The cytology of acute inflammation was originally described by Metchnikoff in experimental animals. Rebuek and Crowley (1) have advanced the technic of human skin windows which confirmed the description of the acute inflammatory cycle. The basic sequences consisted of an early migration of phagocytic granulocytes, reinforcing available tissue macrophages. These phagocytes were supplemented by migrating lymphocytes and blood mononuclears (monocytes) which hypertrophied to form additional

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... ges. In the present study we have employed the skin window technic to study the inflammatory response to a contact allergen. MATERIALS AND METHODS Technic: The skin of the forearm was shaved, cleansed with 70% ethanol and air-dried. By means of a sterile Bard Parker No. 15 scapel blade, the epithelium was scraped away from an area of skin 3 to 4 mm. in diameter until the papillary layer of the corium was exposed. Multiple, minute bleeding points were evidence that the corium was reached and capillary loops exposed. A drop of the solution or suspension of the desired testing agent was applied to the denuded corium. The lesion was then immediately covered with a sterile, chemically clean, 12 mm., No. 2 coverglass, which was, in turn, covered by a square of cardboard of the same size. The eoverglass and cardboard were fixed in place by a special surgical tape (Experimental surgical tape, Scotch Brand, was supplied through the courtesy of Minnesota Mining and Manufacturing Company. This tape produced less epithelial damage from repeated applications at the same site. It also permitted evaporation of skin moisture thus causing less maceration of the skin). 409 The cells of the inflammatory exudate migrated to the under-surface of the eoverglass flattening out much in the same manner as a blood smear, thus permitting detailed study of the cellular infiltrate. At regular intervals the eoverglass was removed and rapidly air-dried. At the same time another sterile eoverglass was placed over the same denuded area and the process was repeated at designated intervals as often as desired. In this way, a series of permanent, fixed preparations of in vivo samplings of the inflammatory exudate was obtained. The eoverslips, after being air-dried, were stained like blood smears with the May-Gruenwald-Giemsa stain. After dehydration and mounting, the specimens were ready for cytological examinations. Experiment I. Diphtheria toxoid (Aluminum phosphate adsorbed, Bio. 2110, Parke, Davis and Company) was employed as a non-pyogenic antigen in patients with various skin diseases, as well as in normal volunteers. Simultaneously with the application of the skin window, a Schick or Moloney skin test was performed. Two time schedules were chosen for this experiment. (a) The eoverglasses were removed and reapplied at 3, 6, 9, 12, 14 and 24 hours. (b) The eoverglasses were removed and reapplied at 24, 27, 30, 33, 36, 38, 48, 52, 56, and 60 hours. Experiment II. Diluted acetone extract of Rhus oleoresin* (1:200) was used as antigen in patients with atopie dermatitis and in normal volunteers. At the time the window was applied, a patch test to Rhus extract 1:1000 was applied to the skin to determine whether the individual was allergic by contact to Rhus antigen. A peripheral blood smear was taken at the same time the window test was initiated and a second blood smear was taken at the end of 48 hours. The same time schedule was employed in this experiment as in the experiment 1(a) and 1(b). RESULTS Experiment 1(a): Employing diphtheria toxoid as antigen. 3 Hour Stage: About 90% to 95% of the exu-* Rhus oleoresin, courtesy of Allergy Laboratories, Hugh Graham, Inc., Dallas, Texas.