PSORIASIS AS A DISTURBANCE OF LIPID METABOLISM
The conception of psoriasis as a metabolic disturbance of the skin has received increasing support in recent years. Madden's excellent histologic study1 of the uninvolved skin of patients with acute guttate and generalized papular psoriasis has strengthened greatly the concept of this disease as a disturbance of fat metabolism. The histologic changes which Madden found in the uninvolved skin but at the sites of election for psoriasis were: an increase of extracellular fat around the pilosebaceous apparatus and sweat glands and throughout the corium and a constant leukocytic infiltrate in the papillary bodies and in the upper half of the cutis. When the infiltrate was great the capillaries were dilated and engorged and the papillary bodies elongated and pushed toward the surface. These findings confirmed and extended those of Kartamyshev.2 One is tempted to conclude that the difference between the apparently