The clinical manifestations, histology, ultrastructure, and etiology of angiolymphoid hyperplasia with eosinophilia are presented. The relationship to Kimura's disease and pseudopyogenic granuloma is discussed. A comparison of therapeutic modalities is presented and the authors conclude that deep surgical excision is the procedure of choice.

Peripheral blood mononuclear cells were obtained from 20 untreated condyloma acuminatum patients and from an equal number of sex- and age-matched controls and assayed for cell surface antigen expression, natural killer activity, and lymphokine production. Patient peripheral blood mononuclear cells had significantly lower helper-to-suppressor T-cell ratios (Leu3/Leu2) (P less than 0.05) and significantly higher percentages of Leu 2+ Tac+ cells (activated suppressor/cytotoxic cells) (P less than 0.05) and Leu 2+ OKM1+ cells (suppressor cells) (P less than 0.01). Natural killer activity of condyloma acuminatum patients was significantly lower (P less than 0.05) than that of controls. Production of interleukin-2 and interferon gamma, but not interferon alpha, was significantly (P less than 0.01) decreased in condyloma acuminatum patients. There was an inverse correlation between the in vitro production of interleukin-2 and interferon gamma and the percentage of Leu 2+ OKM1+ cells (suppressor) (P less than 0.01). Thus, patients with condyloma acuminatum differ from controls by demonstrating decreased natural killer-cell activity, decreased production of lymphokines which enhance natural killer-cell activity (i.e., interferon gamma and interleukin-2), and an increased proportion of T cells with a suppressor phenotype.

We report herein four cases of nodular syphilis, a rare form of secondary syphilis that closely simulates lymphoma and granulomatous disease processes of variable origins. We discuss the clinical presentations, serologic and histologic features, treatment, and course of these patients and review the manifestations of secondary syphilis. We conclude that secondary syphilis is still the great imitator. (JAMA 1983;249:3069-3070

ALTERATIONS IN SUN-DAMAGED SKIN 533cally affected gargoyles excrete significantly increased quantities of mucopolysaccharide. The known carriers and most of the siblings are in or near the normal range. Based on these quantitative data it is not yet possible to identify carriers by these procedures.Since the analytical methods employed yield values for total mucopolysaccharide without distinguishing among the various types which may be present, the present results do not preclude the existence of qualitative differences between carriers and normal individuals which would not be quantitatively evidenced. Such qualitative differences are currently being investigated.Summary. The urinary mucopolysaccharide excretion of a family with the sex-linked form of gargoylism has been quantitatively studied, using several methods. The results indicate that neither carriers nor unaffected siblings excrete significantly higher than normal quantities of total acid mucopolysaccharides. 1. McKusick, V. A., Hereditable Disorders of Con-2. Brante, G., Scandinav.