An ultrasonically vibrating knife has been developed for producing surgical incisions with reduced hemorrhage. Tissue injury and wound healing of porcine cutaneous incisions produced by this instrument, conventional scalpel, electrosurgery, and CO2 laser were compared regarding clinical, histopathologic, and tensile strength differences. Scalpel incisions had the least tissue injury and fastest healing, but the ultrasonically vibrating knife produced less tissue injury and faster healing than electrosurgery or CO2 laser.

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The histological appearances found in biopsies from fifty-seven patients with secondary syphilis have been correlated with the clinical morphology of the eruptions. Considerable variation of histological pattern was encountered, and the frequency with which some of the classically described changes were found to be absent or inconspicuous is stressed. Of particular interest were the findings that, in nearly one-quarter of the biopsies, plasma cell infiltration was either absent or very sparse, and that vascular damage was seen in less than half. Where present, the vessel changes were almost entirely confined to swelling of the endothelial cells. Proliferation of the endothelial cells was most uncommon. The epidermis was very frequently involved in the inflammatory process. Exocytosis, spongiosis, parakeratosis, and acanthosis were the most frequent changes. No consistent histological difference between papular and papulo-squamous lesions could be found but macular lesions demonstrated more superficial and less intense dermal infiltration as well as less severe epidermal involvement. In late secondary lesions, the infiltrate became granulomatous, but in other respects the duration of the exanthem could not be correlated with the pathology. The differential diagnosis from pityriasis lichenoides and other inflammatory dermatoses is discussed and the value of histopathology in the diagnosis of secondary syphilis is emphasized.

With rare exceptions, the presence of cornoid lamellae in skin biopsy specimens is considered diagnostic of porokeratosis. Since the initial descriptions of this condition by Mibelli (1893) and Respighi (1893), there has been debate concerning its relationship to the eccrine sweat duct. This paper describes an epidermal naevus, which pathologically demonstrated gross examples of cornoid lamellae associated exclusively with the eccrine duct and ostia, and which appears to represent a naevus or benign hamartoma of these structures. This entity needs to be clearly differentiated from porokeratosis of Mibelli.

Direct immunofluorescent (IF) staining was performed on biopsy specimens from fifty-three patients with active lichen planus. In fifteen of these cases uninvolved skin sites were also examined. Globular or cytoid body-like deposits of immunoglobulins, mainly IgM, were detected in forty-six of the active lesions, and in half the uninvolved skin biopsies. The deposition of fibrin in the papillary dermis and around follicular structures was seen only in the active lichen planus papules. The significance of these findings was assessed by comparison with the IF results obtained in 252 biopsies from various cutaneous disorders, stained by the same technique during the period of this study. Although the presence of immunoglobulin cytoid bodies and fibrin was found to be highly characteristic of lichen planus, these findings were not specifically diagnostic. Morphologically identical deposits were seen not infrequently in lupus erythematosus and in eczema. Active lesions of dermatitis herpetiformis, erythema multiforme and other rare dermatoses also showed these cytoid body-like immunoglobulin deposits.