Biomedical subjects
Publications and source records attributed to P O Rudolph.
By means of architectural and cytological features, atypic and severe atypic melanocytic hyperplasia (AMH and SMH) as well as severe melanocytic dysplasia may be differentiated from malignant melanoma on one hand and benign nevus on the other.
A 57-year-old female patient has had generalized cutaneous lesions since birth. Clinically there are patch- and band-like areas of erythrokeratotic and pigmented skin in reticular arrangement. The most important histological findings are band-like parakeratosis, psoriasiform acanthosis, vacuolization of the keratinocytes in the upper layers of the epidermis with a high frequency of binuclear cells, and deposits of amyloid in the dermis. Ultrastructurally, the formation of perinuclear shells built from a three-dimensional network of fine filaments is the most peculiar finding. Binuclear cells are frequently found from the first suprabasal layers. Oedematization of the perinuclear cytoplasm within the shells finally leads to vacuolization of the uppermost granular cells. The horny layer is parakeratotic and contains debris of nuclei and lipid vacuoles. In the clinically normal appearing skin within the reticular network, keratinization occurs in a completely normal fashion. In spite of a good response to retinoid treatment, perinuclear shells and binuclear cells remain demonstrable in involved regions. The clinical, histological and ultrastructural peculiarities of this case suggest the diagnosis of a special type of congenital disturbances of keratinization, which can be clearly distinguished from the well-known ichthyosiform dermatoses and other inborn errors of keratinization.
Retinoids are effective in all forms of psoriasis and can be used alone or in combination with other therapeutic measures (anthralin, corticoids, PUVA, SUP). The effect of retinoids on psoriasis, in the final analysis still open to question, is discussed with regard to three parameters of psoriatic epidermis (enhanced proliferation, disturbance in differentiation, leucotaxis).
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The history of a patient with a clinically and histologically peculiar annular form of lupus erythematosus is presented. The differential diagnosis with other annular variants of lupus erythematosus is discussed.
An unusual form of secondary syphilis is reported. Because of the exceptionally large nodular cutaneous lesions, reticulosis or sarcoidosis was clinically suspected. The results of the serologic tests for syphilis and the concurrent histologic examinations established soon the correct diagnosis.
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