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The main macroscopic features of 4 cases presented here are erythroderma-like lesions and solid papules. The former covers extensive areas over entire trunk and extremities, especially extensor surfaces. The latter is observed mainly on flexor surfaces of extremities and around the former. The axillae, inguinal regions, cubital and popliteal fossae, and big furrows on abdomen are spared from these lesions. Rashes appear first as papules and form erythroderma-like lesions through their assembly and confluence. Histologically, both show almost the same findings. Patients are older males with no general symptoms except itching. Although the course is chronic, lesions improve slowly and heal only after years.

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SUMMARY This paper describes the clinical and histopathological features in ten cases of spontaneously involuting plane warts. In all, rapid regression occurred after the sudden development of an inflammatory reaction. At an early stage a degenerative change appears in the upper epidermis and the typic features of the warts are masked. At the height of the reaction an intense mononuclear cell infiltrate in the dermis associated with epidermal spongiosis, exocytosis cell necrosis and focal parakeratosis is found. It is suggested that the development of cell mediated immunity may be responsible for spontaneous involution of warts.

6 cases with acute febrile neutrophilic dermatosis (Sweet’s syndrome) responded rapidly and dramatically to treatment with potassium iodide. All patients became afebrile and symptom-free within 24–48 h after therapy. The cutaneous eruptions subsided completely in 3–5 days. 5 of the patients received the drug only for 2 weeks, but they have had no recurrences. Although the remaining 1 patient had shown minor recurrences after cessation of the medication, he was free of all symptoms during the therapy. The mode of the action of potassium iodide is also discussed.

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In an attempt to elucidate the mechanisms underlying the production of transepidermal migration of leukocytes toward the stratum corneum in psoriatic lesions, the chemotactic properties of soluble substances in psoriasis scales were examined by a modified Boyden's chamber. All crude extracts of horny tissues studied, i.e. callus, scales of exfoliative dermatitis and of psoriasis vulgaris, showed chemotactic activity for human peripheral blood leukocytes. But only the chemotactic activity of the psoriasis scale extract was highly potent. This was greatly reduced after dialysis. Fresh serum was not required to manifest the chemotactic activity. By Sephadex G-200 chromatography, the scale extracts from psoriasis vulgaris and pustular psoriasis had potent activity eluted near the cytochrome C marker. The same fractions of other horny tissue extracts, bacterial filtrate prepared from cultured psoriasis scale fragments, and serum did not show such potent activity. On the basis of analysis by gel filtration and recent findings of immunopathological studies, a postulate was made that a complement derived chemotactic factor, possibly a C5 cleavage product, developed as a result of antigen-antibody reaction in the stratum corneum of psoriatic lesions.

A study was made on the in vitro characteristics and in vivo biological activities of a leukotactic factor derived from psoriatic scale (PLF). Sephadex G-75 chromatography showed that PLF eluted in the region of the 12,500 dalton protein marker. It resisted heating, lyophilization, acidity (pH 3) and alkalinity (pH 11), but was destroyed by trypsin digestion. The substance attracted polymorphonuclear leukocytes (PMNs) in vitro; this ability was inhibited by antiserum to C3a and was partially reduced by antiserum to C5. Although PLF showed strong chemotactic activity for PMNs, its activity for mononuclear cells was only mild. Intradermal injection of PLF into man or guinea-pig produced an erythematous response with dense tissue neutrophilia, the time course of which was similar to that of the Arthus response. PLF also provoked increased vascular permeability in guinea-pig skin. Moreover, repeated intradermal injection of PLF to the same site in guinea-pigs led to moderate acanthosis of the overlying epidermis. These observations strongly suggest that transepidermal migration of leukocytes in psoriatic lesions is provoked by PLF, whose activity appears to reflect that of complement cleavage products, particularly C3a, presumably produced by complement activation in the subcorneal region of the epidermis. Furthermore, it is postulated that PLF may be a factor which plays a crucial role in the production of typical psoriasiform tissue changes.