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We studied biopsy specimens taken from the scalp of four normal volunteers by transmission electron microscopy (TEM). At the suprabulbous level of the follicle, where the cells of Henle's layer are fully keratinized but the cells of Huxley's layer are not, the cytoplasmic processes of Huxley's layer ("Flügelzellen") reach the cells of the outer root sheath through the keratinized cylinder of Henle's layer. This junction between the outer root sheath cells and the "Flügelzellen" has not been previously characterized ultrastructurally. It is peculiar in its total lack of desmosomes, and it may have the features of a gap junction. The function of this structure and its possible role in hair growth is unknown. It may be related to nutrition, differentiation, or both.

Fourteen patients with Lyme disease showed typical clinical features of erythema chronicum migrans. Eighteen biopsy specimens in all were obtained from the cutaneous lesions of these patients. The predominant histologic finding was a superficial and deep perivascular and interstitial infiltrate composed mostly of lymphocytes, or lymphocytes and either plasma cells and eosinophils or both. The plasma cells were found most frequently in biopsy specimens taken from the peripheries of the lesions, whereas eosinophils were found mostly in the centers of lesions. With the Warthin-Starry silver stain, spirochetes were found mostly at the borders of the lesions an in biopsy specimens containing plasma cells. Spirochetes were subsequently cultured from a typical skin lesion of erythema chronicum migrans. These findings corroborate previous indirect evidence that a spirochete might be the cause of Lyme disease.

Histologic examination of the prepuces removed from 78 consecutive patients with phimosis was performed during a 2-year period. In 15 cases (14.2%), the typical changes of lichen sclerosus et atrophicus (LSA) were found. A different, distinct histologic pattern of fibrosis was noticed in six patients (7.7%). Clinically, the two conditions were indistinguishable and presented as severe, nonretractable phimosis. The largest group of the patients (46.2%) had histologically normal prepuces, but clinically they too had severe phimosis. Since phimosis especially in young boys may regress spontaneously, and since on the other hand LSA may evolve into squamous cell carcinoma, we conclude that treatment of phimosis should be planned according to its histologic pattern and not according to its monotonous clinical appearance.