tion of the neck appearedto be definitely increased at the site of previous lesions. However,
little 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 backlesion.
In contrast to the neck and other lesions mentioned, the deepest foot lesions showed no
hyper pigmentation but, on the contrary, persisting depigmentation. Plates 3 and 4 show deeper
foot lesions early and at 6 months post-exposure. The skin texture in these depigmented lesions appeared essentially normal on a gross scale. However, pictures magnified 20 times
showed that there was scattered, blotchy, faded pigmentation with someslight atrophy (flattening 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 of 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, tex-
ture, 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 individuals 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 undersideof the nail.
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 some 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, b, c, and d are considered to be pages
17 through 24.
16