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Biomedical subjects

R K Winkelmann

Publications and source records attributed to R K Winkelmann.

At least 325 records · Page 18Linked to original sources
PubMed1977

Histologic, ultrastructural and histochemical studies of granuloma annulare.

We reviewed and reclassified the histology in 207 cases of granuloma annulare from our files. The most common pattern found was mononuclear infiltrative type (72%) in contrast to the palisading group (25%) and the epithelioid nodules (3%). Indeed, and entire spectrum from mononuclear infiltrates to the epithelioid sarcoidal types is seen. The electron microscopic findings include histiocytes with membrane activity, well-developed rough endoplasmic reticulum, large mitochondria, and numerous lysosomes. Pathcy damage of collagen and elastic fibers with the presence of vesicles, lysosomes, and cytoplasmic debris are demonstrated. The histochemical and ultrastructural studies localized acid phosphatase in the primary lysosomes and the routh endoplasmic membrane. The presence of fibrin deposition confirmed our previous immunofluorescence results.

Acid Phosphatase↗
PubMed1977

Acral arteriovenous tumor.

A unique, superficial, lobulated, benign vascular tumor of the skin, found in the acral areas of adult males, is described. The combination of three different elements--arterial, venous, and transitional vascular channels--make up the predominant histologic features of this tumor. The transition of fibromuscular channels indicates a venous lesion, but the acral location of the lesions and the structure and staining characteristics suggest that the lesion is a hamartomatous proliferation of the Sucquet-Hoyer canal of the true glomus.

Adult↗
PubMed1977

Unusual normolipidemic cutaneous xanthomatosis: a comparison of two cases illustrating the differential diagnosis.

A patient who developed diffuse normolipidemic plane xanthomas also presented with IgG lambda monoclonal gammopathy, hypernephroma, an unusual family cluster of leukemia (with two family members in two generations), and a unique, acquired C1-esterase inhibitor deficiency. A second patient presented with widespread normolipidemic papular xanthomas in which histiocytes containing Langerhans' granules were found. The lipid composition of the lesions of these two patients showed striking differences. Excesses of triglycerides and cholesterol ester were demonstated in plane xanthoma, whereas phospholipids were prominent in the popular xanthoma of histiocytosis X. We present and classify these two cases to emphasize the diagnostic value of chemical and ultrastructural studies of normolipidemic cutaneous xanthomatosis.

Adult↗
PubMed1977

Epidermal mast cells.

Tissue from 134 patients with neurodermatitis and prurigo, pseudoepitheliomatous hyperplasia, pemphigus, and urticaria pigmentosa was examined qualitatively for epidermal mast cells. Epidermal mast cells were found in all of the diseases that were studied except dermatitis herpetiformis. Pemphigus vegetans and dermatitis vegetans were frequently associated with the presence of epidermal mast cells. In other pseudoepitheliomatous diseases, such as tuberculosis verrucosa cutis, blastomycosis, and bromoderma, epidermal mast cells were present in many cases. Four of eight patients with acral dermatitis with elevated IgE blood levels had intraepidermal mast cells; the number was much lower in patients with usual neurodermatitis and prurigo nodularis. Only two of ten cases of alopecia mucinosa showed epidermal mast cells. A single epidermal mast cell was found in ten cases of urticaria pigmentosa. Chronic inflammation associated with epidermal cell proliferation appeared to correlate with the presence of epidermal mast cell.

Dermatitis↗
PubMed1977

Giant basal cell carcinoma.

Whereas basal cell carcinoma usually is a slow-growing tumor of the head and neck region, we have observed, over a 20-year period, three large, unique basal cell tumors of the back that were distinctive and presented clinical and histologic problems in diagnosis. They commonly formed exophytic, vegetative, flesh-colored to red, sessile plaques up to 20 cm in diameter. Ulceration was the principal feature of a fourth tumor, which destroyed the skin of the entire lumbar area and invaded the muscle. Regional-node metastases from this tumor showed basal cell carcinoma. Histologically, all the primary lesions were adenoid basal cell carcinomas with mucinous stroma. Histochemistry in two cases demonstrated minimal respiratory enzymes and no special esterolytic or lysosomal enzymes. Surgery was curative in three of these cases of rare, giant variant of basal cell carcinoma of the skin.

Adult↗
PubMed1977

Acute panniculitis: a clinical and histopathologic study of 34 cases.

Thirty-four patients had histopathologic findings of acute panniculitis. 15 had clinical findings of erythema nodosum; 6 had infectious lesions; and 5 had Weber-Christian-like conditions with recurrent febrile suppurative or nonsuppurative nodular eruptions; 3 of the 5 had amylase and lipase enzyme abnormalities with or without pancreatic disease. Five additional patients had acute panniculitis that would be termed "deythema induratum" or "nodular vasculitis" by most clinicians, and the subsequent pathologic findings and courses were consistent with this view. Two patients had limited, traumatic panniculitis, forming a distinctive group, but trauma was a factor in lesion formation in all groups, and one patient had vasculitis. Whereas acute panniculitis, with or without fat necrosis, may be associated with many inflammatory syndromes of the skin and subcutaneous tissue and may rarely occur in all, the most common relationship is with erythema nodosum in its most acute forms.

Acute Disease↗
PubMed1977

Flat warts undergoing involution: histopathological findings.

Patients with multiple flat warts were observed during the period of involution, shortly before regression of the warts. The histopathological process was characterized by mononuclear cell infiltration around subpapillary blood vessels, exocytosis of mononuclear cells into the epidermis, and a spectrum of degenerative epidermal changes that culminated in focal areas of necrosis within the epidermis. Lesions near the end stage of involution did not show the histopathologic features of flat warts. The mononuclear cell-associated injury to the epidermis resembles that seen in delayed cutaneous hypersensitivity responses and suggests that regression of flat warts may be due to a cell-mediated rejection reaction.

Adult↗
PubMed1977

Cell populations in experimental contact dermatitis.

Sequential biopsy specimens from contact dermatitis induced in the guinea pig by the application of dinitrochlorobenzene were studied by histologic, histochemical, and electron microscopical methods. At 12 hours, mononuclear cells and polymorphonuclear cells reached their peak numbers. Increasing numbers of basophils were observed, and at 24 and 48 hours, the basophils reached their maximal numbers. The basophils were observed not only in the dermis but also in the epidermis, and they may have had an active role in inflammation or repair. A close relationship was noted between the macrophage and all of the successive cell populations in the dermis.

Animals↗
PubMed1976

On the nature of desmoplastic melanoma.

Pathologic study demonstrated lentigo maligna melanoma in three of four cases of desmoplastic melanoma and demonstrated spindle cell masses with features of atypical fibroxanthoma in all four of the cases. Pigment enzymes of melanosomes were not found in the mesenchymal portion of the tumor. The cellular atypia and the histochemical and ultrastructural findings favor the fibroblastic nature of this melanoma-related dermal mass.

Aged↗
PubMed1976

Prostaglandins and chemotaxis: enhancement of polymorphonuclear leukocyte chemotaxis by prostaglandin F2alpha.

Prostaglandins E1, E2, F1alpha, and F2alpha did not demonstrate direct in vitro chemotactic properties either to rabbit peritoneal polymorphonuclear leukocytes or to rabbit or human polymorphonuclear leukocytes isolated from blood. Prostaglandin F2alpha, however, enhanced the chemotactic responsiveness of human polymorphonuclear leukocytes to the chemotactic agent casein.

Animals↗
PubMed1976

Macrophage inhibitor factor (MIF) in cutaneous lymphoproliferative diseases.

Macrophage migration inhibitor factor (MIF) activity in the sera of patients with mycosis fungoides, Sézary syndrome, and cutaneous lymphoma was observed in the sera of eight of the ten patients with stage II (infiltrative) mycosis fungoides, but in only one of the eight patients with stage I and in neither of the two patients with stage III mycosis fungoides. Two of the three patients with Sézary syndrome had MIF in the serum. No MIF was observed in cutaneous lymphoma. These data support the concept that Sézary syndrome and mycosis fungoides are T-cell diseases, and transitional, prelymphomatous diseases.

Cell Migration Inhibition↗
PubMed1976

Lymphokines (MIF) in the serum of patients with sarcoidosis and cutaneous granuloma annulare.

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 with cutaneous sarcoid lesions. One of four patients with necrobiosis lipoidica demonstrated minimal serum MIF activity. Data on serum lymphokine activity in sarcoidosis and granuloma annulare suggest that these two diseases are related to delayed hypersensitivity mechanisms.

Granuloma↗
PubMed1976

Granuloma annulare: direct immunofluorescence study.

Direct immunofluorescence studies were carried out in eleven specimens of granuloma annulare. The results (in all cases) indicate the presence of focal deposition of fibrin, localized primarily in the intervascular portion of the dermis, corresponding to the granulomatous and necrobiotic areas. These findings implicate the cellular mechanism of delayed hypersensitivity with focal involvement of the clotting system in the development of granuloma annulare lesion.

Blood Coagulation↗
PubMed1976

Hypersensitivity of scleroderma cutaneous vascular smooth muscle to 5-hydroxytryptamine.

Vascular smooth muscle strips from subcutaneous wrist vessels of patients with scleroderma (systemic sclerosis) were studied in an isolated system. No difference between catecholamine response of scleroderma or control vessel strips was observed. Three of four patients demonstrated significant hypersensitivity to 5-hydroxytryptamine as compared to control values. Serotonin hypersensitivity may play a role in the evolution of Raynaud's phenomenon and vascular scleroderma.

Adenosine Triphosphate↗
PubMed1976

Tubular apocrine adenoma.

Two cases of tubular apocrine adenoma were studied by light, histochemical, and electron microscopic methods. This benign apocrine hamartoma must be considered in the classification of appendage tumors, particularly those associated with organoid epithelial nevus, and may be confused with metastatic adenocarcinoma. The tumor is characterized by dermal and subcutaneous lobular masses of tubular structures. Connection to the epidermis by one or more ductlike structures is observed. The tubules contain typical apocrine epithelial cells, some with hyaline or clear cell differentiation. The tumor cells have apocrine differentiation by histochemistry and ultrastructure. The localization to the scalp and the nodular, lobulated appearance and the apocrine structures indicate that this tumor is similar to nevus syringocystadenoma papilliferum and must be diffentiated from it.

Adenoma↗