An algal enzyme required for biosynthesis of the most abundant marine carotenoids.

Fucoxanthin and its derivatives are the main light-harvesting pigments in the photosynthetic apparatus of many chromalveolate algae and represent the most abundant carotenoids in the world's oceans, thus being major facilitators of marine primary production. A central step in fucoxanthin biosynthesis that has been elusive so far is the conversion of violaxanthin to neoxanthin. Here, we show that in chromalveolates, this reaction is catalyzed by violaxanthin de-epoxidase-like (VDL) proteins and that VDL is also involved in the formation of other light-harvesting carotenoids such as peridinin or vaucheriaxanthin. VDL is closely related to the photoprotective enzyme violaxanthin de-epoxidase that operates in plants and most algae, revealing that in major phyla of marine algae, an ancient gene duplication triggered the evolution of carotenoid functions beyond photoprotection toward light harvesting.

The usefulness of single and combined clinical characteristics for the diagnosis of dysplastic naevi.

A total of 761 melanocytic lesions were studied to elucidate the usefulness of clinical features for the diagnosis of dysplastic naevi. Characteristics associated with high (irregular border, irregular pigmentation), intermediate (black coloured areas, largest diameter greater than 0.5 cm, change of size, change of colour) and low diagnostic efficiency could be defined. Combinations of criteria had high sensitivities: at least one of the following four criteria was positive in 96% of the dysplastic naevi and in all melanomas with less pronounced clinical characteristics: irregular border, irregular pigmentation, greatest diameter greater than 0.5 cm, black coloured areas. A lesion is therefore unlikely to be a dysplastic naevus or a melanoma if all these criteria are absent. When change of size and change of colour were analysed in addition to the features mentioned above a sensitivity of 0.96 was found for at least two of these six criteria. At least three of these six criteria were observed in all melanomas with less pronounced clinical characteristics. However, a rather low specificity (0.19 for at least one of four positive criteria, 0.20 for at least two of six positive criteria) indicated that dysplastic and non-dysplastic naevi cannot be clinically differentiated with acceptable certainty. With less stringent histological criteria approximately twice as high specificities were found. Specificities were about twice as high in a subgroup of patients with at least one proven dysplastic naevus besides the lesion under diagnostic consideration. This facilitates the identification of individuals at risk of developing a melanoma.

[Proliferative myositis]. / Proliferative Myositis.

We report on a 42-year-old woman showing a rapidly growing tumor on her left flank; it was removed by surgery. Histological examination revealed the typical picture of proliferative myositis. Since the clinical symptoms of this disease are nonspecific, the diagnosis always depends on histological evidence. Despite its rapid growth and its cellular pleomorphism, proliferative myositis is a reactive process and has to be differentiated histologically from sarcoma of the soft tissue.

[Degenerative changes in schwannoma (neurilemmoma)]. / Degenerativ verändertes Schwannom (Neurilemmom).

We report on a 51-year-old male patient showing a slowly growing, pedunculated, hairless tumor on the back of his head. The tumor grew up to the size of 4.2 cm in diameter, before it was removed by surgery. Histological examination revealed the typical picture of an ancient schwannoma (degenerated neurilemmoma). In spite of its highly atypical nuclei, the biological behavior of ancient schwannoma is benign, and it must be differentiated from malignant tumors of the nerve sheath.

[Multiple basaloid follicular hamartomas in 2 members of a family with Gorlin-Goltz syndrome]. / Multiple basaloide follikuläre Hamartome bei zwei Mitgliedern einer Familie mit Gorlin-Goltz-Syndrome.

We report on a 20-year-old man and a 14-year-old girl showing multiple basaloid follicular hemartomas on face and upper back. Both patients were members of a family with Gorlin-Goltz syndrome.

Malignant blue nevus with metastases to the lung.

A malignant blue nevus of the right upper arm with hematogeneous lung metastases is presented. Histological examination showed that the tumor was composed of spindle, dendritic, and globular cells with hyperchromatic and polymorphic nuclei, atypical mitoses, and tumor cell necrosis. There was no proliferation of atypical melanocytes at the dermoepidermal junction. Histologically, malignant blue nevus should be distinguished from benign cellular blue nevus, primary cutaneous malignant melanoma, cutaneous metastases of malignant melanoma, and clear cell sarcoma.

[Elastofibroma dorsi]. / Elastofibroma dorsi.

We report on an 80-years-old woman suffering from subacute prurigo simplex, who had developed a painless subcutaneous tumor on her right upper back, 8 cm in diameter. In palpation, the tumor was firm and did not adhere to the overlying skin. The movability of her arms and back was not restricted. The tumor could not be distinguished from its surrounding tissue by means of ultrasound. Surgery revealed that the tumor was firmly attached to the thoracic fasciae, periosteum, and ligaments, which prevented its complete removal. On histological examination, the tumor was diagnosed as elastofibroma dorsi. We discuss our microscopical findings of this very rare neoplasm in detail.

[Vater-Pacini neurofibroma]. / Vater-Pacini-Neurofibrom.

We report on a 49-year-old female patient suffering from Pacinian neurofibroma on her right middle finger. The microscopical findings of this rare neoplasm are discussed in detail.

Architectural features in melanocytic lesions with cellular atypia.

According to the quantity of single atypical melanocytes at the dermoepidermal junction 334 nevi were assigned to 3 groups: (1) with pronounced nuclear and cellular atypia (n = 73); (2) with moderate atypia (n = 127), and (3) without atypical melanocytes (n = 134). Three architectural features were almost exclusively observed in groups 1 and 2 with cellular and nuclear atypia: atypical localization of melanocytes in the epidermis, irregular distribution of melanocytes in the junctional zone and atypical nests of melanocytes. A combination of 2 or 3 of these features was seen in 76% of the nevi with pronounced cellular and nuclear atypia, in 28% of those with moderate atypia and in none of those without atypical melanocytes. Regarding 4 other criteria only minor but still statistically significant differences were found between the 3 groups of nevi. We conclude that these 4 other criteria, i.e. inflammatory infiltrate, lamellar and/or concentric fibroplasia, persisting lentiginous hyperplasia and dust-like pigment in melanocytes and nevus cells are not helpful for the diagnosis of a dysplastic nevus because of their low specificity. Minimal requirements for the diagnosis of a dysplastic nevus are suggested.

[Desmoplastic syringoid eccrine cancer with basalioma]. / Desmoplastisches syringoides ekkrines Karzinom mit Basaliom.

We report on a 59-year-old woman suffering from desmoplastic syringoid eccrine carcinoma with basal cell epithelioma at her right temple. 40 years ago, lupus vulgaris had been X-rayed in this area.

Congenital nevi less than or equal to 10 cm as precursors to melanoma. 52 cases, a review, and a new conception.

Fifty-two congenital melanocytic nevi (CMN) as precursors to melanoma or severe melanocytic dysplasia were reviewed macroscopically and microscopically. Forty-eight "small" CMN measured less than 10 cm in diameter. Histologically, only five reached to the lower third of the dermis or subcutis ("deep type"); the remaining 47 were limited to the upper two thirds of the corium ("superficial type"). There were 47 invasive melanomas, two in situ melanomas, and three severe focal melanocytic dysplasias. All melanomas were of "epidermal" origin and primarily of the superficial spreading type. The age at diagnosis ranged from 18 to 79 years. Prepubertal melanomas were not observed. Melanoma may also arise on small CMN. The most frequent origin of the melanomas in small CMN and the preferred age at manifestation seem to be different from that for giant nevi.

[Eccrine porocarcinoma]. / Ekkrines Porokarzinom.

We report on a 74-year-old female suffering from an eccrine porocarcinoma nea the mons pubis. Two additional tumors appeared in the same area. The three tumors revealed different stages of development.

[Fibrofolliculoma]. / Fibrofollikulom.

We report on a 85-year-old woman suffering from a fibrofolliculoma at the root of her nose. This benign tumor is very uncommon, and its histological findings are little known. Pathogenetically we suspect a self-contained interaction between the epithelial and mesodermal component of the pilary complex.

[Skin manifestations in sinus histiocytosis with massive lymphadenopathy (Rosai-Dorfman syndrome)]. / Hautveränderungen bei Sinushistiozytose mit massiver Lymphadenopathie (SHML) (Rosai-Dorfman-Syndrom).

We report on a 19-year-old girl suffering from cutaneous manifestation of sinus histiocytosis associated with massive lymphadenopathy (SHML) (Rosai-Dorfman syndrome); as SHML had first appeared at her 7th month of life, the disease had taken an uncommonly long period of time. At the age of 15, cutaneous manifestations developed on cheeks and left upper arm which histologically showed the same infiltrate as affected lymph nodes usually do in SHML. So far, participation of the cutaneous system in SHML has been observed in only 12 cases.

[The Spitz nevus. Spindle cell and/or epithelioid cell nevus--a clinical analysis of 652 tumors]. / Der Spitz-Naevus. Spindelzellen- und/oder Epitheloidzellennaevus--Eine klinische Analyse von 652 Tumoren.

We report on clinical aspects of 652 Spitz' nevi. In 42.9% of the cases, this tumor has been observed in people over 19 years. The female sex with 61.6% was much more concerned than the male sex. Most frequently, the lower extremities were affected (30.1%). The clinical diagnosis of Spitz' nevus could be definitely made in only 13.9% of the cases. We are going to discuss the very variable clinical picture of Spitz' nevus.

[The Spitz nevus. Spindle cell and/or epithelioid cell nevus--a histological analysis of 652 tumors]. / Der Spitz-Naevus. Spindelzellen- und/oder Epitheloidzellennaevus--Eine histologische Analyse von 652 Tumoren.

652 Spitz' nevi have been histologically analysed and separated into epidermal and dermal changes. There are similarities between Spitz' nevus and melanocytic nevus. 44.9% of the examined Spitz' nevi consist of spindle cells only, 34% of spindle as well as epithelioid cells, and 21% of epithelioid cells only. We are going to discuss the difficulties in histological examination; more or less important signs are differentiated in detail. In some cases, Spitz' nevus will remain a somewhat dubious and disturbing tumor.

[The antifungal agent naftifin. Placebo-controlled therapeutic comparison in tinea pedis]. / Antimykotikum Naftifin. Placebo-kontrollierter Therapievergleich bei Tinea pedum.

The antimycotic efficacy of Naftifine was compared with that of placebo in a double-blind randomized trial in 60 patients with Tinea pedum proved by culture and microscopic examination. Naftifine was significantly superior to placebo concerning the number of mycologically cured patients as well as the clinical response to therapy. At the end of the study all patients were cured by Naftifine, whereas no patient of the placebo group showed an improvement.