What do we know about palmoplantar pustulosis?

Palmoplantar pustulosis is characterized by a chronic eruption of sterile pustules on palms and soles. The disease affects mainly women in the sixth and seventh decade of life. Some authors consider palmoplantar pustulosis a separate entity, whereas others consider it a condition in the spectrum of psoriasis. Aim of this study was to summarize the most recent data about PPP which aimed at establishing the nosological position of palmoplantar pustulosis. A systematic search of published literature was carried out. General characteristics of patients with PPP in different populations were present. We reviewed histological, immunological and genetic studies, as well as treatment options for PPP. PPP presents with clinical features, which are not present in psoriasis; however, the common coexistence of psoriasis vulgaris and/or positive family history for psoriasis indicates at least a close relationship between PPP and psoriasis. At present, there are not sufficient data to exclude PPP from psoriasis group.

Dermal toxicity of 8-methoxypsoralen administered (by gavage) to hairless mice irradiated with long-wave ultraviolet light.

Hairless mice were administered various amounts of 8-methoxypsoralen (8-MOP) by gavage, followed by irradiation with ultraviolet light (UVA) two or more times per week for periods ranging from 1 to 12 months. The minimum phototoxic dose was 20 mg/kg body weight by this route of administration and potential for serious organ toxicity in long-term exposures was investigated. No histologic features of cutaneous malignancy were encountered under test conditions which produced prolonged phototoxicity, deep ulceration, cicatrization, and other deformities. Repeated daily gavaged doses of 20 mg psoralen/kg body weight in conjunction with twice weekly irradiation for 10 min with UVA elicited an erythematous phototoxic reaction, but did not give rise to subsequent skin lesions. 8-MOP in repeated daily gavage doses of 30 mg and 40 mg/kg body weight combined with twice weekly UVA irradiation for 10 min caused severe burning with subsequent scarring, but did not induce malignant tumors in experiments lasting lasting 8 months. No organ toxicity was seen except for toxic liver changes when severe cutaneous burn and pronounced ulcerations were produced. Limited immunologic studies disclosed no abnormalities in this system.

Beneficial response of local immunotherapy with Propionibacterium granulosum KP-45 in combined treatment of inflammatory breast carcinoma.

Nine 44- to 67-year-old patients with inflammatory breast carcinoma were treated over 2 weeks with intratumoral injections of Propionibacterium granulosum KP-45 (KP). This period of immunotherapy was succeeded by four courses of chemoimmunotherapy (FAC: 5-fluorouracil, adriamycin, and cyclophosphamide + intratumoral KP). Inflammatory symptoms disappeared in three patients during immunotherapy and in the remaining six patients during the following chemoimmunotherapy. Finally, 3 to 4 months after starting the therapy, all nine patients were free from inflammatory symptoms and it became possible to perform radical (seven cases) or simple (two cases) surgery. Thereafter routine therapy (radiotherapy, fractionated dose of 5500 R, followed by 10 FAC courses + single injections of KP for each FAC course) was used. After 19 to 32 months observation time all patients are still in complete remission with no local recurrences. Only one patient showed distant metastases during the observation period.

A case of renal lymphangioma with a karyotype 45,X,-X,i dic(7q).

Cytogenetic analysis of a polycystic unilateral renal lymphangioma was performed by short-term culture and banding methods. The tumor's cells showed an isochromosome of the long arm of chromosome #7 and monosomy of X chromosome, whereas the peripheral lymphocytes stimulated with phytohemagglutinin showed a normal female karyotype, 46,XX. These karyotypic anomalies suggest that lymphangioma, although clinically benign, may have malignant potential.

Action of topically applied arachidonic acid on the skin of patients with psoriasis.

Concentrations of arachidonic acid ranging from 0.1% to 2% were applied under occlusive dressings to psoriatic plaques in 45 patients. Alleviation of the clinical symptoms of psoriasis including complete clearing in some cases was obtained with the use of 0.5% to 2% arachidonic acid applied under occlusion every 24 to 48 hours five to seven times. Histologic examination showed polymorphonuclear leukocytes penetrating into the stratum corneum and formation of microabscesses or wide-spread accumulations of polymorphonuclear leukocytes in the stratum corneum, with its eventual destruction. The parakeratotic horny layer became detached; this was followed by restoration of the granular layer and an apparently normal stratum corneum. While arachidonic acid metabolites can be proinflammatory and proproliferative, they may also be important in the healing process for psoriasis.

Repair of UV-damaged DNA in mammalian skin followed by the immunohistochemical method.

DNA repair in murine and guinea pig skin has been studied by the immunohistochemical method. For the detection of DNA photolesions in situ by the indirect immunofluorescence (IF) method two antisera directed against DNA-pyrimidine-dimers and DNA-psoralen-photoadducts have been applied. The IF assay enabled to detect the DNA photodamage induced by high UV-doses, exceeding more than fivefold minimal phototoxic response of the skin. It was found that IF staining gradually disappeared due to DNA repair, and at 48 h after UV-exposure both types of the DNA photolesions were no more detectable. Importantly, the IF method revealed that the persistence of DNA-pyrimidine-dimers could be traced for a longer time than that detectable by UV-endonuclease incision method.

Effects of systemic etretinate treatment on natural cytotoxicity, immune angiogenesis and neutrophil adherence in patients with various forms of psoriasis.

The effects of etretinate treatment on natural killer cell activity, on angiogenic capability of peripheral blood mononuclears and on neutrophil adherence were studied in 20 patients with various forms of psoriasis. In all forms of active psoriasis, etretinate was found to affect first the angiogenic reaction and PMN adherence, whereas NK cell activity usually normalized only after a long-term therapy. The earliest normalization of all three parameters was noticed in pustular psoriasis, and it was correlated with the clinical improvement. In two cases of palmo-plantar pustular psoriasis, in 5 cases of arthropathic variety, and in 5 cases of common psoriasis, the normalization preceded clearing of the skin lesions.

Diagnosis of metastatic renal cell and thyroid carcinomas by intermediate filament typing and cytology of tumor cells in fine needle aspirates.

Coexpression of keratin and vimentin was found in carcinoma cells of 13 fine needle aspirates of metastatic lesions that showed some cytologic features considered to be consistent with a renal or thyroid origin, but in which a large number of other possible primary sites would have to be taken into account on the basis of the morphologic evidence alone. Immunochemistry thus narrowed the cytologic differential diagnosis to thyroid, renal, endometrial and ovarian carcinomas, which are known to show true coexpression of keratin and vimentin. In most cases, clinical data available at the time of the fine needle aspiration supported the thyroid or renal origin of the carcinoma cells found in the aspirates. In two cases, which lacked significant clinical information, the diagnosis of metastatic renal cell carcinoma was provided on the basis of the combined morphologic and immunocytochemical evidence. In these two cases, computed tomography or ultrasonography revealed kidney tumors, which were removed and confirmed histologically to be clear cell carcinomas.

Treatment of psoriasis of the scalp with coal tar gel and shampoo preparations.

Psoriatic lesions on the scalp are cosmetically troublesome and present problems for therapy, particularly over a long-term period. A gel containing refined coal tar in solution (psoriGel) was effective in clearing or markedly improving psoriasis of the scalp in 83 percent of 112 patients. The study population included thirty-five patients who were unresponsive to other therapies. The treatment regimen described here used tar gel for five days, vegetable oil soaking for the sixth day, and no treatment on the seventh day. This procedure reduced considerably the tendency of tar gel to cause drying of the skin. Fifty percent of the patients remained in remission for about three months using a nontar shampoo. However, using a tar shampoo (Ionil T), the median remission time was extended to over eight months with 30 percent of the patients still in remission thirteen months later. No adverse reactions were reported.

[Treatment of head pediculosis. Comparative studies of a shampoo containing 0,33% Pyrethrum extract and shampoo containing 1% malathion]. / Leczenie wszawicy glowy. Badania porównawcze szamponu zawierajacego 0.33% wyciagu z chryzantem (pyretrum) i szamponu zawierajacego 1% malationu.

The insecticidal effect was tested of a shampoo with 0.33% of pyrethrum extract and a shampoo with 1% malathion. The study was carried out in 222 patients and better results were observed with the pyrethrum shampoo which required only one application.