Volume 7 | July 1962 | Number 4

I     EpidermalReactive Dermatoses

Association with spongiosis and parakeratosis on almost all cases of eczema with acanthosis had been described by Unna.

I made histological and histochemical study of the specimens of epidermis under affection with varieties of dermatoses, i.e., eczema,neurodermatitis disseminata, Lichen simplex chronicus or atopic dermatitis, and of those with experimental dermatitis. (Table I & II). The presence of acanthosis was accompanied with increased quantity in epidermal cells of protoplasmic RNA, and later finding suggested that the rate of the metabolism of nucleoprotein had been accelerated in epidermis. Evidence was thus presented that allergens could be formed within

Table I.                          Patch tests on human skin

the region of epidermis through conjugation with intracellular protein of chemical agents of low molecule which would act as a hapten in the production of the allergic contact sensitization. That antibodies formed in the intercellular circulating lymphatic space around the squamous cells could be attached intimately to the epidermal cells led me to the concept that epidermal reactive dermatoses should result from pathologic conditions under epidermo lymphatic allergic reaction. This can be founded further with facts that an accumulation of glycogen and an augmentation of phosphorylase are observed in the affected site of epidermis, though with varying degree or distribution on each case. Favourite site of glycogen accumulation or phosphorylase augmentation is, on the cases of those with lichenoid type, the upper prickle-cell layer or the rete pegs, respectively and is, on the cases of those with eczematous type, the lower prickle-cell layer.

Eczematous dermatoses should, therefore, be considered reactive affections originating in the epidermis. Individual difference of irritability or reactivity of the skin especially may, in combination with chemical nature of irritants, be a determinating or an influencing factor causing conditions manifested as either lichenoid type or eczematous type.

II     Urticaria

Histological and histochemical observations of the lesions under states of urticaria acuta, chronica and facitis as well as of urticarial wheal were made consequtively on the skin specimens taken directly from the locci of the axillary region where histamine, sinomenine or one of the several agents of other kinds were injected intra-dermally. Through the results obtained, the authors concluded that an antigen antibody reaction carried out into effect locally should cause a degranulation on mast cells of capillary walls releasing histamine or heparin. Action of these substances on minute vessels in papillary area should cause temporarilly constriction which results in relaxation or dilatation of urticarial wheals being developed (Table III). These phenomena seem to be similar to those observed by Rossle-Frohlich's school on pieces of frog mesenterium under conditions of tissuse anaphylaxis. Lewis' opinion that vasoconstriction should be an initiating and basic mechanism about urticarial wheal formation might be founded with the results given by the author.