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Sea nettle (Chrysaora quinquecirrha) tentacles inflict cutaneous damage on many animals, including man. The cardiovascular action of the nettle toxin was investigated to determine whether this agent was capable of injuring tissues other than skin. Cardiac conduction abnormalities and ischemic electrocardiographic changes occurred in rats shortly after intravenous injections of the nettle toxin. Large doses of toxin produced a prompt increase in arterial blood pressure. These results support the premise that the nettle's sting, which clinically injures human skin, might affect other tissues if an adequate dosage were administered.This study was supported in part by grants-in-aid from the U. S. Bureau of Commercial Fisheries and Maryland Department of Chesapeake Bay Affairs, Grant 14-17-007-959 and the U. S. Department of Health, Education and Welfare, Grant 1 R01 UI 00642-01. The authors gratefully acknowledge the assistance of Mrs. Patricia Fannin, Mr. Michael P. Zimring, Mr. John C. Lee, Dr. John H. Stone, Dr. Leo M. Karpeles, Dr. F. H. J. Figge, and Dr. Y. C. Lee of the University of Maryland School of Medicine.

FAMILIAL BRACHYDACTYLIA AND HEMANGIECTASIA (TYPE UNDETERMINED). PRESENTED BY R. C. V. ROBINSON, MD. Two years ago, a 17-year-old boy was noted to have a peculiar redness surrounding the eyes. This appeared suddenly, but has persisted, with color variations from pink to almost purple. It is apparently worse when he is warm or perspires. There is no history of a similar condition in other members of the family. There is no familial history of other systemic diseases.This patient, his 22-year-old sister, his mother, and his maternal grandmother have `short fingers.' It has not appreciably affected his physical activities. PHYSICAL FINDINGS.— Involving both periorbital areas and the adjacent tissues, there is mottling similar to, if not identical with, that seen in nevus flammeus. There is no obvious thickening of the tissues. Funduscopic examination reveals no abnormalities.There is a peculiar stubbiness of the fingers. LABORATORY DATA.— X-ray examination of the skull

Lipoid proteinosis is a rare form of storage disease characterized by the deposition of an abnormal hyaline-like material primarily in the skin and mucous membranes. Approximately 100 cases have been recorded in the literature.2 At least one-third have been distributed across Europe and America.The following case emphasizes the principal clinical and histologic features of this disease. REPORT OF A CASE A 2½-year-old white girl was admitted to the Children's Service of the Massachusetts General Hospital for evaluation of dysphonia, alopecia, and unusual skin lesions.The patient's mother noticed that the child had a high-pitched hoarse cry since early infancy. A barium swallow performed at an outside hospital at 1 year of age was interpreted as normal. Four months prior to admission, erythematous, pruritic, maculopapular cutaneous lesions appeared on the central region of the face. Within 2 months, welldemarcated, slightly infiltrated brown lesions with central ulceration developed on the

Experimental, superficial, streptococcal cutaneous infections were produced by repeated stripping of the skin of hairless mice before inoculation with a broth containing streptococci.Fifteen or more strippings were necessary to produce a crusted lesion.Pathological examination of biopsies taken from the denuded skin of mice inoculated with live streptococci immediately after stripping, showed that the bacteria delayed the process of reepithelialization in the stripped wound.

Reports of infections caused by unusual bacteria are becoming more common. Nonetheless, they are repeatedly misdiagnosed. It is the purpose of this paper to delineate the methods by which a correct diagnosis can be made of an unusual infection in the skin.The problem of separating the pathogen from the contaminant can be difficult. A positive culture in pure growth from a cutaneous lesion is not always sufficient to implicate an organism as a pathogen. It is necessary to have a rising antibody titer or to culture a bacteria from several sources or from an unbroken lesion before it can be regarded as a proven pathogen. Because of this, many cases reported in the literature as lesions due to rare bacteria must be disregarded as probable coincidental eruptions in patients from whom carrier organisms were cultured on the skin.Cutaneous manifestations of infections are of 2 types: primary or secondary.

Soluble toxin was released from fresh Chrysaora quinquecirrha(sea nettle) nematocysts by gentle grinding or sonic treatment in distilled water. The lethal activity was not decreased by three cycles of freezing and thawing nor by lyophilization. Organic solvents such as acetone, ether, alcohol, and dimethylsulfoxide inactivated the toxin. Passage of the toxin through Sephadex gel results in partial purification and separation of the lethal activity into at least 2 fractions which are presumably proteinaceous.The authors acknowledge the aid and assistance of Drs. Elijah Adams, Seymour H. Pomerantz, and J. Tyson Tilden of the University of Maryland School of Medicine.

The sea nettle (Chrysaora quinquecirrha), a venomous jellyfish, occurs in great abundance in the Chesapeake Bay and other coastal waters. This coelenterate inflicts injury to swimmers by injecting a toxin-coated thread into the skin. Recent investigations have demonstrated that soluble toxin released from nettle nematocysts is neurotoxic, myotoxic, and cardiotoxic, as well as capable of producing dermonecrosis and hemolysis (1-3). It has also been shown that Chrysaoratoxin increased the sodium permeability of active membranes independent of ATPase or cyclic AMP (4). In order to understand the toxin's physiological action at the cellular level, its effect on rat liver mitochondria and lysosome preparations was studied.Passage of the nematocyst fluid through Sephadex gels resulted in partial purification and separation of the lethal activity into at least 2 fractions (5). In the present investigation, isoelectric focusing was applied to further separate and define the active components.Materials and Methods.Nematocyst suspensions (NS) were prepared from fresh Chrysaoratentacles according to previously described techniques (5). Sonic treatment of NS with 3 A for 90 sec ruptured the nematocysts and released the soluble toxins. This suspension was then centrifuged at 50,000g for 1 hr before the resultant supernatant (SU) was inoculated into a Sephadex G-200 gel column (30 cm height × 2 cm diam). Four milliliter fractions were collected and assayed for protein according to the method of Waddell (6). The ascending portion of the major peak in the protein curve of the eluate (FAS) was freeze-dried, resuspended in distilled water and inoculated into the isoelectric focusing apparatus (Model No. 8101, LKB Produkter AB, the Netherlands). Two to three watts were supplied to the focusing column for 2.5 days at 4°. At the conclusion of this run, serial 4 ml fractions of the sample within the column were collected.

A case of Kaposi's varicelliform eruption complicating pemphigus foliaceus is reported. The patient was taking 200 mg of prednisone daily throughout her herpetic infection in order to control her pemphigus. It cannot be stated with certainty that prednisone influenced the course of the recurrent viral disease.