Juvenile colloid milium. Immunohistochemical and ultrastructural studies
Department of Dermatology, Wayne State University School of Medicine, Detroit, MI.Journal of Cutaneous Pathology (Impact Factor: 1.58). 07/1989; 16(3):164-74. DOI: 10.1111/j.1600-0560.1989.tb00033.x
A 7-year-old Italian girl with juvenile colloid milium was studied with histological, immunohistochemical, and electron microscopic methods. This patient had a well-documented history of severe sunburn and developed the lesions on the face shortly afterward. Numerous apoptotic keratinocytes were observed in the lower epidermis. These cells began their degeneration with filamentous whorl formation (or filamentous degeneration) of tonofilaments. In the papillary dermis the colloid substance was resolved by the electron microscopy into either wavy, thin filaments derived from the epidermal keratinocytes or typical amyloid filaments. Many desmosomes and gap junctions were found in the colloid substance. Polyclonal antikeratin antibody (DAKO) was positive in the colloid substance, particularly in the parts close to the epidermis. These findings suggested that juvenile colloid milium is different from adult colloid milium despite clinical similarities and that the former belongs to the group of actinic amyloid K, i.e. amyloidoses due to actinic degeneration of keratinocyte and its keratin.
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ABSTRACT: The case history is given of a woman of 65 (in 1973) with a granulomatous conjunctival inflammation in the right eye and chronic recurrent polyps on the vocal cords. Several times, granulomatous tissue was removed from the conjunctiva of the right eye but the result was recurrences at shorter intervals. Seven years after the onset in the right eye the left eye became affected. Various treatments, both systemic and local, were tried without success. The histological diagnosis of ligneous conjunctivitis was not made until 1981. Treatment with the known remedies for ligneous conjunctivitis was not successful. At the end of 1984 treatment with Imuran (azathioprine) was started. Since that time the patient has been practically free of recurrent granulomatous tissue on the conjunctiva and vocal cords. The treatment of ligneous conjunctivitis with Imuran has not previously been reported in the literature.
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ABSTRACT: When Congo red stain was the only criterion, “amyloid” was considered to be a single substance. With the advent of electron microscopy, this idea was further strengthened because unfortunately the ultrastructure of all amyloids including those of the skin was found to be uniform. Clinical dermatologists knew that there were two types of skin amyloidoses; one manifesting itself in the skin as well as in various internal organs, the other being exclusively limited to the skin. The first group included amyloidoses associated with multiple myeloma (now termed AL amyloid), infections (now termed AA amyloid), and familial hereditary disease (of chemically variable composition). The second group consisted of truly cutaneous diseases such as lichen amyloidosus, macular amyloidosis, and cutaneous epithelioma-associated amyloidoses. Nodular amyloidosis was thought to be the link between these two groups because occasionally it can become systemic disease; it turned out to be a systemic disease of immunoglobulin light-chain production with a limited skin manifestation. Today we realize that this clinical division was more important than histologic and ultrastructural analyses of amyloid deposits: the second group of amyloidoses occur exclusively in the skin because the amyloid substances come from a special degeneration of keratinocytes of the epidermis and its derivatives.
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ABSTRACT: We report the clinical, histological and ultrastructural features of juvenile colloid milium affecting a brother and sister. In this rare condition, translucent papules develop on sun-exposed areas of skin, with onset in childhood. Histologically and ultrastructurally, the papules consist of amyloid-like material derived from epidermal keratonocytes. A review of the literature suggests a possible genetic abnormality that leads to sun-induced degeneration of keratinocytes.
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