Retinyl esters are hydrolyzed in liver both during uptake and mobilization of vitamin A. Studies were conducted to explore the enzymatic hydrolysis of retinyl palmitate in normal rat liver. Retinyl palmitate hydrolase activity was assayed with a sensitive and accurate microassay, employing retinyl [~-‘~C]palmitate as substrate…

Urokinase-type plasminogen activator (uPA) is produced and secreted by cultured human keratinocytes as a single chain precursor. UPA in keratinocyte conditioned medium is not susceptible to inhibition with diisopropylfluorophosphate (DFP), and it has an apparent molecular weight of 55 kD under both reducing and nonreducing conditions…

This article summarizes the management of 22 cases of pyoderma gangrenosum over the past four years at the hospital of the University of Pennsylvania, Philadelphia. Eighteen patients with pyoderma gangrenosum were studied using the most sensitive routine laboratory method for detection of monoclonal immunoglobulins, immunofixation electrophoresis. Four cases of IgA gammopathy were detected, confirming previous reports of the incidence of monoclonal gammopathy in pyoderma gangrenosum…

UVB radiation is beneficial for the treatment of psoriasis vulgaris. Patients with recalcitrant disease, however, are slow to respond to UVB phototherapy with and without the use of coal tars or emollients. Etretinate and, more recently, acitretin have proved useful, but clinical improvement is slow when they are used as monotherapy in plaque psoriasis. Each drug also produces side effects, some of which are dose related…

A survey of all MD-PhD residents in dermatology in the United States was conducted to evaluate the factors important to them in making career pathway decisions. Twenty-six MD-PhDs responded to the survey representing a 90% response rate. Although essentially all entered dermatology with the intention of pursuing a career in academic medicine, 77% percent thought they would be in academic medicine 5 years post-residency…

The preliminary study published in this issue of the Archives by Matsuoka et al1 addresses the question of whether the long-term use of sunscreens by the elderly will result in poor vitamin D status. Comparing two adult populations, one that used a p-aminobenzoic acid (PABA)-containing sunscreen with one that did not use sunscreen, these investigators found significantly lower levels of serum 25-hydroxyvitamin D (25-OH-D) in the group that used sunscreen…

The diagnosis of pityriasis rubra pilaris is based essentially on characteristic clinical features. Although the histologic features are not pathognomonic, a lesional skin biopsy for evaluation is important to rule out other papulosquamous and erythematous disorders. The presence of prominent seborrheic keratoses occurring in two cases of pityriasis rubra pilaris is presented. Our understanding of the relationship between vitamin A metabolism and pityriasis rubra pilaris is discussed…

In this report, we have presented our experience with a patient with a rare cutaneous granulocytic sarcoma. In addition to hematoxylin and eosin, myeloperoxidase stain and specific stains for lysozyme and esterase were helpful in confirming the histologic diagnosis of granulocytic sarcoma. Despite multiple attempts to control this patient’s tumor by conservative surgery, radiation therapy, and chemotherapy, we eventually had to resort to limb amputation. This procedure restored a meaningful quality of life to this patient for one and a half years prior to the development of acute leukemia…

Previous work on patients with muscular dystonia has shown that small intramuscular doses of botulinum toxin A eliminated hyperkinetic facial lines for approximately 6 months. The purpose of this study was to determine the efficacy of botulinum toxin A injections in eliminating facial wrinkles in aesthetic surgery patients who do not have muscular dystonia. Eleven healthy subjects were studied in a double-blind fashion. On both sides of the face, 0.2 cc of either normal saline or botulinum toxin A was injected into the forehead or into the periorbital wrinkles (crow’s feet)…

Irradiation of EGF-stimulated human keratinocytes in vitro with ultraviolet B (UVB) radiation inhibited both ornithine decarboxylase (ODC) activity and cellular proliferation. A dose-dependent reduction in ODC activity occurred in primary cultures of adult facial keratinocytes and neonatal foreskin keratinocytes, and in an SV40-transformed keratinocyte cell line derived from neonatal foreskin. When SV40-transformed keratinocytes were treated with epidermal growth factor (EGF), ODC activity was induced up to 21 times in the absence of ultraviolet radiation. However, pre-treatment with UVB significantly reduced the EGF induction of ODC…

Treatment of SV40-transformed keratinocytes (Z114) with epidermal growth factor (EGF) resulted in an increase in ornithine decarboxylase (ODC) activity and a dose-dependent increase in ODC mRNA levels. Pretreatment of keratinocytes with all-trans-retinoic retinoic acid inhibited the EGF induction of ODC activity. In both quiescent and EGF-stimulated cells, all-trans-retinoic acid inhibited ODC gene transcription and lowered ODC mRNA levels, whereas glyceraldehyde phosphate dehydrogenase expression remained unaffected. Treatment with all-trans-retinoic acid for 24 h resulted in a dose- and time-dependent decrease of up to 52% in EGF binding to EGF receptors and a 30-75% decrease in EGF-receptor quantity…

BACKGROUND:
Phototherapy for the eyelid has not previously been recognized as a safe and effective treatment of photoresponsive dermatoses of the eyelid, such as atopic dermatitis, vitiligo, psoriasis, lymphomatoid papulosis, and parapsoriasis.
OBJECTIVE:
The purpose of this study was to demonstrate the efficacy and safety of this treatment…

Caffeic acid phenethyl ester (CAPE) was evaluated for its potential in regulating keratinocyte proliferation. CAPE inhibited the proliferation of SV40 transformed keratinocytes (Z114) in a concentration- and time-dependent manner. Inhibition by CAPE was seen with 0.5 to 5.0 micrograms/ml at 48 h. Cell toxicity was observed at 10 micrograms/ml by changes in morphology and decreased viability. Pretreatment of Z114 cells with CAPE significantly prevented the full induction of ornithine decarboxylase (ODC) by epidermal growth factor (EGF) in a concentration- and time-dependent manner…

BACKGROUND:
Phototherapy and activated froms of vitamin D help clear psoriasis.
OBJECTIVE:
The influence of UVB phototherapy and oral calcitriol (1,25-dihydroxyvitamin D3) on vitamin D photosynthesis was assessed in 16 patients...

Vitamin A and its derivatives (retinoids) are capable of inhibiting vascular smooth muscle cell proliferation in vitro. The present study examines the effect of two retinoids, all-trans retinoic acid and 13-cis retinoic acid, on intimal hyperplasia following arterial injury. After receiving varying doses of all-trans retinoic acid or 13-cis retinoic acid, 78 male Sprague-Dawley rats underwent standard balloon catheter denudation of the left common carotid artery. Morphometric analysis and immunohistochemistry for proliferating cell nuclear antigen was performed at early and late time points…

Over a 2-year period, 31 lower extremity wounds in 16 patients (12-82 years old) were treated with a dermal regeneration template (IntegraTM) to enhance healing. Wounds treated included chronic leg ulcers (four venous, five ischemic, two rheumatoid), as well as skin cancer (18) and benign lesion (one congenital nevus) excision sites. Once the outer silicone layer was removed from the regenerated dermis, the wounds were autografted (eight patients) or left to heal by secondary intention (23 patients). Of the wounds that were autografted, five were successful…

BACKGROUND:
A dermal regeneration template indicated for life-threatening third-degree burn injuries is a product with potential application to smaller wounds to aid in healing and closure of complex excision sites.
OBJECTIVE:
To assess the effectiveness of dermal regeneration template for closure of skin cancer excision sites that would have otherwise required complicated closures…