tion of the neck appeared to be definitely increased at the site of previous lesions. However,
Httle thickening, if any, was apparent and the skin appeared otherwise normal. It is noteworthy
that none of the neck lesions showed depigmentation. Small areas of hyperpigmentation

persisted also at the site of two axillary, four antecubital fossae, one arm, and one back lesion.
In contrast to the neck and other lesions mentioned, the deepest foot lesions showed no
hyperpigmentation but, on the contrary, persisting depigmentation. Plates 3 and 4 show deeper
foot lesions early andat 6 months post-exposure. The skin texture in these depigmented le-

sions appeared essentially normal on a gross scale. However, pictures magnified 20 times

showedthat there was scattered, blotchy, faded pigmentation with some slight atrophy (fatten-

ing of skin ridges). Depigmented foot lesions were observed in six cases. One antecubital

fossae lesion also showed a small area of depigmentation.
The persistent lesion of the ear, noted in the initial examination, had gradually healed with
considerable scarring and atrophy and some scaling cof the epidermis. Plates 5, 6, and 7 show
this lesion early and at 6 months post-exposure. Telangiectatic vessels can also be seen in

Plate 7 (magnified 20 times).

In every case, there appeared to be a complete regrowth of hair, with normal color, texture, and distribution. Plates 5, 6, 8, and 9 show epilation and regrowth of hair.
The bluish-brown pigmentation of the nails, noted in most of the Marshallese in the initial
examinations, had disappeared, apparently with growth of the nails, in all but three cases. The
pigment in these indiv.tuals remained at the distal end of the nail (Plate 10). It was evident in
these cases that the pigment was not in the nail plate but between it and the nail bed, closely
adherent to the underside of the aai!.
Biopsies showed some residual damage to the epidermis, as well as to the dermis. In the
epidermis the following changes were present: (1) focal atrophy of the stratum granulosum;

(2) slight focal pigmentary disturbances in cells of the basal layers; (3) slight-to-moderate

hyperheratinization; and (4) in sor-e cases persistent, but minimum cellular, changes as manifested by the presence of paranuclear cytoplasmic halos and slight disturbances in polarity of
epithelial cells in the basal capillary projections. In the dermis a slight-to-moderate degree
of telangiectasis was evident. Some of these changes are shown in Plates 11 and 12.

NOTE
Color plates ,Plates 1 through 12) numbered with
letters a, 6, c, and d are considered to be pages
17 through 24.

16

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