A case of epidermotropic eccrine carcinoma 76-year-old man, was reported. The primary lesion was on the prepuce and progressed slowly to involve the scrotum up to the suprapubic region and inguinal region. The inguinal lymph nodes were enlarged to the size of a hen’s egg. The histological features were as follows: (1) The sections of primary lesion and all metastatic nodules showed acanthosis with papillomatous pattern — intraepidermal tumor nests, and the tumor cells connected the surrounding prickle cells with intercellular bridges. (2) The nests of tumor cells were present in dilated lymph vessels in the upper dermis. (3) The tumor cells were small and hyperchromic, and showed no evidence of keratinization. Mitoses were present. (4) The nests of tumor cells contained several lumina and cystic spaces.
A 65 year-old-man, suffuring from acut myeloic leukemia, tinea cruris, tinea pedis and tinea unguium, complained of reddisch lesion on right preauricular area and helix. The lesion consisted of annular erythema and reddish nodules. The histological picture of the nodule was granuloma in dermis which was composed of histiocytes, lymphocytes, plasma cells, leukemic cells, etc. Eosinophilic asteroid body of various size and shapes were observed within the granuloma. Trichophyton rubrum was cultured from tissue.
The histological features of lichen planus are hyperkeratosis, hypergranulosis, irregular acanthosis, liquefactions degeneration of the basal cell layer and band like lymphoid cell infiltration in the upper dermis. On the other hand, these histological changes are cosidered as a reaction cutaneé against the various etiologies. The subject of this report to study the pattern of the tissue reactions in lichen planus and lichenoid eruptions using the term of lichenoid tissue reactions. The histological studies were carried out on the 22 specimens from 12 cases of lichen plauns, 2 of them being of the oral mucosa and the lip and the 4 specimens from 2 cases of lichenoid eruption due to color developer and hypotensive agents. The results obtained were as follows. Epidermal findings; In the early stage, the epidermis showed slight edematous changes, inter cellular edema, vacuolation of prickel cells and basal cells, and accompanied the involvement of basement membrane. As the disease progressed, liquefactions degeneration of the basal cell layer became more obviously, the prickel cells hypertrophied and the epidermis showed pseudoacanthosis. These changes may be a sign of adaptation to keep the homeostasis of the epidermis against the various detriments such as epidermal nutritional insufficiency and abnormal metabolites produced in the dermal lesions. When the balance was disturbed, the epidermis revealed degenerative changes, atrophy and even necrosis. In the advanced lesions, occasionaly, regeneration of the epidermis was noticed and the epidermis showed true acanthosis and occasionally slight parakeratosis. Hyperkeratosis were distinctive findings of this disease. They were a sign of retention of the epidermal cells resulted from supression of the mitosis which was caused by undernutrition of the epidermis. Dermal findings; In the early stage, nonspecific mild inflammation was noticed in the area of the subpapillaries. The infiltrated cells were polymorphous; a few neutrophils, eosinophils, mast cells and moderate lymphocytes. Typical lesions showed marked dilatation and toutous meadering of the capillaries and dilatation of the lymphcapillaries. They are a sign of microcirculations failure, which is a significant element of the histgenesis of this disease. The continuous microcirculations failure elicite reactive lymphoreticular cell hyperplasia. The process of lichenoid tissue reaction can be assumed as follows. When there is reduction in biological activity of the epidermis as a diathesis, the mild inflammation, which may be a certain allergic reaction in the area of the subpapillary pulls the trigger of microcirculations failure. It elicite hypertrophy, degenerative changes and regeneration of the epidermis. These various changes are intermingled in the same lesion and at the same time. This characteristic tissue reaction may be occured on the basis of lichen diathesis. In two specimens, enlargement of the nerves were observed. Involvement of the nerves may be one of the significant element of lichen diathesis. Lichenoid eruptions due to color developer and hypotensive agents showed the same tissue reactions. Ten specimens from 8 cases of melanosis Riehl were observed histologically. They showed similar process of the reaction to that of lichen planus, but lymphoreticular hyperplasia and toutous meandering of the capillaries were not striking. The degeneration of the collagen were remarkable, in two of them hyaline depositions were observed in the papillary region.
Percutaneous absorption of 3H-labelled beclomethasone dipropionate cream under plastic film was studied by means of an autoradiography. It has been proved that beclomethasone dipropionate is readily absorbed in the normal human skin. The main pathway of percutaneous absorption of beclomethasone dipropionate is proved to be trans-follicular route, but under plastic film a considerable amount of beclomethasone dipropionate is absorbed through the horny layer and the malpighian layer of epidermis. The basal layer of epidermis serves as a skin barrier for the percutaneous absorption of beclomethasone dipropionate through the normal skin.
Electron microscopic study on squamous cell carcinoma in burn scar revealed the followings, concerning the prickle-cell layer of cancer nests. Nuclei of the cells which arranged lamellarly exhibiting little tendency of keratinization and so seemed to be in the biginning stage of cancer pearl formation (hereafter refered to as B. P. F.) mostly flattened, being dislocated in one side of the cytoplasm, and often showing saw-toothed border. Most of their nucleolei were not so large in size but commonly displayed distinct nucleolonemata. The cancer cells located in the center of B. P. F. were filled with many tonofibrils distributed in their cytoplasm showing meshy arrangement, while peripheral cells contained fine or thick bundles of tonofibrils arranged in concentric whorls surrounding the center B. P. F. Intercellular spaces between cancer cells were mostly narrow or indistinct, but occasionally vacuolarly dilated. In such portions desmosomes were often lengthened. Round-shaped or horseshoe-shaped structures, a portion of which contained desmosomes or desmosome-like structures were recognized in the cytoplasm of cancer cells located in the center of B. P. F. The cytoplasm of cells showing individual cell keratinization was packed with inocmpletely keratinized tonofibrils of various sizes and random orientations with the disappearance of cytoplasmic organelles. It occasionally contained desmosomes or round shaped structures presumed to be derived from the tight junction.