The antinuclear factor (ANF) is present in most cases of systemic lupus erythematosus. We got 185 sera from the patients with erythematodes and other diseases, and normal control. They were each diluted from 20-fold to 1,280-fold. Mouse liver cell and human white blood cell were used as nuclear materials and indirect immunonuorescent technique was carried out. Circulating ANF was found in 37 sera from 40 patients with SLE, but in three sera from 38 DLE. Five sera from 117 other patients and normal control were ANF-positve. We also investigated the types of nuclear staining pattern, the staining titer, and antigen specificity on positive sera of SLE. The relation between ANF and clinical courses of SLE as following: in most cases, it showed high titer of antinuclear antibody and peripheral or shaggy pattern in active SLE, and low titer and speckled pattern in inactive SLE.
Thirty-five cases of erythematodes (18 cases of SLE and 17 cases of DLE), 6 cases of dermatomyositis, 18 cases of normal skin and 119 cases of the other skin diseases are examined of virus-like particles. Virus-like particles which located chiefly in the endothelial cells of the small blood vesseles of the upper dermis are detected in all the cases of erythematodes, dermatomyositis and lymphocytic infiltration of the skin. The relation between the eruption and the frequency of the appearance of the virus-like particles are as follows: exudative erythema>exudative discoid patches>discoid patches>pigmentation. Virus-like particles are detected not only at the endothelial cells of the blood vesseles, but also at histiocytes, pericytes and the endothelial cells of the lymphatic vesseles. At the epithelial cells, no virus-like particle is detected. Virus-like particles are negative by the acid phosphatase staining, so they are not lysosomes. Some relations to the rough endoplasmic reticulums are observed. Virus-like particles are continued directly to filaments of the endothelial cells. At the nuclei virus-like particles are located just between the outer and the inner membranes. In the sera of erythematodes patients, antibody which reacted to the virus-like particles are detected, but IgG is not there. So, the relation between antinuclear antibody and virus-like particles is still unknown. On the other hand, at the basement membrane IgG is positive, but no antibody is detected in the patients’ sera. The earlier diagnosis of erythematodes may be possible by the detection of virus-like particles according to the following reasons: 1) Virus-like particles are able to be detected only in erythematodes and dermatomyositis among the skin diseases which show butterfly rashes. 2) Among the skin diseases which discoid patches, only lymphocytic infiltration of the skin are positive to virus-like paticles except erythematodes. 3) The nonspecific erythema except that of erythematodes are negative to virus-like particles. 4) Virus-like particles are not detected in the normal skin.
As SLE is one of the so-called autoimmune diseases, a treatment with the immunosuppresive drugs in SLE is of great theoretic interest, however they should be used with steroids. The following results have been lead from our small number of the cases with SLE; in the treatment of SLE, steroids are administered in first and after an improvement of the clinical symptoms are seen, the immunosuppresive drugs are used for relatively long term carefully taking not have any side effects. An early inhibition of the antinuclear antibody production and gamma-globulin and returning of serum complement level to nomal will be expected by concurrent corticosteroids and immunosuppresive drugs administration.
Immunopathological studies were performed on the renal tissue of 20 biopsy cases and 7 autopsy cases of lupus nephritis by means of the direct immunofluorecent method and on that of some of them by the electron-microscopic enzymelabeled antibody method. The results obtained were as follows. 1) Serological abnormality, i. c. more than 20 per cent in serum anti-DNA antibody level and less than 20 in CH50 level was seen in 88 per cent of the active lupus nephritis group (Shur’s classification) and in a few of the inactive and without group. 2) Staining patterns observed in the glomeruli of lupus nephritis by the fluorescent antibody method can be classified into three groups: linear, granular and lumpy patterns. 3) The linear, granular and lumpy patterns were observed in the majority of the inactive or without group, active group and cases expired by uremia, respectively. 4) The majority of cases displaying the granular and lumpy patterns belonged to the group showing more than 20 per cent in anti-DNA antibody level and less than 20 in CH50 level and many of cases displaying the linear pattern to the group showing less than 20 per cent in anti-DNA antibody level and more than 20 in CH50 level. 5) Localization of IgG and β1c was almost same in the granular and lumpy patterns. No β1c was detectable in the linear patterns. 6) The cases showing the granular pattern revealed electron-dense deposits in the glomerular basement menbrane by electron microscopy and fine granules indicating the localization of γ-globulin within the deposits by the enzyme-labeled antibody method. 7) Fluorescence in the granular and lumpy patterns was remarkably reduced by acid treatment and the eluate was observed to contain anti-nuclear factor. Hence, it was presumed that the deposits seen in these patterns contained anti-nuclear factor-nuclear substance complex.
Discoid LE and SLE are closely related. Genetic factors are considered to be important in the development of SLE. On exposure to sun light, DNA seems to denature and become antigen-like substance in persons with lupus diatheses in the meanings of genetic factors, sex hormones, age factor etc. It is hypothesized that, if the defence mechanism of the basement membrane of the skin is complete, the pathologic process manifests as DLE and that SLE develops when this defence mechanism is destroyed.
Two cases of trichostasis associated with intradermal nevus cell nevus was reported. On one of these cases, compound follicles were found histologically, which may be responsible for trichostasis together with hyperkeratosis of the follicles. The abnormal angle formation of the follicles due to hypertrophy of the sebaceous glands was not observed.
Eight patients with typical botryomycosis, four of them are pregnant have been seen in our clinic recently. So far, 169 cases have been reported under same diagnosis in Japan. Including our cases, the statistical observation and possible causes of this dermatosis were discussed. As the cause of these cases, the haemangiomatous change is mostly considerd as generally reported before.
Syringoma with lesions limited to the bilateral upper arms occurred in a 39-year-old woman. Limitation of the lesions to this appears unique. Syringoma should be added to the differential diagnosis of papular lesions of the upper arms and biopsy must be required when it is occurred in a woman of climacterium.
In order to detect the drugs causing patients to suffered from drug eruptions peripheral blood lymphocytes taken from the patients were cultured with the suspicious drugs for 120 hours. Culture rods were divited into three groups: 1. positive control group with phytohaemagglutinin 2. negative control group without any drugs 3. main group with some stepped concentration of suspicious drugs. Cells after 120 hours incubation were morphologically classified into three types and counted; large cell, intermediate cell and small cell. The results were reached by using the ratio of these three cell types. Simultaneously, incorporation of tritiated thymidine was also examined by autoradiography and Backman’s liquid scintillation counter.
Recent advances in autoradiographic technics have been applied to various fields. Using these technics, we could study dynamic cellular activities besides static ones with histochemical method. In the dermatological field, many interesting problems such as function and differantiation of the skin, the effect of various agents on skin tissue, the process of skin and hair transplantation, pathophisiology and immunopathology of dermatoses, and origin and malgniancy of tumor cells could be made an object of the microautoradiographic study. As a clue in solving these problems, the author introduced the established technics which are essencial for a right understanding of the result.