Richard K Winkelmann

Clinical and histopathologic findings were reviewed in 57 cases in which there had been a diagnosis or suspicion of malignant lymphoma in the skin other than mycosis fungoides. Patients were included only if 1) extracutaneous tissue satisfactory for lymphoma classification was available, or 2) there was no evidence of extracutaneous involvement after a minimum of five years. Thirty-five patients had systemic lymphoma; in eight of these that disease first became manifest in the skin. ...

Previous studies identified autoantibodies against the IgE high affinity receptor alpha-chain, Fc epsilon RI alpha, in sera of selected patients with severe chronic idiopathic urticaria. We have now determined the incidence of anti-Fc epsilon RI alpha autoantibodies in a group of 163 patients. Intradermal injection of autologous serum caused skin reactions indicative of mast cell degranulation in 98 (60%) patients. Based on histamine release from IgE-sensitized and nonsensitized basophil ...

Antibodies to basement membrane in the sera of patients with bullous pemphigoid were used to study the basement membrane in epithelial tumors. Monospecific fluorescein conjugate of IgG was used to detect the antibody fixation. Squamous cell carcinoma of the skin was notable for absence of basement membrane related to anaplasia. Squamous cell carcinoma of the lip and vulva had well-preserved basement membrane despite deep invasion of the subcutaneous tissue. In verruca, basement membrane ...

Serum MIF activity was studied in ten patients with sarcoidosis, fourteen with granuloma annulare, four with necrobiosis lipoidica, and nine with various dermatological diseases. Positive MIF activity was found in the sera of nine of the ten patients with sarcoidosis and eleven of the fourteen patients with granuloma annulare. The delayed hypersensitivity tests were negative in all nine of the patients with sarcoidosis who had serum MIF activity and were positive in only three patients ...

Urticarial dermographism and delayed pressure urticaria are two forms of physical urticaria which are well defined clinically and histologically. Previous studies have shown eosinophil granule protein deposition in urticarial reactions, including chronic urticaria, solar urticaria and delayed pressure urticaria. To evaluate and compare the involvement of granulated inflammatory cells in urticarial dermographism and delayed pressure urticaria, we studied sequential biopsies of induced ...

BACKGROUND: Recent reports have implicated Borrelia burgdorferi infection as a possible cause of localized scleroderma (LS).

OBJECTIVE: Our purpose was to describe the clinical, histologic, and immunopathologic features of patients with LS who had serum antibodies to B. burgdorferi.

METHODS: Ten patients were examined clinically and by routine microscopy. Biopsy specimens from seven patients were studied immunohistochemically with monoclonal antibodies. The proliferative response of ...

Adenoacanthoma (Lever)9 is a distinctive tumor of the skin, best designated as ``adenoid squamous cell carcinoma." From a review of the histopathologic material seven cases seen at the Mayo Clinic from the period 1940 through 1962 are presented, and published reports of 15 additional cases are reviewed.The tumors occurred in persons aged 50 or more, usually on the face, and were associated with chronic sun damage to the skin. Three times as many men as women were affected. Basal cell ...

Skin lesions and clinically normal skin of thirteen patients with systemic lupus erythematosus (SLE) were examined, by the use of immunofluorescent techniques, to determine the presence of CIq, C3, C3 proactivator (C3PA), properdin, immunoglobulins (IgG, IgA, and IgM), and fibrin. IgM deposition was present in all thirteen skin lesions and in eleven normal areas tested, whereas IgG deposition occurred in eleven of the lesions but in only six normal areas. IgA was the least frequently ...

Serum samples from 539 subjects were screened for the presence of the anticentromere antibody on a human laryngeal carcinoma (HEp-2) cell line (Antibodies, Inc.). The antibody was present in 61 patients (11%), most of whom had features of limited scleroderma or the CREST syndrome (calcinosis cutis, Raynaud's phenomenon, esophageal dysfunction, sclerodactyly, and telangiectasia), either independently or in association with primary biliary cirrhosis. The antibody was rarely found in ...

Lupus erythematosus panniculitis is a clinical variant of lupus erythematosus in which the main pathologic process involves the deep corium and subcutaneous tissue. We reviewed twenty-nine cases of lupus panniculitis, as well as the cases previously reported in the literature. The histopathologic changes in lupus panniculitis are characterized by a lymphocytic panniculitis, hyaline degeneration of the fat, hyaline papillary bodies, and lymphoid nodular structures in the lower dermis and ...

Fifty-one patients (twenty at the Mayo Clinic from 1960 to 1969 and thirty-one collected from the literature) had herpes simplex virus (HSV) infections and hematologic malignancies of diverse types. Patients with extensive malignant disease were more commonly affected. The most serious infection was a generalized mucocutaneous vesicular eruption similar to Kaposi's varicelliform eruption, except that a preceding rash was seen in only one of the five patients described. Three patients ...

Histamine releasing autoantibodies play a central role in the pathogenesis of chronic urticaria (CU) in approximately 30% of affected patients. We investigated the therapeutic effect of high-dose intravenous immunoglobulin (IVIG) on disease activity in patients with severe CU of autoimmune aetiology. Autoimmune urticaria was diagnosed by the development of a weal-and-flare reaction to the intradermal injection of autologous serum and by serum-induced histamine release from the basophil ...

The pattern of distribution of T and B lymphocytes was investigated in a group of patients with contact, atopic, and mixed dermatitis by means of immunofluorescence and T-cell rosette tests. A significant increase (P less than .001) in B lymphocytes with surface IgD but without changes in the lymphocytes bearing other immunoglobulins or C3 and T cells was noted in patients with contact dermatitis when compared with a control group. A significant increase (P less than .001) in B ...

Thirty cases formerly diagnosed as Grade I lipogenic liposarcoma (well differentiated liposarcoma) were reviewed. The basic histologic pattern in all was that of adult fat modified by the presence of cells with enlarged, hyperchromatic nuclei; in most cases there was also a component of myxoid and/or fibrous tissue. The length of follow-up ranged from two to 30 years. Nine of the tumors were located in the subcutaneous layer. None of these recurred after excision, not even those which ...

The wheal-and-flare response to intradermal autologous serum in chronic urticaria offers a model for study of the pathogenesis of the disorder. Serial biopsies of autologous serum induced wheals were performed in 5 chronic urticaria patients to assess the evolution of the cellular inflammatory response and to look for evidence of mast cell degranulation. Perivascular neutrophils and eosinophils were seen as early as 30 min, becoming more intense and diffuse over 2 h. T lymphocyte numbers ...