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Biopsies were taken from 18 cases in whom skin had been transplanted to the alveolar ridge five years previously. Comparing these biopsies with the control biopsies obtained from 10 samples of skin and 10 samples of oral mucosa in denture-bearing areas revealed the following findings: 1) In the majority of cases the thickness of the epithelial layer of the transplanted skin and the surrounding mucosa differs noticeably. 2) The length of the rete pegs in the transplanted skin increases and tends to reach the same length as the surrounding mucosa. 3) In some transplants the epithelium becomes unkeratinized, whereas two-thirds of the material preserved its orthokeratosis. 4) The elastic fibers in the skin transplant decreased in quantity and thickness in areas close to the graft bed and disappeared completely from the juxtaepithelial layer. 5) In two-thirds of the biopsies the skin grafts showed slight or no inflammation, whereas the adjacent mucosa exhibited a slight or marked inflammatory reaction.

A review of the literature revealed 28 previously reported cases of white sponge nevus of the oral mucosa. The 28 lesions showed various clinical appearances leading to disagreement as to the proper name for the lesion. The lesion exhibited a familial incidence in all instances when attempts were made to correlate it with a genetic factor. The histopathology of the 28 white sponge nevi revealed the same characteristics of hyperplasia, acanthosis, dyskeratosis, elongation and fusion of the rete pegs, intact basement membrane and no inflammation. The two patients reported in this article and the 28 reported in the literature were identical from a histopathologic standpoint, although various clinical criteria were represented. The latter patients were unrelated.

IN PEMPHIGUS vegetans, in contradistinction to pemphigus vulgaris, there is close agreement concerning histologic changes. These are acanthosis and papillomatosis involving predominantly the rete pegs (ridges) and microabscesses within the hyperplastic rete pegs containing large numbers of eosinophiles. I cite a few representative opinions without attempting to review all sources. Montgomery and co-workers 1 state that the histologic changes of pemphigus vegetans are quite distinctive and may occur at any level of the epidermis. Ormsby and Montgomery 2 are in general agreement, adding that eosinophiles also predominate in the papillae and that there is a resemblance to blastomycosis and bromoderma. Lever 3 agrees and mentions that early there is low-level acantholysis as in Darier's disease (keratosis follicularis) but without dyskeratosis; that older lesions show no bullae but only acanthosis and papillomatosis resembling pseudoepitheliomatous hyperplasia, while the intraepidermal abscesses resemble bromoderma and pyogenic granuloma. Civatte, 4 also in

In view of the fact that dental cysts are of inflammatory origin, an investigation was carried out on histologic sections of 200 cysts in order to determine the influence of inflammation on these cysts. As a result of this investigation, the following conclusions may be drawn: 1. 1. The thickness of the epithelial lining of the cyst is not related to the degree of inflammation in either the epithelium itself or the fibrous cyst wall. 2. 2. There is a far greater incidence of polymorphonuclear leukocyte infiltration of the epithelial linings than of the connective tissue walls, and there is also a far greater incidence of chronic inflammatory cells than of acute inflammatory cells in the fibrous cyst walls. 3. 3. The frequency of rete pegs is greater in the thicker epithelial linings than in the thinner linings, and there is a greater degree of inflammation in the epithelial linings with rete pegs than in those without rete pegs. 4. 4. Although inflammation within the epithelium results in proliferation of that epithelium, it does not appear to produce a thicker epithelium. It is suggested that the thickness of the epithelial lining may be dependent upon the rate of desquamation of the epithelial cells. 5. 5. Inflammation of the epithelial linings is an important factor in the production of spongiosis, degeneration, and eventually ulceration of the epithelium.

To the Editor.— The mucous membranes are occasionally affected in some cases of psoriasis. 1-4 The lips were involved in 2% of 500 patients with psoriasis. Ten patients out of the 500 cases studied had lip psoriasis, while five patients had mucosal psoriasis, ie, 1%, in the form of oral psoriasis and psoriasis linguae (Fig 1). Before discussing the existence of mucosal psoriasis and psoriasis linguae in our patients, which was verified by histologic examination of the materials obtained from skin lesions, mucocutaneous junctions, lips, buccal mucosa, and the tongue itself, we must refer in brief to the salient features of the histopathologic findings in these cases (Fig 2 and 3). Lip and Mucocutaneous Junction Cases.— Microscopic examination of the mucosal psoriasis showed a picture more or less similar to psoriasis of the skin. There was hyperkeratosis, parakeratosis, and acanthosis, with elongation of the rete pegs forming test tube-like structures. The

We report a case of a 24-year-old man who presented with a complaint of reduced mouth opening and a burning sensation. On examination, he was clinically diagnosed with oral submucous fibrosis (OSF). Following routine biopsy and histopathological confirmation of OSF, the patient was supplemented with zinc acetate along with vitamin A and was followed up for 4 months. Following treatment the patient reported increased mouth opening and a reduced burning sensation. Histopathologically re-epithelialisation was evident along with the appearance of normal rete pegs. The data for mouth opening, collagen content and epithelial thickness of six other cases similarly treated are also presented, showing a significant increase in mouth opening and epithelial thickness and decrease in collagen content. We propose the use of zinc acetate and vitamin A for the management of OSF.

The lesions in rumens of goats with soft foreign bodies (SFB), namely plastics, and its prevalence in Jordan are investigated. In cases where hard masses of plastics were seen, congestion, erosions, focally denuded areas and focal thickening of nodular- and proliferative-type were seen in the mucosal wall of the rumen. Shortening and stunting of the papillae with irregular distribution, and in some cases thinning of the walls were also observed. Histopathologic examination revealed the presence of rumenitis and prolonged rete pegs with a papillary or frond-like downward growths. This hyperplastic growth also took the shape of numerous epithelial islands of variable thickness, approaching the muscularis mucosae. These revealed differentiated stratified squamous epithelium with intercellular bridges, keratin formation and with several mitotic figures as seen under a high-power field (40×). In cases where floating plastic was found, the changes were less prominent. These findings suggest that plastics play an important role in the pathogenesis of rumenitis and ruminal hyperplasia. This could be the consequence of partial degradation and/or chronic irritation of plastics. Out of 347 rumens examined in the summer of 1996, 39 (11%); 10/136 (7%) rumens at Ajloun and 29/311 (7%) at Irbid slaughterhouses contained plastics. Out of the 888 goats brought to the Veterinary Health Centre (VHC) from January 1993 to September 1997 for treatment of different conditions, 32 (3.6%) had plastic impaction and were treated by rumenotomy of which 32/722 (4.5%) were older than one year. Out of 28 goats brought dead to VHC for routine necropsy examinations, three goats had plastic impaction. No significant differences were found in the prevalence of plastic among Shami, local and mixed-breed goats. These results suggest that subclinical cases exceed clinical ones. The prevalence, although when compared with our previous results in sheep, is low, yet it is still considered quite high and public awareness and anti-littering laws and a clean-up of the environment would substantially reduce this problem in Jordan.

Nineteen rats and 30 guinea pigs having regular cycles were used. Daily smears were taken in the rats for 3 weeks and in the guinea pigs for 2 months. The animals were killed at various times during the oestrus cycle. The height of the epithelium was determined by averaging 10 cell-counts taken from sections near the center of the nipple.In the rat the difference of the cell-count at oestrus and dioestrus is slight, but the shape of the epithelial cells changes. At dioestrum the cell is flat and the nucleus occupies most of the cell. During oestrum the cell is oblong. The change in shape increases the distance from the basement membrane to the periphery, while the nucleus appears to occupy a smaller part of the cell.In the guinea pig the change in the shape of the superficial epithelial cells of the nipple is marked and there is an increase in number. The epithelium of the nipple of the guinea pig has rete pegs. During dioestrum the epithelium averages 10.5 cells for the height of the papilla and 4.2 cell...

Verrucous carcinoma is a type of epidermoid carcinoma usually found in the oral cavity. It is locally invasive but rarely metastasizes. Since it resists radiation therapy, wide local excision is the treatment of choice. Pathologic specimens show a thick epithelial surface with normal maturation, an intact basement membrane, and deep, wide rete pegs. These features make it necessary to perform an incisional biopsy for proper diagnosis of this tumor. A case of verrucous carcinoma of the pyriform sinus is presented.

A 15 year old boy developed skin changes compatible with chronic graft versus host reaction (CGVHR) following bone marrow transplantation. His skin was thin, dry, inelastic, and telan-giectatic. Biopsy revealed basal vacuolization, loss of rete pegs, atrophy of sweat glands, perivascular lymphocyte cuffing, and dense dermal collagenization. Because of the dermatologic similarity to PSS, we compared this patient to 38 PSS patients for evidence of systemic involvement. He had significant restrictive lung disease (VC and TLC 50% of predicted), cardiac conduction abnormalities (first degree heart block, right bundle branch block), and a pericardial effusion. Each of these abnormalities was found in 30-40% of the PSS group. Arteriolar intimal proliferation was seen in the heart and kidneys of our patient at autopsy. This finding has been noted in approximately 25% of PSS patients. Our patient had Raynaud's phenomenon as did 95% of the PSS group. He had a striking polyclonal elevation in serum IgG (4 gms/dl), an uncommon finding in PSS. 84% of the PSS patients showed esophageal dysmotility, but our patient did not have this abnormality. The clinical and pathologic similarities between this patient and PSS patients suggest that CGVHR and PSS may have a common pathogenesis. The use of animal models of graft versus host reaction may lead to an understanding of mechanisms responsible for both disease processes.

To the Editor :—"Rete ridges" will be inserted for the nonexistent "rete pegs" in our reprints. We apologize for the old error.

Leprosy. Presented by Dr. Hopkins. A. G., aged 35, an Italian, had been presented at the meeting of Jan. 4, 1927. The following histologic report was made on a section of skin removed from the neck. "There is a slight parakeratosis in places, a moderate acanthosis, with a few round cells infiltrating the malpighian layer. The rete pegs are slightly elongated and wider than normal. The papillary layer of the corium shows moderate edema. This and the upper reticular layers show a moderate perivascular infiltration consisting chiefly of lymphocytes, a few plasma cells, and newly formed fibroblasts. A similar picture is formed about the follicles. Acid-fast staining revealed no bacilli." A repeated neurologic examination did not reveal any positive symptoms in the realm of subjective sensation. DISCUSSION Dr. Pollitzer: I discussed the case when first presented and have nothing to add. I understand that no report has yet been made

Lichen nitidus is a well-recognized dermatosis composed of minute, dome-shaped papules having a characteristic tuberculoid histology. Microscopically there is flattening of the epidermis with some lengthening of the rete pegs at the margin of the lesion, and close beneath the epidermis is an infiltrate consisting of round cells, epithelioid cells, and occasional Langhans' giant cells (Fig. 1). Pinkus (1907), in his original paper, described the formation of actual tubercles, but Lever (1954) states that tubercles are never formed; Ormsby and Montgomery (1954) accept a tuberculoid infiltrate without actual symmetrical arrangement of the cells into a tubercle. In contrast to lichen nitidus, lichen planus shows a monomorphic infiltrate consisting principally of lymphocytes lying close beneath the epidermis and having a well-defined lower border (Fig. 2). These 2 types of lesions have, however, been described from time to time in the same patient (Civatte, 1911; Lewis, 1937; Wilson, 1949), and Civatte (1927)

During a histological analysis of 361 primary malignant melanomas of the skin certain histological features indicating partial regression or disappearance of the tumour were appreciated. The features were derived by the study of depigmented areas in melanomas in which there was a clinical history of disappearance of tumour in the depigmented area. The histological features in the regressed area are absence of tumour in the junctional zone and dermis, loss of rete pegs, absent or diminished melanin in the epidermis and clear cells, variable lymphocytic infiltration, pigment-containing macrophages, and increased vascularity and oedema in the upper dermis. Using these criteria 57 cases (16%) of the 361 tumours showed partial regression. On analysing the 57 cases, partial regression was more common in females than males (F, 41; M, 16) and the back was the commonest site for males and females (M, 12/16; F, 14/41). There were only slight changes in the average ages of the males and females with partial regression compared with the average of the 361 cases. Partial regression occurred more frequently in fiat, larger than 2 cm. lesions. Partial regression was seen more often in the in situ and superficially invading lesions (stage 1 & 2) than in the more deeply invading lesions (stage 3 & 4). Partial regression was seen in the pigmented flare adjacent to the invasive part of the tumour in the majority of the cases. In the pigmented flare the non-regressed tumour cells were mainly in groups or clusters in the junctional zone in 33 tumours, whilst in only 9 were they mainly single cells in the epidermis. Using the histological features, exposed sites did not show a greater incidence of regression than non-exposed sites. Ulceration was less but lymphocytic infiltration was more marked in the regressing tumours compared with tumours without partial regression. No significant differences were seen in the following features: cell type, cell arrangement, cell pleo-morphism, mitotic rate, pigmentation, cell cytoplasm or presence of plasma cells. Eighteen of the tumours showing partial regression were resected in the period 1963-5. At the end of 1968, 2 were dead with disseminated melanoma, one had lung secondaries and one had positive lymph nodes.

Bowen's Disease of Penis; Late Latent Syphilis (Treated). Presented byDr. James StrauchandDr. S. Colimodio. R. M., a Negro aged 51, was previously presented before the Cleveland Dermatological Society from the department of dermatology, University Hospitals, as "A Case for Diagnosis (Chronic Balanoposthitis?)." The penile lesions have shown no real change in the past four years. The glans penis continues to exude and is painful. A second biopsy was made on Jan. 9, 1941. Sections showed hyperkeratosis and patchy parakeratosis. There was definite acanthosis. Rete pegs were elongated. There was variation in the appearance of cells of the malpighian layer. There were many vacuolated cells with eccentrically placed nuclei and others decidedly swollen. Some cells had circular, deeply chromatic, irregularly shaped nuclei that were surrounded by small clear spaces. The nuclei were hyperchromatic. There were many atypical mitotic figures. Numerous lymphocytes and large round cells infiltrated the

To the Editor: —It may sound like sheer ingratitude, but I have to protest one word in the article on Marfan's syndrome by A. B. Loveman and coauthors, in spite of the fact that they quote my reports and opinions so graciously and liberally. I talked to Dr. Loveman, and it seems that an unfortunate lapsus linguae in redictating my histologic report caused "rete pegs" to be substituted for "rete ridges." The word "peg" in this connection stands for everything I have fought against in histopathologic description and anatomical teaching for many years. I have ridiculed this expression to my students, and in my exhibit on Structure and Function of Skin at the Academy and the AMA (Scientific Exhibits AMA, Grune & Stratton, 1955). I have spoken against it in my Pusey lecture on Four Dimensional Histopathology ( Arch Derm 82:681, 1960). I translated Oberste-Lehn's paper on the Dermo-Epidermal Interface ( Arch Derm