcinoma of the stomach. Double-diffusion precipitation and indirect immunofluorescence, however, failed to demonstrate circulating antibodies against the tumor tissue in our patient.

Functional and morphological analysis of the horny layer of pityriasis alba.

The affected skin of pityriasis alba showed functional defects in both hygroscopicity and water-holding capacity detectable by water sorption-desorption test. Furthermore using skin surface biopsy technique in 5 patients, we noted that the mean area of corneocyte obtained from the affected skin of pityriasis alba was smaller and that the surface of that area showed a more prominent villous pattern than the adjacent normal skin in scanning electron microscopical observation. In this study we demonstrated the abnormalities of the horny layer in pityriasis alba, which suggest that the condition is similar to a dermatitic change and that its hypopigmentation may be due to postinflammatory mechanisms.

Unilateral ashy dermatosis occurring in a child.

An unusual case of ashy dermatosis of Ramirez occurred in a 5-year-old-girl who had ash-colored hyperpigmented macules and plaques on the left leg and the left side of the trunk. These unilateral lesions showed histopathologic changes of a lichenoid tissue reaction. Although the exact cause of ashy dermatosis remains unknown, the positive test result for serum rheumatoid factor and the granular deposition of IgM at the dermoepidermal junction found in our case has immunologic implications.

Successful treatment of chromoblastomycosis with topical heat therapy.

Four female patients with chromoblastomycosis were completely cured by prolonged topical application of tolerable heat from pocket warmers. The lesions involuted after 2, 3, and 6 months, respectively, in three patients who faithfully followed our strict treatment schedule, in contrast to the fourth patient who performed the topical heat therapy in an irregular manner at home over a 12-month period. In vitro studies showed that the mature colonies of Fonsecaea pedrosoi, isolated from three of the patients, withstood persistent heating at 42.5 degrees C for more than 1 month. This suggested that heat killing of the causative organisms is unlikely to have been the sole reason for the effectiveness of this simple therapeutic modality.