Search

To the Editor.— Localized scleroderma differs from systemic sclerosis because of the difference in the distribution of skin sclerosis and the lack of Raynaud's phenomenon, acrosclerosis, and internal involvement. In localized scleroderma, the lesions are usually limited to the skin and to the subcutaneous tissue beneath the cutaneous lesions. However, it has been suggested that the disease has an immunologic basis because the serum samples of patients frequently contain antinuclear antibody (ANA). Recent reports on ANAs by indirect immunofluorescence methods using monolayer cultured cells showed greater frequencies than those by previous standard tests using frozen tissue sections. We first reported that 72% of the patients with localized scleroderma have positive ANAs when HeLa cells served as the test substrate. 1 Recently, Falanga et al 2-4 have reported elevated levels of anti-single-stranded DNA (anti-ss-DNA) antibody in localized scleroderma. They have also shown a positive correlation between anti-ss-DNA antibody and joint contracture

• Three patients with systemic lupus erythematosus had positive antiribosomal P protein antibodies. The patients are women who had mild diseases that did not involve prominent internal organs. By using an immunofluorescence method for the detection of antinuclear antibodies that employs HEp-2 cells, these serum samples produced intense stainings on cytoplasm and nucleoli that were digested with RNase. With the use of an immunoblotting technique, these serum samples recognized three ribosomal P proteins, called PO (38 kd), P1 (19 kd), and P2 (17 kd). We suggest that antiribosomal P protein antibodies can be detected in patients with systemic lupus erythematosus and associated mild clinical features. (Arch Dermatol.1990;126:1184-1186)

• A 23-year-old woman presented with Trichosporon cutaneum , which invaded deep into the dermis and subcutaneous tissue of the face and developed chronic granulomatous reactions. We postulated that the local use of an occlusive dressing with topical corticosteroid ointment in the early stage of the infection played a role in promoting the process of this opportunistic fungal infection. Antifungal chemotherapies, selected according to sensitivity testing to the isolated organism, were unsuccessful, mainly because of the acquired resistance of the organism to the chemical agent. Surgery was finally performed and a good result was obtained. ( Arch Dermatol 1986;122:1176-1179)