Biomedical subjects
Publications and source records attributed to G W Korting.
An eosinophilic pattern of hepatopathy is described and discussed in a female patient with atopic eczema and with eosinophilic reticular hyperplasia of the skin (combined with marked blood eosinophilia). Contrary to the hitherto known opinion a participation of intern organs in the case of reticular hyperplasia seems to be possible.
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Regarding the rare phenomenon of diffuse melanosis of the skin secondary to widespread melanoma, the possibility of a circumscribed melanosis in melanoma patients is hypothetically discussed on the basis of a personal observation. Microscopically, such a circumscribed melanosis appears as clusters of melanin-laden macrophages.
A patient with widely metastasized malignant melanoma assocaited with diffuse melanosis is presented. The widespread metastases in liver; skin and tonsilla are remarkable. The cutaneous melanosis in the form of the slate-blue colour caused by the increased dermal melanin deposits can arise in two different ways. One possibility is that melanin or precursors can be released from liver or other metastases and reach the dermis via the circulation. On the other hand a diffuse direct haematogenic single cell metastatic formation in the dermis with melanin formation and release can occur. In the case of the described patient the first etiopathology is dominating as it is shown by the light and electron microscopical results presented here.
In 20 patients with progressive systemic sclerosis the activity of collagen peptidase in serum before and after gestagen therapy of 10 resp. 20 days was determined. After 20 days the enzyme activity was significantly decreased. These findings show no correlation to the known gestagen induced alterations of the collagen metabolism.
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Preferring to the antecedent sparse literature an observation of "dermatitis nodularis necrotica" is described in a 15 year old girl with constipation showing the typical coarse-nodular necrotizing exanthema especially on the extremities. Histologically there was a perivasculitis with prevailing excessive cellular infiltrates (reticulum cells, granulocytes). Immunological tests (immunoelectrophoresis, fluorescence-histology in skin and intestinal biopsy) were negative. On the other hand staphylococcus aureus (as detected in skin scratches and by intracutaneous tests) seemed to play an etiologic role. Thus "dermatitis nodularis necrotica", on clinical grounds somewhat similar to papulo-necrotic tuberculids, seems to be a bacteride with secundary alterations of the skin vessels and not a variant of primary vasculitis.
In 15 patients with progressive systemic sclerosis esophageal function was examined radiologically and by manometry. Only one third of the patients had experienced dysphagia, while radiologically esophageal motility was abnormal in 8 patients (55%) and by manometry even in 11 patients (73%). Therefore the absence of symptoms does not exclude extensive involvement of the esophagus. Furthermore the manometric results indicate that involvement of the esophagus in the edematous-indurative stage of scleroderma should be suspected more frequently than assumed generally on the base of radiological studies alone.
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