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Reticular erythematous mucinosis versus plaquelike cutaneous mucinosis
Volume 8 Number 1 January, 1983
Correspondence
Reticular erythematous mueinosis versus plaquelikc cutaneous mucinosis To the Editor: In a recent report on five patients with reticular erythematous mucinosis,1 the histochemical findings in the skin biopsies from these patients were closely similar to the findings in those with plaquelike cutaneous mucinosis as described by Perry et al2 and in the article by Quimby and Perry entitled "Plaquelike Cutaneous Mucinosis: Its Relationship to Reticular Erythematons Mucinosis" (J AM ACAD DERMATOL6:856-861, 1982). In our report 1 we found that colloidal iron staining was more sensitive than that of alcian blue for the demonstration of acid mucopolysaccharide. Electron microscopy with x-ray microanaIysis using colloidal iron as a stain showed the presence of mucin as electrondense reticular material in close proximity to elastic and collagen fibrils. An additional finding was the presence of interwoven tubular viruslike aggregates in the cisternae of rough endoplasmic reticulum in the endothelial and periendothelia! cells of the dermal blood vessels. These tubular aggregates were found by Steigleder and Kanzow 3 in the REM syndrome. We agree with Drs. Quimby and Perry and with others that the plaquelike cutaneous mucinosis and reticular erythematous mucinosis are the same condition with similar clinical features and histopathology.
S. S. Bleehen, F.R.C.P. D. N. Slater, M.R.C.Path. University of Sheffield Royal Hallamshire Hospital Sheffield $10 2JF England
REFERENCES 1. Bleehen SS, Slater DN, Mahood JM, Church RE: Reticular erythematous mucinosis: Light and electron microsCopy, immunofluorescence and histochemical findings. Br J Dermatol 106:9-18, 1982. 2. Perry HO, Kierland RR, Montgomery H: Plaque-like form of cutaneous mucinosis. Arch Dermatol 82:980-985, 1960. 3. Steigleder GK, Kanzow G: Muzinablagerungen in der Dermis und REM-Syndrom. Hautarzt 31:575-583, 1980.
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on page 133. A short editorial cannot adequately cover the development of dermatopathology or include all the names of the many dermatologists who made this development possible, but the omission of the names of Marcus R. Caro, Leopoldo F. Montes, and A. Bernard Ackerman requires comment. Dr. Marcus Caro, with Drs. Weidman and Beerman, was a dominant force in developing the dermatopathology program of the American Academy of Dermatology, and in particular the Clinical Pathology Conference (on which Dr. Beerrnan served as chairman for 19 years). 1-3 Dr. Leopoldo Montes developed and is still editor of the Journal of Cutaneous Diseases, the first periodical devoted to dermatopatho!ogy. Dr. A. Bernard Ackerrnan has made a tremendous contribution to modern dermatopathology with his beautifully illustrated textbooks ~,s and as editor of the American Journal of Dermatopathology. Further, he was a leader in the formation of the International Society of Dermatopathology and has contributed greatly to the success o f that organization. No description of dermatopathology as it exists today should fail to acknowledge the contribution made by these physicians.
Margaret Gray Wood, M.D, University of Pennsylvania 229 Medical Education Bldg. 36th & Hamilton Walk, GM Philadelphia, PA 19104
REFERENCES 1. Beerman H: Cutaneous pathology--a historical view. J Cutan Pathol 1:3-9, 1974. 2. Beerman H: My half century in dermatopathology (19281978). Am J Dermatopathol 1:237-243, 1979. 3. Beerman H: J AM ACAD DERMA'rOE 5:210-213, 1980. (Contemporaries.) 4. Ackerman AB: Histologic diagnosis of inflammatory skin diseases. Philadelphia, !978, Lea & Febiger, p. 862. 5. Ackerman AB, Niven J, Grant,Kelz JM: Differential diagnosis in dermatopathology. Philadelphia, 1981, Lea & Febiger, p. 195.
Reply Contributors to dermatopathology To the Editor: I have read with interest the editorial "Dermatopathology 1982" in the July, 1982, issue of the JOURNAL
To the Editor: The editorial mentioned traced the organizational development o f dermatopathology from the American Academy of Dermatology course directors through the American Society for Dermatopathology to the special
Correspondence
Reticular erythematous mueinosis versus plaquelikc cutaneous mucinosis To the Editor: In a recent report on five patients with reticular erythematous mucinosis,1 the histochemical findings in the skin biopsies from these patients were closely similar to the findings in those with plaquelike cutaneous mucinosis as described by Perry et al2 and in the article by Quimby and Perry entitled "Plaquelike Cutaneous Mucinosis: Its Relationship to Reticular Erythematons Mucinosis" (J AM ACAD DERMATOL6:856-861, 1982). In our report 1 we found that colloidal iron staining was more sensitive than that of alcian blue for the demonstration of acid mucopolysaccharide. Electron microscopy with x-ray microanaIysis using colloidal iron as a stain showed the presence of mucin as electrondense reticular material in close proximity to elastic and collagen fibrils. An additional finding was the presence of interwoven tubular viruslike aggregates in the cisternae of rough endoplasmic reticulum in the endothelial and periendothelia! cells of the dermal blood vessels. These tubular aggregates were found by Steigleder and Kanzow 3 in the REM syndrome. We agree with Drs. Quimby and Perry and with others that the plaquelike cutaneous mucinosis and reticular erythematous mucinosis are the same condition with similar clinical features and histopathology.
S. S. Bleehen, F.R.C.P. D. N. Slater, M.R.C.Path. University of Sheffield Royal Hallamshire Hospital Sheffield $10 2JF England
REFERENCES 1. Bleehen SS, Slater DN, Mahood JM, Church RE: Reticular erythematous mucinosis: Light and electron microsCopy, immunofluorescence and histochemical findings. Br J Dermatol 106:9-18, 1982. 2. Perry HO, Kierland RR, Montgomery H: Plaque-like form of cutaneous mucinosis. Arch Dermatol 82:980-985, 1960. 3. Steigleder GK, Kanzow G: Muzinablagerungen in der Dermis und REM-Syndrom. Hautarzt 31:575-583, 1980.
125
on page 133. A short editorial cannot adequately cover the development of dermatopathology or include all the names of the many dermatologists who made this development possible, but the omission of the names of Marcus R. Caro, Leopoldo F. Montes, and A. Bernard Ackerman requires comment. Dr. Marcus Caro, with Drs. Weidman and Beerman, was a dominant force in developing the dermatopathology program of the American Academy of Dermatology, and in particular the Clinical Pathology Conference (on which Dr. Beerrnan served as chairman for 19 years). 1-3 Dr. Leopoldo Montes developed and is still editor of the Journal of Cutaneous Diseases, the first periodical devoted to dermatopatho!ogy. Dr. A. Bernard Ackerrnan has made a tremendous contribution to modern dermatopathology with his beautifully illustrated textbooks ~,s and as editor of the American Journal of Dermatopathology. Further, he was a leader in the formation of the International Society of Dermatopathology and has contributed greatly to the success o f that organization. No description of dermatopathology as it exists today should fail to acknowledge the contribution made by these physicians.
Margaret Gray Wood, M.D, University of Pennsylvania 229 Medical Education Bldg. 36th & Hamilton Walk, GM Philadelphia, PA 19104
REFERENCES 1. Beerman H: Cutaneous pathology--a historical view. J Cutan Pathol 1:3-9, 1974. 2. Beerman H: My half century in dermatopathology (19281978). Am J Dermatopathol 1:237-243, 1979. 3. Beerman H: J AM ACAD DERMA'rOE 5:210-213, 1980. (Contemporaries.) 4. Ackerman AB: Histologic diagnosis of inflammatory skin diseases. Philadelphia, !978, Lea & Febiger, p. 862. 5. Ackerman AB, Niven J, Grant,Kelz JM: Differential diagnosis in dermatopathology. Philadelphia, 1981, Lea & Febiger, p. 195.
Reply Contributors to dermatopathology To the Editor: I have read with interest the editorial "Dermatopathology 1982" in the July, 1982, issue of the JOURNAL
To the Editor: The editorial mentioned traced the organizational development o f dermatopathology from the American Academy of Dermatology course directors through the American Society for Dermatopathology to the special