No abstract

M N, woman aged 64. Housewife History: Several years ago suffered from suspender-buckle dermatitis. August 1971: The patient acquired a chromealloy dental plate, and four weeks later was admitted to hospital with acute generalized eczema which responded well, but not completely, to treatment. Patch-testing confirmed sensitivity to nickel and cobalt. She continued to have a mild hand eczema.

No abstract

A group of thirty-six patients of whom fourteen were being treated with methotrexate, were studied in order to assess T-lymphocyte function by in vitro techniques. Circulating T-lymphocytes in aliqots of blood were assessed by the rosetting technique. No differences were found in psoriatics, whether on methotrexate or not, compared with fifteen control subjects. Lymphocyte counts and lymphocyte transformation to phytohaemagglutinin (PHA) tended to be lower in the psoriatic group as a whole than in the controls, but the differences were not statistically significant, However, a significant inverse relationship was found between the extent of the skin lesions and lymphocyte transformation to PHA, i.e. the smaller the area of skin affected the higher the lymphocyte transformation. Psoriatics treated with methotrexate had fewer skin lesions and higher lymphocyte transformation to PHA than psoriatics not so treated, probably reflecting this inverse relationship. The reason why the presence of extensive psoriasis is associated with depressed lymphocyte transformation is not understood. No evidence was found that methotrexate depressed cell-mediated immunity as judged by these in vitro tests.

Paraproteinaemia may be associated with xanthomatous skin deposits and these can arise in the absence of elevated lipid levels. Two cases of benign monoclonal gammopathy with diffuse plane xanthomatosis are reported. Case 1 exhibited hypolipidaemia and a functional deficiency of C1 esterase inhibitor. Case 2 showed a normal lipoprotein profile, abnormal platelet aggregation, and a cutaneous vasculitis with evidence of complement consumption via the classical pathway. The significance of these abnormalities is discussed.