We report the provocation of localized psoriasis at the sites of application of topical imiquimod, possibly evolving into a generalized flare. A patient with pre-existing psoriasis that had been stable for 14 years was treated with imiquimod 5% cream daily for 6 weeks to three superficial basal cell carcinomas. During treatment one of the lesions developed severe local skin reactions necessitating rest periods, and received only 18 applications in 6 weeks. The other two lesions were treated for all 42 days. Psoriasiform changes developed at all three application sites. Nine-and-a-half weeks after completing treatment the patient developed disseminated small psoriatic lesions. Other recognized triggers of psoriasis were not identified. The psoriasis resolved slowly with conventional treatment.

The expression of transferrin receptors (TFR) by normal and neoplastic urothelial cells was studied in "control" patients and in patients with transitional cell carcinoma of the bladder. These tumours were graded independently and consisted of 19 grade I, 30 grade II and 19 grade III lesions. TFRs were identified using a monoclonal antibody specific for TFR (OKT9) in an immunofluorescent or avidin/biotin-immunoperoxidase technique on fresh frozen sections. TFRs were not detected on normal urothelium. However, positive staining was found to increase with increasing pathological grade and stage of the tumours, ranging from 31.6% of grade I to 78.9% of grade III tumours and 51.2% of pTa (mucosa only lesions) to 87.5% of pT2/pT2+ (muscle invasion +/- deeper) primary urothelial malignancies.

An immunohistochemical profile of cells in the mucosa and lamina propria of adult human bladders is described. Urothelial cells were HLA-DR-ve, ACP + ve and ATPase-ve. All lymphocytes in this layer were of the suppressor/cytotoxic T subgroup and dendritic cells with an identical phenotype to Langerhans cells were seen. In the lamina propria most lymphocytes were of the suppressor/cytotoxic type with some helper/inducer cells. An occasional natural killer cell and Langerhans cell was identified and large macrophage cells with a common phenotype to antigen presenting interdigitating (ID) cells were noted. Fibronectin staining was dense in the vicinity of basement membranes merging to form fine interconnecting latticework-like structures elsewhere in the lamina propria.

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