[Cutaneous lesions due to inhibition of epidermal growth factor receptor]. / Hautveränderungen nach Blockade des Epidermal-growth-factor-Rezeptors.

Malignant tumors are increasingly being treated with therapeutic agents having molecular mechanisms of action (so-called biologics). These include therapeutic agents for the blockade of epidermal growth factor receptor (EGFR). The adverse drug reaction profile associated with EGFR inhibitors is dominated by cutaneous lesions. Most common are acneiform skin reactions followed by xerosis, eczema and changes to the hair and nails. The cutaneous changes vary greatly between individuals and may be relatively insignificant. However, they may also prevent continuation of therapy. During the use of EGFR inhibitors, a correlation was observed between the severity of cutaneous changes and the effectiveness of the therapeutic agent, a finding potentially useful for individual dose adjustment.

Unilateral linear lichen planus with mucous membrane involvement.

Linear lichen planus is a rare distinctive variant of lichen planus (LP) characterized by a pruritic eruption of lichenoid, violaceous papules in a linear distribution that sometimes assume a Blaschko line pattern. We describe a 33-year-old woman who presented with a 4-month history of a slightly pruritic unilateral linear array of papular lesions on the left side of her neck that were clinically and histologically consistent with linear LP. Two months after the onset of her skin disease she developed typical lesions with a lacy white pattern on the left lateral aspect of her tongue and the left buccal mucosa with a striking predominance for the left side. Clinically the lesions on the patient's neck were similar to lichen striatus or lichenoid epidermal naevus, a variant of linear verrucous epidermal naevus. However, the histological features and the fact that later in the course of her disease the patient developed typical LP of the oral mucosa suggest that this patient has the rare condition of linear LP with unilateral restriction.

[Eccrine porocarcinoma (malignant eccrine poroma)--a follow-up study]. / Ekkrines Porokarzinom (malignes ekkrines Porom)--eine Verlaufsbeobachtung.

We report on a 78-years-old man having suffered from malignant eccrine poroma since 1983. Two years after the first therapy, we proved lymph node and skin metastases which in spite of radiotherapy caused death in 1986.

[Formation of pseudolumina and stroma phagocytosis in eccrine spiradenoma. Electron microscopic study]. / Pseudolumina und Stroma-Phagozytose beim ekkrinen Spiradenom. Elektronenmikroskopische Untersuchung.

2 cases of eccrine spiradenoma were analyzed histologically and electron microscopically. In neither case true glandular structures could be found. On the submicroscopic level, 'lumina', as seen by light microscopic method, were found to be stroma islands containing fibrillar material, or cavities probably formed by cell decay. In case 2, submicroscopic examination revealed a considerable degree of cell and tissue alteration as intercellular edema, cellular shrinkage and phagocytic phenomenons. A striking finding was a marked dissociation of the stroma resulting in the formation of small units which were sometimes found to be phagocytized within tumor cells. These alterations are interpreted as a sign of regressive transformation of the tumor.

[Association of disseminated syringoma and mast cells clinically resembling urticaria pigmentosa (author's transl)]. / Multiple Syringome mit Vermehrung von Mastzellen unter dem klinischen Bild einer Urticaria pigmentosa.

In a 37-year-old female with the clinical appearance of urticaria pigmentosa histologic examination revealed disseminated syringomata. By toluidine blue staining, a marked increase of tissue mast cells was demonstrated in the interstitial connective tissue, thus explaining the clinical appearance.

Membrane activity in juvenile xanthogranuloma.

In a case of juvenile xanthogranuloma in an early stage, electron microscopic examination revealed membrane activity resulting in complex interdigitations with subsequent transformation into aggregated cytoplasmic vesicles. Similar membrane complexes were encountered in multinucleated giant cells and they may be a result of endocytosis of remnants of cell membranes of fused macrophages. Other findings were "virus-like inclusions" in histiocytes and giant cells, intracytoplasmic collagen in fibroblasts and "cross-banded filamentous aggregations".

Ultrastructural investigation on cutaneous angioleiomyoma.

Electron-microscopic examination of a cutaneous angioleiomyoma demonstrated that the muscular coat enveloping the blood vessels is formed of typical smooth muscle cells. The central vessels exhibit the ultrastructural features of small venules with a prominent endothelium and large numbers of Weibel-Palade bodies. Except for scanty unmyelinated nerve fibers accompanying small arterioles, no significant nerval structures were encountered. In view of the evident ultrastructural differences, a relationship of angioleiomyoma and glomus tumor can be ruled out.

[Electron microscopic investigation on cutaneous leiomyosarcoma (author's transl)]. / Elektronenmikroskopische Untersuchung am cutanen Leiomyosarkom.

A 61-year old woman developed a tumourous nodule in her left leg. Fifteen years ago a similar tumour had been removed in the same localization. Histological examination performed on biopsy material showed bundles of predominantly fusiform tumour cells with nuclear pleomorphism and many mitotic figures. Electron microscopic examination confirmed the diagnosis of leiomyosarcoma by demonstration of the ultrastructural characteristics of smooth muscle cells. Cellular differentiation showed various degree ranging from smooth muscle cell type to dedifferentiated edematous tumour cells with scanty myofilaments. An important finding was the demonstration of multiple accumulated centrioles.

[Multivesicular vacuolization in malignant histiocytoma of the skin (author's transl]. / Malignes Histiocytom der Haut mit multivesiculärer Vacuolisierung.

A 47-year-old patient developed several rapidly growing tumours in his right leg. Histiologic and electron microscopic examination revealed morphological characteristics suggesting the histiocytic origin of the tumour cells. An important finding was the striking number of pleomorphic membraneous inclusions and large vacuoles containing numerous small vesicles. These cytoplasmic inclusions are interpreted as transformed multivesicular bodies. Their formation may be an expression of an increased and bizarre membraneous activity of a malignant cell race. Radiotherapy resulted in a remarkable rapid and complete remission.

[Contagious ecthyma with virus demonstration in a negative staining method]. / Ecthyma contagiosum mit Virusnachweis im Negative-Staining-Verfahren

The diagnosis of contagious ecthyma was presumed by history and clinical appearance in a 33-year-old farmer. In electron miscroscopical preparations viral particles were found by the negative staining method. It is proposed to use this method for rapid diagnosis of suspected cases. In old lesions it is more difficult to demonstrate viral particles than in fresh lesions. Differential diagnosis and the position of Orf-virus in the system of viruses are briefly discussed.