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Eosinophilic pustular folliculitis (EPF) is a dermatosis of unknown aetiology, characterized by repeated development of pruritic follicular papulopustules with a tendency to form an annular configuration on the face and other seborrhoeic areas, and by palmoplantar pustular lesions in one-fifth of the patients. Both types of lesions are infiltrated mainly by eosinophils with some polymorphonuclear leukocytes (PMN). To elucidate the mechanisms underlying pustule formation, we studied the chemotactic activity for leukocytes of the skin surface lipids (SSL) obtained from seborrhoeic areas. No specific chemotactic activity was detectable in stored SSL from patients with EPF. However, fresh SSL collected from the seborrhoeic areas of normal adults contained chemotactic substances for eosinophils and PMN which were labile on storage in air. In stratum corneum extracts from palmoplantar lesions of patients with EPF we demonstrated the presence of a 13000 molecular weight chemoattractant factor for PMN, the activity of which was partially inhibited by antiserum against C5a, and a low molecular weight lipid-soluble chemotactic factor for eosinophils, the activity of which was also lost on storage in air. Our findings suggest that these chemotactic factors play a role in the production of the characteristic pustular lesions of EPF.

Melanoma occurs much less frequently among Japanese I han among white people. The occurrence of subungual melanoma is uncommon both among white rind among Japanese people. However, the authors found 16 subungual melanomas among 86 cases of cutaneous melanoma (19%) at their clinic, quite a high incidence. O f these, 69% (11/16) occurred on the hands and 31% (5/16) on the feet. By far the most common site was the right thumb. Histologic examination revealed that 67% were characterized by acral lentiginous, 50% by superficial spreading, and that there were no nodular melanomas. Most were Clark's Level IV and V at the time of diagnosis. The 5-year survival rate for subungual melanoma was 40%. No statistically significant differences in rate were found between subungual melanoma and volar melanoma. The term ''acral" melanoma is recommended to describe the melanomas in the acral regions, because it is descriptive of the regions directly affected.Cancer 552725-2731, 1985.N 1886, Hutchinson' described melanomas of the nail I bed, to which he applied the term melanotic whitlow.Similar cases were subsequently Clinical, epidemiologic, and therapeutic studies of subungual melanomas have beenIn 1972, Luprescu et a/." reported two cases of malignant melanoma on the fingertips and found that the lesions had the histologic characteristics of lentigo maligna.Recently, there has been growing concensus that acral lentiginous melanoma (ALM) represents a distinct entity having characteristic histologic and biologic features.'8-22 Subungual melanoma has been categorized as one form of ALM.20-27 However, there have been few studies dealing with the histologic features of subungual melanoma, and it is doubtful whether all subungual melanomas are ALM. The lack of a single large scale study of subungual melanomas due to its low incidence prevents our making absolute conclusions based on comparative studies.Racial differences are quite pronounced in the incidence and predilection of sites of melanomas. Melanoma occurs much less frequently among Japanese than among white patients.24 Although melanomas occurring in the acrd regions are the most common type of melanoma among Japanese people,2s the number of cases is small, with only 63 cases having been reported in the Japanese literature. During a 13-year period (1969)(1970)(1971)(1972)(1973)(1974)(1975)(1976)(1977)(1978)(1979)(1980)(1981)(1982), I6 sutlungual melanomas were observed among 86 cases of cutaneous melanoma at the Department of Dermatology, Tohoku University School of Medicine, quite a large number in one institution. This article describes the histologic and clinical findings for subungual melanoimas and compares the biologic behavior and histopal hologic features of subungual melanomas with melanomas occurring on the volar skin. Materials and Methods'This is a retrospective study of all cases of subungual melanoma seen at the Department of Dermatology, Tclhoku University School of Medicine during the 13-year period from 1969 to 1982. Eighty-six patients had cutaneous melanoma,...

Complement components C3a, C4a and C5a were assayed in corneal scale extracts from psoriasis and other dermatoses characterized by sterile subcorneal pustules, using radioimmunoassay. Larger amounts were detected in psoriasis and related pustular dermatoses than in extracts of non-inflammatory stratum corneum. It is concluded that complement is activated via the classical pathway and releases the neutrophil chemotactic fragment C5a.

Interleukin-1 (IL-1)-like activity was assessed in scale extracts prepared from skin specimens from 36 cases of psoriasis and other dermatoses characterized by the formation of sterile subcorneal pustules. IL-1 activity was detected in only 2 samples. In contrast, much higher IL-1 activity was demonstrated in horny tissue extracts prepared either from normal skin or from noninflammatory skin such as plantar callus, scar or ichthyosis. No correlation was found between neutrophil chemotactic activity and IL-1 activity demonstrable in horny tissue extracts.