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Sixteen cases of Basal Cell Carcinoma have been tested with monoclonal antibodies to HLA-class I, beta 2-microglobulin, HLA-DR, DP and DQ antigens immunohistochemically using frozen tissues. HLA-class I antigens were expressed weakly on BCC in thirteen and fifteen out of sixteen cases using two different monoclonal antibodies respectively. beta 2-microglobulin was expressed differently with the same intensity as normal epidermis in 6 cases, weaker than normal epidermis in 8 cases and absent in 2 cases. There is no correlation with the expression of HLA-class I between histological type and lymphocyte infiltration. On the other hand, HLA-DR, DP and DQ antigens were positive in 4, 3 and 3 cases respectively. But the percentage of positive cells for HLA-class II were only 1-2%. The expression of HLA-DR antigen was most strongest among HLA-class II antigens.

Malignant skin carcinomas occur in a large variety of forms, among them malignant melanoma with a poor prognosis, such as squamous cell carcinoma, basal cell carcinoma, appendix tumors of skin (e.g., sweat gland carcinoma, sebaceous gland carcinoma), metastatic carcinomas of skin, intraepidermal carcinomas (e.g., Bowen's disease, Paget's disease) and mesenchymal carcinomas including mycosis fungoides (cutaneous T cell lymphoma). Furthermore, not only do they present with varied clinical symptoms, some forming tumors or erythemas, some being infiltrative in nature and some being flat in shape, but the clinical symptoms also vary with time during treatment. All these conditions conspire to make the evaluation of chemotherapeutics complicated and difficult. In the field of dermatology topical drugs provide a no less powerful weapon than drugs for systemic administration with which to combat skin carcinomas and are simple and easy to administer. In consideration of those clinical and therapeutic aspects of malignant skin carcinomas new evaluation criteria for chemotherapeutics for topical and systemic administration have been established by adding three-way measurement to the conventional methods of one- and two-way measurement for measurable lesions along with the evaluation of the response of clinical symptoms to chemotherapeutics in unmeasurable carcinomas. The new version of criteria is based in its general framework on the Japan Society for Cancer Therapy's Evaluation Criteria for Chemotherapeutics for Solid Carcinomas by Koyama and Saito and the new version has been approved at the 26th general meeting of the Japan Society for Cancer Therapy (1988, Niigata).

The immunogenicity in patients with melanoma of three high molecular weight melanoma associated antigens (HMW.MAA) defined by murine monoclonal antibodies (MoAb) was investigated. For this end sera from patients with melanoma (stage I, IV) and normal individuals were tested by inhibition assay and sandwich assay using antiidiotypic MoAb to anti HMW.MAA MoAb. In inhibition assay, sera were tested for their ability to inhibit the binding of murine antiidiotypic MoAbs to biotin conjugated anti HMW.MAA MoAbs. Some of the sera from patients with melanoma significantly inhibited the binding of antiidiotypic MoAb to anti HMW.MAA MoAb in comparison with that from normal individuals. In sandwich assay, sera were tested for their ability to bind to precoated murine antiidiotypic MoAb and to biotin conjugated anti HMW.MAA MoAbs. Positive findings suggest the existence of anti HMW.MAA antibodies in sera were showed in several sera from the patients, which were less in frequency than that in inhibition assay. These results suggest that HMW.MAA could elicit the immune response in some melanoma patients and also suggest that the assay anti HMW.MAA MoAb in sera will help us to understand the prognosis of the patients and to evaluate the usefulness of treatment with antiidiotypic MoAb as vaccine therapy.

Immunohistochemical localization of nerve growth factor (NGF) receptor in normal skin and melanocytic tumor was analysed using monoclonal antibody. In normal skin and fetal skin NGF receptor was good marker for cutaneous nerve sheath and schwann cells. In melanocytic lineage, the NGF receptor was not expressed in fetal, normal and dermal melanocyte and weakly positive in only small part of nevus cell nest. Positive staining was seen in primary and metastatic melanoma lesion and restricted to melanoma cell membrane. The distribution of the receptor suggests that the NGF-receptor may be involved in the control of proliferation and malignant transformation in melanocytic lineage.

Sixteen primary and ten metastatic melanoma lesions were stained in indirect immunoperoxidase with HLA-DR, DP and DQ monoclonal antibodies. In primary lesions, HLA-DR, DQ and DP antigens were much more expressed in nodular melanoma lesions than in acral lentiginous melanoma lesions. In metastatic lesions HLA-DR, DQ and DP antigens were expressed more than in primary lesions, but there were no significant differences between ALM and NM. In primary melanoma, 82%, 75%, and 75% of lesions tested were stained by anti HLA-DR, DP and DQ monoclonal antibodies, respectively. In metastatic melanoma, 90% of the lesions tested were stained by anti HLA-DR, DP and DQ monoclonal antibodies. HLA-class II antigens on melanoma cells were much more expressed in cases of high levels of invasion, high degrees of lymphocyte infiltration, and lower melanin content.

Carcinoma of cutaneous appendages, which are derived from hair follicles, sebaceous glands and sweat glands, are generally rare. Although no papers on malignant tumors derived from hair follicles have been reported either at home or abroad, several cases of distinct hair follicle carcinoma have recently been reported in this country. In this paper, malignant change of epidermoid cyst (follicular), malignant proliferating trichilemmal tumor, malignant change of trichilemmoma, and BCC-like tumor associated with immature hair follicle formation, were discussed as several types of malignant changes occurring in the hair follicle. Both sebaceous and sweat gland carcinomas, frequently show a relatively poor prognosis due to a marked tendency for widespread metastasis. In apocrine gland carcinoma appearing in axillar and chest areas, there is a difficulty in making differential diagnosis from carcinoma of latent accessory mammary gland. An outline of metastatic carcinoma to the skin was given.

A 32-year-old Japanese woman with a giant pigmented congenital nevus of the torso presented with a massive pigmented tumor mass of the vulva which grew over an 8-year period. Histologically, the tumor was composed of benign appearing nevus-like cells with focal areas of extensive fibrous response. The tumor cells were positive for S-100 protein and with an antihuman melanoma antibody (MoAb 225, 28S) stain. Electron microscopy confirmed the nevomelanocytic nature of the tumor cells and demonstrated peculiar cytoplasmic crystalline tubular structures similar to those seen in cells infected with herpes virus type II. We propose the term "proliferating giant pigmented nevus" for this previous undescribed tumor.

Three cases of pigmented basal cell carcinoma were reported which needed to be differentiated from malignant melanoma based on their location and clinical features. Clinicopathologically, they were characterized by a large number of melanophages in the stroma, blockade melanocytes in the parenchyma, and phagocytosis of melanosomes in tumor cells as well as a large number of intraparenchymal melanophages. Two cases were characterized by the aggregation of melanophages in cystic spaces caused by stellate atrophy.