Winkelmann, R.K.

Malignant pyoderma is a rare inflammatory pyoderma of unknown cause with characteristic destructive and necrotizing ulcers limited to the face, neck, and upper trunk. The typical lesions are small, purulent, periauricular ulcers. Enlargement and coalescence result in extensive lesions that may ultimately destroy portions of the external ear. The histopathologic findings are acute and chronic inflammation with necrosis. Treatment consists of long‐term systemic corticosteroids. We present two new cases and alert otolaryngologists to the seriousness of this disease.

ABSTRACTHuman and dog and rabbit skin blood vessel strips give contractile responses to catecholamines, serotonin, and angiotensin II. Alpha receptors for catecholamine can be demonstrated. Species and organ variations occur in the small vessel tissue response to bradykinin (dog), histamine (rabbit) and acetylcholine (lung). A prostaglandin‐contractile activity could be demonstrated on cutaneous vessels. This activity was most marked in dog paw vessels and rarely occurred in human skin. Potentiation of catecholamine by prostaglandin E‐, A‐ and F‐ contractions could be demonstrated. The prostaglandin receptor was not blocked by alpha or beta blocking agents. The prostaglandin response was related to calcium concentration and was unrelated to exogenous or endogenous cyclic AMP.

AbstractStudy of the histopathologic pattern of 28 cases of superficial granulomatous pyoderma demonstrated an ulcerative, verrucous pyoderma of the superficial dermis. Focal abscesses in the subepidermis or dermis were juxtaposed with granuloma formation and plasma cell inflammation. Hemorrhage and granulation tissue were present. The clinical lesions are indolent, and this feature is confirmed by chronic inflammatory elements, including sinus tract formation and focal fibrosis. Superficial granulomatous pyoderma must be added to the histologic differential diagnosis of the vegetative and ulcerative granulomas: blastomycosis, tuberculosis verrucosa cutis, and bromoderma.

Vasodilating agents were tested on smooth-muscle strips of small arterial blood vessels of dog and rabbit skin and mesentery, and two patterns of reaction were demonstrated. The type 1 Vasodilating agents, for example nicotinate, caused relaxation of contracted strips or blocked their contraction. The type 2 Vasodilating compounds, histamine, choline esters, and bradykinin, either caused contraction or had no effect on the vascular smooth-muscle preparation. Responses that were species specific and region specific characterize the action of type 2 vasodilators and must be accounted for in any in-vitro testing procedure for vasodilator drugs.

Smooth muscle strips from rabbit subarachnoid arteries did not respond to catecholamines in concentrations which caused strips from skin, mesentery, and kidney vessels to contract. The strips from subarachnoid arteries responded to serotonin, histamine, and angiotensin II but not to bradykinin, acetylcholine, methacholine, and adenosine phosphate compounds. Heart and lung vascular strips did not respond to catecholamines but responded to acetylcholine; cardiac strips responded to dilute methacholine. Lung strips often failed to respond to histamine in usual concentrations and did respond to bradykinin. The subarachnoid strips had a distinactive pattern of respone as compared to vascular tissue from other organs. Results of other isolated vessel studies are reviewed along with pertinent investigations of cerebral autoregulation, vasospasm, and autonomic nerves. The possible significance of these findings is discussed.

Silver ion is not specific either in location or in action in the present silver method. Studies with radioactive silver, with the dark-field microscope, and with simple reducing solutions demonstrate a general distribution of silver ion in the impregnated tissue. Copper and mercury may be substituted for silver in the impregnating solution. A water-soluble aldehyde is necessary as a fixative. The substrate for staining appears to require the presence of protein-bound amine groups. The product-forming solution does not require the presence of a reducing agent. Sulfite ion is not necessary. All controllable sources of base that were utilized produced the histologic results. The product appears to be silver oxide in terms of the present solubility studies.

A study of the mucosal Merkel cells from 10 patients showed that the cell contained an intranuclear rodlet, clear cell qualities, fine desmosomes, characteristic membrane-bound Merkel granules, and cellular "horns" and had a close relationship to terminal axons. The Merkel cell is an intraepithelial cell with features of neurons and of amine-storage cells.