some squamous cell carcinomas of the skin.In 1988, we2 studied the number of S100 protein-positive cells in inflamed and noninflamed keratoacanthoma and squamous cell carcinoma. We observed that the number of Langerhans' cells per high-power field was markedly increased in inflamed keratoacanthoma when compared with early, noninflamed and inflamed squamous cell carcinoma. We hypothesized that increased numbers of Langerhans' cells in inflamed keratoacanthoma were part of the process that results in tumor regression.In the article by Alcalay and coworkers, there was no attempt to differentiate squamous cell carcinoma from kera¬ toacanthoma histologically. In addition, there appeared to be little attempt made to differentiate these lesions clini¬ cally. In fact, two of the patients did not have squamous cell carcinoma, but had squamous cell carcinoma in situ. Cer¬ tainly, squamous cell carcinoma in situ is not the same dis¬ ease biologically as invasive squamous cell carcinoma.In examining many tissue sections stained for S100 pro¬ tein expression, I have been impressed by the natural vari¬ ation in the number of Langerhans' cells identified by this antibody. I recognize that the population under study in such a preparation is limited, since it represents a two-di¬ mensional picture of a much larger lesion. However, the point is that Langerhans' cell density and morphology may represent a dynamic and complicated biologic system. In addition, I do feel that Langerhans' cells are not uni¬ formly distributed within a lesion and may vary in number and morphology for a number of reasons, including coex¬ isting inflammatory infiltrate, the nature of the skin lesion under study, the body location, and the host response to the neoplasm. Miami, FL 33101 1. Alcalay J, Goldenberg LH, Wolf JE Jr., Kripke ML. Variations in the number and morphology of Langerhans' cells in the epidermal component of squamous cell carcinomas. Arch Dermatol. 1989;125:917-920. 2. Korenberg R, Penneys NS, Kowalczyk A, Nadji M. Quantitation of S100 protein-positive cells in inflamed and noninflamed keratoacanthoma and squamous cell carcinoma. J Cutan Pathol. 1988;15:104-108.The correspondence department of the Archives is meant to provide a forumfor exchange ofideas about cuta¬ neous medicine and surgery, and is divided into two sections. The comments and opinions section is intended for responses to articles previously published in the journal or for comments on philosophic and practical issues pertaining to dermatology. If an Archives article is discussed, the let¬ ter should contain this reference and be received within two months of the article's publication. The vignettes section contains ministudies, very short case reports, rapid publi¬ cations, and preliminary observations that lack the data to qualify as full journal articles.We encourage submission of letters for publication in the correspondence section. Acceptance is contingent on edito¬ rial review and space available. Correspondence should be double-spaced, submitted in triplicate, and ...
