Melanoma. Associated antigens in benign melanocytic disorders.

Three instances of depigmentation occurring in children with congenital large nevocytic nevi are reported. Serologic studies for tumour-associated antigens to melanoma were performed by indirect immunofluorescence and complement fixation on these patients and others with benign melanocytic disorders. Positive reactivity in several children was observed. The small numbers studied and lack of uniformity of other testing methods leave open the question of relevance of such reactivity to malignant conversion or protection in congenital nevi.

Peripheral blood flow in the neonate; 1. Changes in total, skin, and muscle blood flow with gestational and postnatal age.

Total peripheral blood flow and blood flow through the skin and muscle were measured in the calf with an electrocapacitance plethysmograph with counter pressure in a group of 62 "well" newborn infants (birth weight, less than 3500 g). Blood pressure in the contralateral leg was measured with an Arteriosonde 1010, and peripheral vascular resistance was calculated as mean blood pressure (mm Hg) divided by blood flow (ml per 100 ml tissue per min). The results show that total peripheral blood flow and blood flow through he skin and muscle correlated inversely with increasing birth weight and gestational age. Postnatally, total blood flow and blood flow through the skin and muscle decreased gradually during the first 7 days of life and in the rest of the neonatal period. Peripheral vascular resistance and resistance in the skin and muscle correlated directly with increasing birth weight and gestational age. Postnatally, peripheral vascular resistance and resistance in the skin and muscle increased during the first 7 days of life and the neonatal period.

Dinitrochlorobenzene responsivity: difference between patients with severe pulmonary coccidioidomycosis and patients with disseminated coccidioidomycosis.

Immunologic responses in 15 patients with severe pulmonary coccidioidomycosis and in 50 patients with disseminated coccidioidomycosis were measured by determination of complement-fixing (CF) antibody titers to coccidioidin in serum, coccidioidin (1:100) skin tests, and sensitization to dinitrochlorobenzene. Among the patients with desseminated coccidioidomycosis, the nine with CF antibody titers of less than or equal to 1:8 had normal responses to dinitrochlorobenzene, but the 41 with titers of greater than or equal to 1:16 had responses that were significantly lower than those of controls (P less than 0.001). In contrast, all patients with severe pulmonary coccidioidomycosis had CF antibody titers of greater than or equal to 1:16 and had responses to dinitrochlorobenzene that were greater (but not significantly greater) than those of controls. Among subjected with antibody titers of greater than or equal to 1:16, responsiveness to coccidioidin was found in 27% of those with severe pulmonary disease and in 39% of those with disseminated disease. Thus impaired responsivity to dinitrochlorobenzene in coccidioidomycosis is restricted to patients who have disseminated illness and high titers of CF antibody and is separable from lack of responsiveness to coccidioidin.

Lucio's phenomenon and diffuse nonnodular lepromatous leprosy.

The records of ten patients with Lucio's phenomenon showed clinical and histopathological changes similar to those described by others. Lucio's phenomenon is a syndrome distinct from erythema nodosum leprosum as indicated by an absence of fever, leukocytosis and tenderness, a failure to respond to thalidomide, and a restriction to patients with diffuse nonnodular lepromatous leprosy. Lymphopenia associated with splenomegaly in three patients and glomerulonephritis in one patient were unexpected findings of unknown relevance.

Histocompatibility antigens in patients with leprosy.

The frequencies of distribution of 25 histocompatibility antigens were determined in 92 Mexican patients with leprosy and compared with those in 315 Mexicans who did not have the disease. No statistically significant differences were found between the patients and the controls in regard to histocompatibility antigens, and subgroups with a significant difference could not be identified by division of the patients according to the density of Mycobacterium leprae or the presence or absence of cell-mediated immunity directed against antigens of M. leprae.

Blood flow and venous distensibility in the upper and lower extremities of newborn infants.

The electrocapacitance plethysmograph was utilized to measure peripheral blood flow and venous distensibility in 17 newborn infants and 20 adults. Measurements were made in the upper and lower extremities in each subject under identical environmental conditions. Blood flow in the forearm and calf were found to be significantly higher in infants than adults. In infants there were no significant differences in the blood flow between the upper and lower extremities. In contrast, in the adults, the blood flow was significantly higher in the upper than in the lower extremities. Similarly, venous distensibility was observed to be higher in infants than in adults. While no significant differences were observed in the venous distensibility between the upper and lower extremities in infants, the venous distensibility was found to be higher in the forearm than in the leg in adults.

Immunologic responses in patients with lepromatous leprosy.

Immunologic responses were measured in 46 patients with lepromatous leprosy. These patients were not distinguishable from controls on the basis of responses to soluble intradermal antigens, sensitization to contactants, peripheral blood T- and B-cell percentages, in vitro lymphocyte responses to a mitogen, or the prevalence of autoantibodies. Generalized immunologic abnormalities in patients with lepromatous leprosy are neither predisposing causes nor necessary accompaniments of lepromatous leprosy, but are probably remote sequellae of the illness. By implication, the generalized immunologic abnormalities reported in other diseases are likely to be remote sequellae of the particular illness.

Dinitrochlorobenzene responsivity in disseminated coccidioidomycosis: an inverse correlation with complement-fixing antibody titers.

The immunologic status of 25 patients with disseminated coccidiodomycosis was evaluated by serum anticoccidioidin complement-fixing antibody levels, coccidiodin skin tests, and dinitrochlorobenzene (DNCB) sensitization. In the 10 patients who had disseminated disease and a complement-fixing titer of 1:32 or less, responses to DNCB were similar to those of 20 controls. In the 15 patients with disseminated disease and a complement-fixing titer of 1:64 or more, responses to DNCB were statistically significantly diminished compared to controls (p = 0.002). Since the complement-fixing titer is associated with extent of dissemination, these results signify a relationship between diminished DNCB responses and extensive dissemination. Of the several hypotheses which might explain this relationship, we find the most attractive is that of a nonspecific deficiency of cell-mediated immunity developing secondarily to extensive disseminated disease.

Erythema nodosum leprosum in a general hospital.

We report 32 patients with erythema nodosum leprosum (ENL). Twenty-two patients developed ENL before beginning chemotherapy. The recognition that ENL in the absence of chemotherapy is not an uncommon event is of importance, not simply as a fact in and of itself, but because this observation raises provocative questions when placed in the context of current ideas concerning ENL. ENL should be regarded as a manifestation of leprosy, not necessarily as a complication of its therapy.

Apparently normal skin in lepromatous leprosy: histopathological findings.

Biopsy specimens of apparently uninvolved skin from 34 patients with lepromatous leprosy were studied histologically. Bacilli were found in 30 of 31 specimens from clinically polar or near-polar lepromatous patients but not in the three from nonpolar patients. A predominantly perivascular distribution of infiltrate and bacilli is consistent with a hematogenous spread of infection. Subclinical, diffuse lepromatous leprosy is found in patients with nodular lesions and may precede the development of nodules. Study of apparently uninvolved skin may be helpful in classifying patients, in interpreting immunologic responses, and in elucidating the natural history of the illness.

Production of ring-shaped particles by normal and metaplastic tissue. I. Human skin.

Maintenance media incubated with biopsy specimens of human skin tissues contained minute (10-12 nm wide), ring-shaped particles (RSP) similar to those described previously in culture media of mammalian cell lines. In addition to the qualitative demonstration of the particles by electron microscopy, a quantitative method was applied to estimate in media the amount of DNA that could be attributed primarily to RSP content. The amounts of DNA, obtained with 146 test specimens, varied with the pathologic condition of the tissue in the following ascending order: normal skin, verruca vulgaris, seborrheic verruca, actinic keratosis, basal cell carcinoma, and squamous cell carcinoma.

Immunoglobulin deposits in lepromatous leprosy skin. Presence of deposits in apparently uninvolved skin and occurrence of serum antiepithelial antibodies.

Immunoglobulin deposits were detected in ten of 13 biopsy specimens from apparently uninvolved skin of patients with lepromatous leprosy. There were deposits of IgM at the dermoepidermal junction in the skin of five patients, and deposits of IgM along the dermal collagen and elastic fibers in the skin of the other five. The deposits were eluted with acid buffers and high molarity salt solution. Circulating IgG antibodies to intercellular substance of epithelial cells, similar to those present in pemphigus vulgaris, were found in 25% of patients with lepromatous leprosy who were studied. These antibodies appeared to be different from the skin-bound immunoglobulin deposits.