Abstract: BROCQ IN his article on parapsoriasis,1based on Unna's original observation,2describes a distinct small plaque form characterized by well-defined plaques, 2 to 6 cm in diameter (plaques circonscites, assez bien limitees, de 2 a 6 cm de diametre). This disease has been recognized since then as an entity by many authorities in both dermatology and dermatopathology.3-6Ackerman et al7-9claim that small plaque (digitate) parapsoriasis (SPP) must be mycosis fungoides (MF). Haeffner et al10came to the conclusion that some cases of SPP show a dominant T-cell clone (results confirmed by further unpublished data). Burg and Dummer11state that SPP is an "abortive" cutaneous T-cell lymphoma (CTCL) kept in a biologically silent stage, but it is not MF. IS MF A CTCL? Mycosis fungoides can be defined as a peripheral non-Hodgkin's T-cell lymphoma initially and preferentially presenting in the skin, showing

Abstract: Background and Objectives. The stratum corneum of some of the scaly (parakeratotic) diseases was examined with light and scanning electron microscopy (SEM) with the purpose to reveal the importance of this layer in the diagnosis of some of the diseases associated with the formation of scales. Materials and Methods. Two biopsies of the skin surface were taken: one, obtained from 80 patients with various parakeratotic scaly diseases and from 25 control subjects, was processed for light microscopy; the other biopsy for SEM was taken from 10 control subjects and 25 patients. The diagnoses of these patients were: psoriasis (5 patients), erythrodermic psoriasis (2 subjects), parapsoriasis (5 patients), pityriasis rubra pilaris (5 subjects), pityriasis rosea (3 subjects), and seborrheic dermatitis (5 subjects). Results. The light microscopic studies showed that normal corneocytes are of polygonal shape with their largest diameter measuring 42 μm; these cells lacked nuclei. All parakeratotic cells appeared bizarre in shape, smaller than normal, and the cells contained a nucleus. With SEM, normal cells appeared relatively regular in size and shape, trabeculated, and had a flat surface. Cells examined in all the diseases revealed various sizes, outlines, and trabeculae. Specific surface patterns (print) of diseased cells were: “fish-scale” in psoriasis; “marbled” in parapsoriasis, “rocky stone” in pityriasis rubra pilaris; “heart-shaped” in seborrheic dermatitis, and semi-crystalloid in pityriasis rosea. Conclusions. Parakeratosis is characterized not only by the retention of the nucleus in keratinocytes, but is also characterized by a cell of smaller size. The specific print of a disease helps in the diagnosis. The print will change with different stages of a disease.

Abstract: A case of acquired reactive perforating collagenosis in a 70-year old man with a long standing digitate parapsoriasis is reported. Multiple asymptomatic cutaneous hyperpigmented papules with a central adherent keratotic plug developed simultaneously with widespread purpuric eruption following a single i.m. diclofenac injection. Histologic examination of a keratotic lesion revealed an epidermal crater with centrally degenerated collagen and elastic fibre extrusion. This case is interesting for the lack of pruritus, the transepithelial elimination of both collagen and elastic fibres and the association with parapsoriasis. The etiologic role of diclofenac is discussed. The term acquired perforating dermatosis may be more suitable for this case.

Abstract: dine for the maintenance of sinus rhythm after direct current cardioversion of atrial fibrillation. Circulation 1990;82:1932-9. 9. Reimold SC, Cantillon CO, Friedman PL, Antman EM. Propafenone versus sotalol for suppression of recurrent symptomatic atrial fibrillation. Am J Cardiol 1993;71:558-63. 10. Suttorp MJ, Kingma JH, Peels HOJ, Koomen EM, Tijssen JG, van Hemel NM, et aI.Effectiveness of sotalol in preventing supraventricular tachyarrhythmias shortly after coronary artery bypass grafting. Am J Cardioll99I;68:1163-9. II. Halinen MO, Hultunen M, Paakkinen S, Tarssanen L. Comparison of sotalol with digoxin-quinidine for conversion of acute atrial fibrillation to sinus rhythm. Am J Cardiol 1995;76:495-8. 12. Cardiac Arrhythmia Suppression Trial (CAST) Investigators. Preliminary report: effect of encainide and tlecainide on mortality in a randomized trial of arrhythmia suppression after myocardial infarction. N Engl J Moo 1989;321:406-12. 13. American hospital formulary service drug information. Bethesda, MD: American Society of Hospital Pharmacists, 1994:1062-6.