Biomedical subjects
D N Silvers
Publications and source records attributed to D N Silvers.
The small lentiginous nevus.
Eighteen small lentiginous nevi, each 1-3 mm in diameter, showed aggregates (nests) of melanocytes in the lower portion of the epidermis. In six of the 18 nevi, nests of melanocytes were evident only after examination of numerous serial sections (approximately 100-125). These six lesions would have been diagnosed as simple "lentigines" if the serial sections had not been examined. Lesions referred to as simple "lentigines" may actually be lentiginous nevi.
Analysis of dendritic cells in solitary angiofibromas for factor VIII.
We studied dendritic cells in the dermis of six angiofibromas by the peroxidase-antiperoxidase method in order to determine whether they are endothelial cells. The primary antiserum used was directed to factor VIII, an endothelial cell marker. The dendritic cells were not immunoreactive for factor VIII, suggesting that they are not endothelial cells.
Pathology of melanoma.
The biologic behavior of several common clinicopathologic types of melanoma is generally predictable by the depth of tumor invasion. However, some individuals have tumors that do no behave as predicted. These include what some authors have called borderline melanoma and minimal deviation melanoma as well as desmoplastic melanoma, thin superficial spreading melanoma with marked regression, and melanomas arising within some nevi. The reasons for the erratic behavior of these melanomas remains enigmatic.
Late reactions at Zyderm skin test sites.
We report on two patients in whom results of skin tests to injectable bovine collagen (Zyderm) became positive six weeks after administration. In one of these patients, the test was repeated, and showed identical result. It is recommended that Zyderm skin test sites be observed for at least six weeks before the test result is considered negative.
Leukocytoclastic vasculitis in urticaria induced by ultraviolet irradiation.
A 35-year-old woman would develop urticarial lesions over one to four hours after irradiation with sunlight or artificial ultraviolet radiation. Lesions could persist for days before resolving. Although lesions were morphologically typical of solar urticaria, their evolution and resolution were both much slower than expected. Histologically, the lesions showed leukocytoclastic vasculitis. This unexpected finding suggests the possibility that there may be novel mechanisms involved in the pathogenesis of some cases of solar urticaria.
Biologic behavior of thin malignant melanomas with regressive changes.
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Erythema marginatum in rheumatic fever: early diagnosis by skin biopsy.
Skin biopsy of a 10-year-old boy with a 3-week history of recurrent rash and fever demonstrated histologic changes suggesting a diagnosis of erythema marginatum associated with rheumatic fever. Subsequently, the patient developed classic cardiac and arthritic manifestations. Skin biopsy is recommended for the early diagnosis of rheumatic fever.
Prophylactic excision of nevocellular nevi.
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Observations on a melanoma by William Norris, M.D., a country practitioner of the early 19th century.
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The color of the skin of the palms and soles as a possible clue to the pathogenesis of acral-lentiginous melanoma.
It is obvious clinically that skin of the palms and soles (volar skin) of blacks is lighter in color than black glabrous skin. The same difference obtains in whites, but is much less obvious. The distribution of melanosomes within keratinocytes of the palms and thighs of blacks and whites was compared. Keratinocytes in skin from the thighs of blacks contained only individually dispersed melanosomes, but keratinocytes in skin from the palms of blacks and from the palms and thighs of whites contained complexed melanosomes. Our observation may explain why the incidence of melanoma of volar skin in blacks and whites is similar, whereas melanoma on the glabrous skin of blacks is extremely rare.
Giant pigment granules in biopsy specimens from cafe au lait spots in neurofibromatosis.
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Photoallergic contact dermatitis to musk ambrette. Histopathologic features of photobiologic reactions observed in a persistent light reactor.
Studies concerning a patient with contact photosensitivity to musk ambrette, a commonly used fragrance, are reported. The patient had a persistent light reaction. The patient's history, clinical appearance, and phototest and photopatch test results are described. The observed patterns of these were identical to those previously noted in patients who had persistent light reactions after exposure to other photosensitizers such as the halogenated salicylanilides. The histopathologic findings in the phototest and photopatch test sites were those of an acute spongiotic dermatitis. No abnormal change was seen with ultraviolet A radiation exposure alone.
Evidence for the derivation of individual hair roots from three progenitor cells.
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Melanocytic nevi in neonates.
The histologic features of seven congenital nevi within 3 months of birth were studied, together with the ultrastructural features of one of the lesions examined microscopically within 48 hours of birth. All seven lesions showed melanocytic hyperplasia within the epidermis and within pilosebaceous and eccrine sweat units. Nevus cells within the dermis were located in proximity to the adnexae. Melanocytic hyperplasia within the epidermis showed a variety of patterns, at least one of which simulated the atypical melanocytic hyperplasia seen in the superficial spreading type of melanoma. The fine structure of the melanosomes in one case studied by electron microscopy resembled hair-bulb melanosomes. They were distinctly different from melanosomes characteristic of epidermal melanocytes, nevus cells, or melanoma cells.
Penicillamine-associated pemphigus: is it really pemphigus?
Penicillamine-associated bullous eruptions share with spontaneously occurring pemphigus intraepidermal acantholysis, epidermal intercellular deposition of immunoglobulin, and circulating serum antibody against the intercellular regions of the epidermis. We report the case of a penicillamine-associated bullous eruption in which there were some of the histologic features of pemphigus, but none of the immunofluorescent features. Instead, the immunofluorescent findings of bullous pemphigoid were demonstrated. Review of the literature reveals that clinical and histologic features of penicillamine-associated bullous eruptions differ in important respects from those of spontaneously occurring pemphigus. Our report adds immunologic data to evidence that the penicillamine-associated bullous eruptions may not be the same disease as spontaneously occurring pemphigus.
Spontaneous regression of a giant keratoacanthoma. Photographic documentation and histopathologic correlation.
An 84-year-old woman developed a keratoacanthoma on the dorsum of her left hand. Photographic documentation of spontaneous resolution of the lesion over a period of eight months is presented. Biopsy of the site of the resolving lesion revealed extensive scarring and granulomatous inflammation.