British Journal of DermatologyVolume 154, Issue 4 p. 779-781 Anti-epiligrin cicatricial pemphigoid initially limited to the upper respiratory tract K. Wozniak, K. Wozniak Department of Dermatology, Medical University of Warsaw, Koszykowa 82a, 02-008 Warszawa, Poland *Department of Dermatology, Medical University of Lodz, Lodz, Poland†Department of Dermatology, Kurume University School of Medicine, Kurume, Japan‡Department of Dermatology, New Jersey Medical School, Newark, NJ, U.S.A.Search for more papers by this authorE. Waszczykowska, E. Waszczykowska Department of Dermatology, Medical University of Warsaw, Koszykowa 82a, 02-008 Warszawa, Poland *Department of Dermatology, Medical University of Lodz, Lodz, Poland†Department of Dermatology, Kurume University School of Medicine, Kurume, Japan‡Department of Dermatology, New Jersey Medical School, Newark, NJ, U.S.A.Search for more papers by this authorT. Hashimoto, T. Hashimoto Department of Dermatology, Medical University of Warsaw, Koszykowa 82a, 02-008 Warszawa, Poland *Department of Dermatology, Medical University of Lodz, Lodz, Poland†Department of Dermatology, Kurume University School of Medicine, Kurume, Japan‡Department of Dermatology, New Jersey Medical School, Newark, NJ, U.S.A.Search for more papers by this authorN. Ishii, N. Ishii Department of Dermatology, Medical University of Warsaw, Koszykowa 82a, 02-008 Warszawa, Poland *Department of Dermatology, Medical University of Lodz, Lodz, Poland†Department of Dermatology, Kurume University School of Medicine, Kurume, Japan‡Department of Dermatology, New Jersey Medical School, Newark, NJ, U.S.A.Search for more papers by this authorJ.D. Torzecka, J.D. Torzecka Department of Dermatology, Medical University of Warsaw, Koszykowa 82a, 02-008 Warszawa, Poland *Department of Dermatology, Medical University of Lodz, Lodz, Poland†Department of Dermatology, Kurume University School of Medicine, Kurume, Japan‡Department of Dermatology, New Jersey Medical School, Newark, NJ, U.S.A.Search for more papers by this authorJ. Narbutt, J. Narbutt Department of Dermatology, Medical University of Warsaw, Koszykowa 82a, 02-008 Warszawa, Poland *Department of Dermatology, Medical University of Lodz, Lodz, Poland†Department of Dermatology, Kurume University School of Medicine, Kurume, Japan‡Department of Dermatology, New Jersey Medical School, Newark, NJ, U.S.A.Search for more papers by this authorT. Rogozinski, T. Rogozinski Department of Dermatology, Medical University of Warsaw, Koszykowa 82a, 02-008 Warszawa, Poland *Department of Dermatology, Medical University of Lodz, Lodz, Poland†Department of Dermatology, Kurume University School of Medicine, Kurume, Japan‡Department of Dermatology, New Jersey Medical School, Newark, NJ, U.S.A.Search for more papers by this authorR.A. Schwartz, R.A. Schwartz Department of Dermatology, Medical University of Warsaw, Koszykowa 82a, 02-008 Warszawa, Poland *Department of Dermatology, Medical University of Lodz, Lodz, Poland†Department of Dermatology, Kurume University School of Medicine, Kurume, Japan‡Department of Dermatology, New Jersey Medical School, Newark, NJ, U.S.A.Search for more papers by this authorC. Kowalewski, C. Kowalewski Department of Dermatology, Medical University of Warsaw, Koszykowa 82a, 02-008 Warszawa, Poland *Department of Dermatology, Medical University of Lodz, Lodz, Poland†Department of Dermatology, Kurume University School of Medicine, Kurume, Japan‡Department of Dermatology, New Jersey Medical School, Newark, NJ, U.S.A.Search for more papers by this author K. Wozniak, K. Wozniak Department of Dermatology, Medical University of Warsaw, Koszykowa 82a, 02-008 Warszawa, Poland *Department of Dermatology, Medical University of Lodz, Lodz, Poland†Department of Dermatology, Kurume University School of Medicine, Kurume, Japan‡Department of Dermatology, New Jersey Medical School, Newark, NJ, U.S.A.Search for more papers by this authorE. Waszczykowska, E. Waszczykowska Department of Dermatology, Medical University of Warsaw, Koszykowa 82a, 02-008 Warszawa, Poland *Department of Dermatology, Medical University of Lodz, Lodz, Poland†Department of Dermatology, Kurume University School of Medicine, Kurume, Japan‡Department of Dermatology, New Jersey Medical School, Newark, NJ, U.S.A.Search for more papers by this authorT. Hashimoto, T. Hashimoto Department of Dermatology, Medical University of Warsaw, Koszykowa 82a, 02-008 Warszawa, Poland *Department of Dermatology, Medical University of Lodz, Lodz, Poland†Department of Dermatology, Kurume University School of Medicine, Kurume, Japan‡Department of Dermatology, New Jersey Medical School, Newark, NJ, U.S.A.Search for more papers by this authorN. Ishii, N. Ishii Department of Dermatology, Medical University of Warsaw, Koszykowa 82a, 02-008 Warszawa, Poland *Department of Dermatology, Medical University of Lodz, Lodz, Poland†Department of Dermatology, Kurume University School of Medicine, Kurume, Japan‡Department of Dermatology, New Jersey Medical School, Newark, NJ, U.S.A.Search for more papers by this authorJ.D. Torzecka, J.D. Torzecka Department of Dermatology, Medical University of Warsaw, Koszykowa 82a, 02-008 Warszawa, Poland *Department of Dermatology, Medical University of Lodz, Lodz, Poland†Department of Dermatology, Kurume University School of Medicine, Kurume, Japan‡Department of Dermatology, New Jersey Medical School, Newark, NJ, U.S.A.Search for more papers by this authorJ. Narbutt, J. Narbutt Department of Dermatology, Medical University of Warsaw, Koszykowa 82a, 02-008 Warszawa, Poland *Department of Dermatology, Medical University of Lodz, Lodz, Poland†Department of Dermatology, Kurume University School of Medicine, Kurume, Japan‡Department of Dermatology, New Jersey Medical School, Newark, NJ, U.S.A.Search for more papers by this authorT. Rogozinski, T. Rogozinski Department of Dermatology, Medical University of Warsaw, Koszykowa 82a, 02-008 Warszawa, Poland *Department of Dermatology, Medical University of Lodz, Lodz, Poland†Department of Dermatology, Kurume University School of Medicine, Kurume, Japan‡Department of Dermatology, New Jersey Medical School, Newark, NJ, U.S.A.Search for more papers by this authorR.A. Schwartz, R.A. Schwartz Department of Dermatology, Medical University of Warsaw, Koszykowa 82a, 02-008 Warszawa, Poland *Department of Dermatology, Medical University of Lodz, Lodz, Poland†Department of Dermatology, Kurume University School of Medicine, Kurume, Japan‡Department of Dermatology, New Jersey Medical School, Newark, NJ, U.S.A.Search for more papers by this authorC. Kowalewski, C. Kowalewski Department of Dermatology, Medical University of Warsaw, Koszykowa 82a, 02-008 Warszawa, Poland *Department of Dermatology, Medical University of Lodz, Lodz, Poland†Department of Dermatology, Kurume University School of Medicine, Kurume, Japan‡Department of Dermatology, New Jersey Medical School, Newark, NJ, U.S.A.Search for more papers by this author First published: 20 February 2006 https://doi.org/10.1111/j.1365-2133.2006.07131.xCitations: 3 Cezary Kowalewski. E-mail: ckowalew@amwaw.edu.pl Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Citing Literature Volume154, Issue4April 2006Pages 779-781 RelatedInformation

A 45-year-old man presented with a 7-year history of keratosis lichenoides chronica (KLC), a mucocutaneous lichenoid disorder of keratinization with no known aetiology, without significant systemic associations. Our patient also had type I diabetes mellitus, mild hypertension and lipid abnormalities. The diagnosis and treatment of KLC is often challenging.

BACKGROUND:Sebaceous carcinoma is an unusual, aggressive, malignant tumor derived from the epithelium of sebaceous glands. It may arise in ocular or extra-ocular sites and is often evident as an ulcerated or non-ulcerated cystic nodule measuring up to 8 cm in diameter. A significant number of extra-ocular sebaceous carcinomas have been associated with metastases and high mortality rate. METHODS AND RESULTS:We reviewed the literature in the context of our report of a 68-year-old woman who had a morpheaform plaque of the upper lip of 15 years duration, extending into the left naso-genal groove, which histologically also showed marked stromal fibrosis. Three years after excision, there were no signs of recurrence or metastases. CONCLUSIONS:This patient is unusual in clinical and histologic pattern, as a morpheaform appearance has only been described previously in only one sebaceous carcinoma. In addition, no metastatic disease 15 years after tumor onset is a fortunate and remarkable feature.

Nevus anemicus (NA) is a congenital localized cutaneous anomaly most often seen on the trunk. It represents a pale-colored irregularly shaped patch of histologically normal-appearing skin in which the pharmacological response to certain mediators may be aberrant, with sympathetic vasoconstriction likely responsible for the pallor. Hence, it has been called a pharmacological nevus. NA may be linked with certain genodermatoses, including neurofibromatosis and phakomatosis pigmentovascularis.

Collagen-derived materials have been used in medicine for many decades. Sutures, hemostatic devices and matrices which stimulate cell growth and soft tissue augmentation are the major applications. In this update, we discuss the two major applications for collagen in dermatology: tissue augmentation and wound healing.

This study directly compares the three major methods of prostaglandin as say for explanted blood vessels in an effort to determine whether reliable assays can be performed on small, localized areas. Under general anesthesia, canine femoral arteries and veins (n =16) were excised after measurement of in vivo dimensions. Each vessel was divided into three segments. Vessel segments were (1) incubated as whole rings ("biopsy" method), (2) incubated with the luminal surface covered by a plexiglass well (well method), or (3) perfused with a pulsa tile pump at physiologic pressure, temperature, and flow rate for two fifteen minute cycles with a balanced salt solution (perfusion method). Perfusion seg ments were also tested by the well and biopsy methods after thirty minutes of ex vivo perfusion. Assays of stable metabolites for prostacyclin (Pc) and throm boxane A2 (Tx) were performed using commercially available radioimmuno assay techniques. Luminal perfusion was used as the "gold standard" for corre lation. Mean values for Pc, Tx, and Pc/Tx ratio were compared for each method on both arteries and veins. In each case, the well method was statistically equiva lent to the perfusion method for the second fifteen-minute cycle, while the biop sy method was significantly different in several groups. Linear regression analysis revealed significant positive correlations between the well method and the per fusion method (r>0.74, P<0.01). The biopsy method did not correlate with the perfusion method in a significant manner (r 0.18 and 0.50, p<0.05). Significant differences between the first and second perfusion cycle were seen in most cases. The wall method revealed trends toward decreased thromboxane production but no change in prostacyclin production for specimens after thirty minutes of perfusion. Conclusions: (1) The well incubation method demonstrates a significant positive corre lation with luminal perfusion while allowing assay of small localized areas. (2) Luminal perfusion is a reproducible technique, but larger vessel areas and more complex appara tus are required. Significant variations in luminal prostaglandin synthesis occur with se quential perfusion cycles, and the mechanism for the decrease in prostacyclin/thromboxane synthetase level or differing mechanisms for prostacyclin and thromboxane synthesis. (3) The vessel biopsy method is not reliable for comparisons with luminal perfusion or as a means of measuring luminal prostaglandin production.

Despite an increase in vaso-occlusive disorders and routine exposures to large quantities of heparin, chronic dialysis (CD) patients have not been studied for the presence of heparin-induced platelet activation (HIPA). Measurement of platelet aggregation and adenosine triphosphate release was performed at hepa rin concentrations of 0.1 U/mL and 100 U/mL using platelet-poor plasma (PPP) from 90 nonthrombocytopenic CD patients; 72 patients received heparin over prolonged periods (108 ±15 weeks); 18 patients received no heparin for two months prior to study. Results: PPP from 1 hemodialysis (HD) patient stimulated strong ( > 19%) platelet activation at both 0.1 and 100 U/mL heparin concentrations. Four pa tients (4.4%) demonstrated intermediate (10-19%) platelet activation in the presence of 0.1 U/mL but not 100 U/mL heparin concentrations. Eighty-five patients demonstrated no platelet activation ( < 10%) at either heparin concen tration. Conclusion: (1) None of the 90 dialysis patients met the strict laboratory criteria for HIPA. (2) Despite long-term exposure to large quantities of heparin, the prevalence of HIPA in CD patients appears to be no greater than that of the general patient population receiving heparin. (3) Nonthrombocytopenic HIPA is not a major factor contributing to thrombotic disorders in dialysis patients.

Carotid endarterectomy can be successfully accomplished using either local or general anesthesia. The purpose of this study was to attempt to discern any differences in perioperative morbidity associated with the two anesthetic tech niques. A retrospective review was undertaken of 324 consecutive carotid en darterectomies performed by fifteen surgeons between 1979 and 1985. There were no significant differences in preoperative cardiac, pulmonary, or renal risk factors between the two anesthetic groups. Postoperative fever (p < 0.005), pulmonary complications (p < 0.05), and neurologic morbidity (p < 0.05) oc curred significantly more frequently in the general anesthesia group. The dura tion of postoperative hospitalization was shorter (p < 0.0005) in the local anes thetic cohort (3.1 ± 2.3 days) than in the general anesthetic group (5.1 ± 8.07 days). Local anesthesia for carotid endarterectomy appeared to result in less morbidity and shorter hospitalization when compared with general anesthesia. There did not appear to be any cerebral protective effect of general anesthesia during carotid endarterectomy.

Observations are reported of an intense solar flare hard X-ray burst on June 27, 1980, made with a balloon-borne array of liquid nitrogen-cooled Ge detector which provided unprecedented spectral resolution (no more than 1 keV FWHM). The hard X-ray spectra throughout the impulsive phase burst fitted well to a double power-law form, and emission from an isothermal 0.1-1 billion K plasma can be specifically excluded. The temporal variations of the spectrum indicate that the hard X-ray burst is made up of two superposed components: individual spikes lasting about 3-15 sec, which have a hard spectrum and a break energy of 30-65 keV; and a slowly varying component characterized by a soft spectrum with a constant low-energy slope and a break energy which increases from 25 kev to at least 100 keV through the event. The double power-law shape indicates that DC electric field acceleration, similar to that occurring in the earth's auroral zone, may be the source of the energetic electrons which produce the hard X-ray emission.