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May 2022


Journal/Book: THE JOURNAL OF ALLERGY St. Louis Vol. 45 No. 5 Pages 266-285 May 1970. 1970;

Abstract: NIKOLAJS CAUNA M.D. D.Sc. and MACY I. LEVINE M.D. With the technical assistance of AGNES CRALLEY B.S. Pittsburgh Pa. From the Department of Anatomy and Cell Biology School of Medicine University of Pittsburgh and the Allergy Clinic Department of Medicine Presbyterian-University Hospital University of Pittsburgh Supported by United States Public Health Service Grant No. NB04147 and by a grant from the Pennsylvania Allergy Association. Presented in part at the 25th annual meeting of the American Academy of Allergy Miami Beach Fla. March 18 1969. Received for publication June 4 1969. Ultrastructural changes in the skin of the upper arm were studied with the electron microscope in a male patient aged 50 with dermographism. Wheals were produced by stroking with 400 Gm. of pressure. Skin samples were obtained with a high-speed dermal punch without anesthesia after 35 seconds 3 10 20 80 and 60 minutes and after 3 weeks. Controls were taken from undisturbed skin areas of the patient and from a healthy individual. Edema of the corium increase of specific cell types and disruption of cells were not observed. Morphological changes occurred in the epidermis mast cells and some sensory nerve endings. The keratinocytes of the epidermis either developed large vacuoles or took up fluid in the peripheral cytoplasm and villous processes. Basal epidermal cells extended pseudopodia into the corium through gaps in the basement membrane. Mast cells showed abnormal structure. Their granules were not released from the cells but underwent transformation during the wheal development. The free subepidermal nerve endings possessed membrane-bounded inclusions in the cytoplasm of their Schwann cells. Some mesaxons of these endings were split apart by accumulation of granular material. The findings provide evidence that the epidermis is a very active tissue layer of the skin and that the morphologio observations are compatible with the current hypothesis that release of histamine by mast cells may play a role in wheal formation. ___MH

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