Oral lichenoid lesions, mercury hypersensitivity and combined hypersensitivity to mercury and other metals: histologically-proven reproduction of the reaction by patch testing with metal salts

We report 11 patients seen between 1991 and 1994 with oral lichenoid lesion(OLL). In 10 cases, there was contact with dental amalgam fillings, and in patient no. 10 with both amalgam restorations and a gold crown. The last patient had, in addition to her OLL, lichen planus of the skin and genital mucosa. In 5 cases, combined sensitization to mercury and other metal salts, particularly gold sodium thiosulfate (GST) and palladium chloride (PDC), was observed. In 10 patients, the lesions considerably improved or totally cleared within 1 to 9 months of replacement of restoration materials. Histological examination of biopsies from the test sites of amalgam, mercuric chloride, GST and PDC, taken 10 or 17 days, after application of patch tests, showed lichenoid changes in 7 patients with at least 1 of the allergens. At least 2 patients had inflammatory lesions of the oral mucosa related to both amalgam and gold restorations, combined sensitization to inorganic and organic mercury derivatives. GST and, in 1 case, PDC, a "dental restoration metal intolerance syndrome" is proposed.     

Evaluation of the growth dynamics of Trichophyton rubrum cultures by morphometry and non-linear curve fitting analysis

To determine the size of dermatophyte thalli, a point-counting procedure with a square lattice grid is proposed instead of using the one-dimensional diameter as the size parameter. For an analysis of the growth dynamics of such colonies, the area values might be subjected to a non-linear curve-fitting procedure. To demonstrate the method, samples of 15 Trichophyton rubrum strains, isolated from human skin and cultured concomitantly on Sabouraud and Selective agar during a period of 8 weeks, were used. The morphometric assessment of the area of the thalli, subjected to non-linear curve fitting, disclosed only a slight difference in the growth dynamics.     

Ultrastructural Features of Malignant Syphilis and Demonstration of Treponema pallidum

This paper reports a case of malignant syphilis (man, 39 years old) in whom ultrastructural investigations of a typical nodule revealed an extremely low amount of bacteria with the characteristics of Treponema pallidum in poorly differentiated cells of the dermal infiltrate with plasma cells, stimulated lymphocytes, and neutrophils as predominating cell types. Most of the microorganisms bore signs of disintegration. Vascular changes and exocytosis were only demonstrable by light microscopy in a second nodule. Together with the high production rate of immunoglobulins and an excessive inflammatory reaction, these findings point to an aberrant biologic reaction pattern of those patients who develop malignant syphilis. Unfortunately, further investigations concerning a possible impairment of cellular immunity as supposed in the literature, had not been possible in the present case.     

The effect of infrared laser rays on herpes simplex virus and the functions of human immunocompetent cells

In vitro investigations were performed to study the effect of infrared Nd:YAG laser irradiation on herpes simplex virus and the viral replication in herpes-infected Vero cell microcultures. In addition, the influence of laser irradiation on human immuncompetent cells was investigated by irradiation and incubation of herpes-infected cell cultures overlaid with leucocytes and observation of leucocyte migration under agarose after laser irradiation. There was no evidence of herpes simplex virus inactivation by laser irradiation. Irradiation of Vero cell microcultures infected with virus did not influence the development of the viral cytopathic effect. However, irradiated cultures showed an increase of about 50% in the virus yield. Only a slight indication of laser influence on immunocompetent cells was found. Cell cultures incubated with leucocytes (from both seropositive and seronegative donors) and irradiated showed an inhibitory effect with about half the virus yield seen in unirradiated controls. However, there was no relation between the energy applied and yield reduction. In addition, laser light caused no change in leucocyte migration.     

Vertical tumor thickness as an estimate of actual tumor volume

According to Cavalieri, the volume of any body-irrespective of its shape-can easily be estimated on the basis of the area of slabs of known thickness. We made use of this old principle in order to determine the correlation between the volume of skin tumors and their maximal vertical thickness. Investigations of a total of 30 benign and malignant tumors of the skin of various shapes showed a correlation coefficient of r = 0.77. Therefore, the widely used determination of the vertical thickness of malignant melanomas can be regarded as a good estimator of the tumor volume and seems to be appropriate for histological tumor staging. Together with high frequency ultrasound, Cavalieri's method allows a simple and rapid pretherapeutical in-vivo determination of the tumor volume. However, only prospective studies can reveal whether the determination of the tumor volume is of superior prognostic significance to the established techniques.     

Immunohistologic characterization of stasis dermatitis transformed skin of the lower leg

Antibodies against human T-lymphocytes and their subpopulations were applied to frozen sections obtained from skin affected with stasis dermatitis of the lower leg from 13 patients suffering from chronic venous insufficiency. In all cases, we observed an intense staining reaction with HLA-DR antibodies, i.e. mainly monocytes, macrophages, fibroblasts, and endothelial cells. Control sections of clinically normal skin taken from patients without stasis dermatitis showed only staining of endothelial cells and of dendritic epidermal cells with HLA-DR antigens. The dermal infiltrate in stasis dermatitis displayed only moderate staining with antigens directed against T-helper and T-suppressor cells. Our findings of large quantities of HLA-DR positive cells in skin affected with stasis dermatitis points to their possible role with regard to the induction and persistence of contact allergies so frequently encountered in this group of patients.     

Cutaneous leishmaniasis as a paradigm of parasitic skin infestation

On the basis of the latest findings, we present the main aspects of cutaneous leishmaniasis with regard to epidemiology, vector, clinical features, histopathology, diagnosis, differential diagnosis, immunology, and therapy.