given by Eugene Landis in "The Mechanism of Edema Formation," which appeared in Modern Concepts of Cardiovascular Disease, vol 4, No. 11, November 1935: was

produces peripheral vasodilation, capillary blood pressure conspicuously and, through relaxation of capillaries, increases the area of endothelium available for filtration. Patients frequently observe spontaneously that warm weather Heat raises

Fig 2.—Multiple

radiodensities within soft tissue of forehead.

Comment.\p=m-\Evidenceof metaplastic bone formation can be seen in numerous

conditions, including long-standing acne vulgaris,

cutaneous

severe

where the osteomas appear clinically as 1- 3-mm pigmented nodules within the areas of acne involvement.45 These lesions are nontender and re¬ semble small foreign body tattoos. Recent x-ray diffraction analysis of clinical specimens from a patient with this type of presentation has demonstrated a crystalline compo¬ nent of hydroxyapatite, suggesting that these are true osteomas.2 This type of postacne osteoma cutis is il¬ lustrated by the present case report. Radiodensities can also be seen in patients with chronic acne without clinically identifiable osteomas. Many of these densities probably represent dystrophic calcification without bone formation. This type of reaction can be seen in any long-standing in¬ flammatory skin disorder with local tissue injury, of which acne is a com-

Eradication of

Syphilis

To the Editor.\p=m-\Dr.Marlow's brief

review, "Syphilis Then and Now" (230:1320, 1974), is interesting. However, he is unduly pessimistic about the prospects for eradicating syphilis.

Numerous US medical visitors to the People's Republic of China in the recent past report that venereal diseases there have apparently been eradicated. The Chinese thesis has been that since venereal diseases are social diseases they can be eradicated by social effort. Dr. Ma Hai-teh reported how it was done in China's Medicine (1:52-68, 1966). Herbert K. Abrams, MD University of Arizona Tucson

Accuracy in Quotation Editor.\p=m-\Inhis editorial (230:1436, 1974), Dr. Hussey has cataloged some of the deficiencies and eccentricities in vocabulary that medical editors are apt to encounter. He stresses quite correctly the importance of precision in medical writing. To

the

example. The roentgenographic detection of ossification or calcifica¬ tion in long-standing acne must be considered presently as an incidental finding in roentgenograms that in¬ clude soft-tissue views of the face; this occurrence, however, may prove to be of significance in the future as an increasing number of these pa¬ tients consider dermabrasion proce¬ dures for cosmetic improvement. mon

Rodney S. W. Basler, MD Jeffrey H. Watters, MD William B. Taylor, MD University of Michigan Medical Center Ann Arbor 1. Leider M: Osteoma cutis

vulgaris

of

long duration.

as a

result of

severe acne

Arch Dermatol 62:405-407,

1950.

2. Basler RSW,

teoma cutis:

Taylor WB, Peacor DR: Post-acne osX-ray diffraction analysis. Arch Dermatol

110:113-114, 1974. 3. Rook A, Wilkinson DS, Ebling FJG (eds): Textbook of Dermatology, ed 2. London, Blackwell Scientific Publications, 1972, vol 2, p 1883. 4. Hopkins JG: Multiple miliary osteomas of the skin. Arch Dermatol 18:706-715, 1928. 5. Jewell EW: Osteoma cutis. Arch Dermatol 103:553\x=req-\

555, 1971.

Under this heading, he might have referred to accuracy in quotation. The line from the song that he quotes should read, "Every little movement has a meaning all its own." Allan J. Ryan, MD

University of Wisconsin

and local heat accentuate their edema.

Milton Kissin, MD New York

Coronary Artery

To the Editor.\p=m-\Thequestion is asked in The Journal (229:1661, 1974): "Why are the coronary arteries so prone to thrombosis?" It seems worthwhile to consider first: "Are the coronary arteries unusually prone to thrombosis?" Coronary artery thrombosis and cerebral artery thrombosis both result in a frightening illness, readily diagnosed, commonly resulting in death, and therefore often seen at necropsy. Are the cerebral arteries also prone to thrombosis? Renal and splenic arteries commonly show severe atheroma, and infarcts or scars are common chance findings in the kidney and spleen at necropsy. Thrombosis is an occasional unexpected finding in small arteries in other regions. Unless the vascular disease is widespread or severe, the resultant condition is usually minor or reversible. Thus: "Is thrombosis unusually common in the coronary arteries, or is it

just commonly diagnosed?"

John R. Warren, MB, BS, Perth. Western Australia

Madison

A number of writers have protested that "moment" should have been "movement" in the editorial "A Word Fitly Spok¬ en. ..." Dr. Hussey thought so too, but his lady said "moment" was correct, and he yielded.—Ed.

Thrombosis

Wrong Authors in Table of Contents.- On page 1491 of the TABLE OF tents.\p=m-\ CONTENTS

in the

Dec

Edema in Hot Weather

(230:1491-1492, 1974), the

To the Editor.\p=m-\Inthe Nov 25 issue of The Journal (230:1201,1974), a correspondent wrote to inquire about the physiological basis for puffiness of the feet and ankles of women during hot

thors

weather. It may be pointed out that men, too, have swelling of the lower extremities during hot weather. In the days when men wore circular garters, it was common to note that they were too tight at the end of a hot day. The best explanation that I know

Downloaded From: http://jama.jamanetwork.com/ by a UCSF LIBRARY User on 06/13/2015

FRCP(A)

were

16 issue wrong au-

listed with the

Communication, "A Guide

Therapy

Special Drug

to

in Renal Failure." The authors of that communication should have been listed in the contents as follows: William M. Bennett, MD, Portland, Ore; Irwin Singer, MD, Philadelphia; Cecil J. Coggins, MD, Boston. The by-line of the article (beginning on page 1544) was correct as

published.

Letter: Eradication of syphilis.

given by Eugene Landis in "The Mechanism of Edema Formation," which appeared in Modern Concepts of Cardiovascular Disease, vol 4, No. 11, November 193...
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