Histochemical demonstration of sialomucin in human eccrine sweat glands.

Eccrine sweat glands in paraffin sections of human skin fixed in neutral buffered formalin nearly always contained acidic carbohydrate detected by the colloidal iron stain, and to a less extent by Alcian blue 8 GX. Additional histochemical procedures designed to detect sulfated carbohydrates showed none. The acidic carbohydrate demonstrated in eccrine sweat glands was presumed to contain only carboxyl groups. As incubation of tissue sections in neuraminidase abolished stainability of the acidic carbohydrate with colloidal iron, the material removed was considered to be a sialomucin. To the best of our knowledge, the identification of the acidic mucin in human eccrine sweat glands as sialomucin has not been reported previously.

Mechlorethamine desensitization in therapy for mycosis fungoides. Topical desensitization to mechlorethamine (nitrogen mustard) contact hypersensitivity.

Five patients with mycosis fungoides who had developed contact dermatitis to a nitrogen mustard, mechlorethamine hydrochloride, even in low concentrations (1 to 5 mg/100 ml), received daily total-body applications of extremely dilute solutions (0.01 to 0.1 mg/100 ml) of mechlorethamine. The concentrations of the drug were approximately doubled weekly if the patient could tolerate it, or they were raised more slowly if the patient could not. Attempts to desensitize one patient were discontinued since he was unable to tolerate a greater concentration than 1.0 mg/100 ml after trying for one year. Another patient was able to tolerate a concentration of 3 mg/100 ml after three months, at which time his skin had completely cleared and treatment was stopped. Three other patients were desensitized during a period of 8 to 13 months to the point of tolerating the full therapeutic concentration used in our clinic (20 mg/100 ml) without experiencing dermatitis or pruritus.

Nasalis myocutaneous sliding flap: repair of nasal supratip defects.

The nasalis myocutaneous sliding flap ("nasalis flap") is an axial island flap based on the branch of the angular artery that supplies the nasalis muscle. The technique for performing this flap for the repair of defects up to 1.5 cm in diameter on the supratip area of the nose is described in detail. Twenty-four cases with supratip defects following Mohs surgery repaired with the nasalis flap are reported. Flap survival was 100% and final cosmetic results were excellent. It is concluded that the nasalis flap should always be considered for the repair of defects of the supratip area of the nose.

The treatment of mycosis fungoides: adjuvant topical mechlorethamine after electron beam therapy.

The feasibility of employing adjuvant topical mechlorethamine after electron beam therapy in the treatment of patients with mycosis fungoides is demonstrated. Patients treated with a planned adjuvant topical mechlorethamine schedule had a median disease-free interval of 25 months compared to 17 months for the group treated with electron beam therapy alone. Projected relapse-free survivals are slightly better in the adjuvant group--37% versus 29%. Patients receiving adjuvant topical mechlorethamine after the electron beam were observed to have a low incidence of contact allergy to the medication. The topical medication can be continued if a contact allergy develops by using a planned desensitization program. We currently treat all mycosis fungoides patients with electron beam therapy, randomizing half to receive adjuvant topical mechlorethamine.

Topical mechlorethamine therapy for mycosis fungoides.

Patients with limited skin involvement by mycosis fungoides were treated with daily topical mechlorethamine. Seven of thirteen patients had a complete remission of diseases. Six of these seven experienced a contact dermatitis and four underwent a successful topical desensitization programme. The possible beneficial therapeutic effects of developing a contact allergy are discussed.