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To the Editor.—
I would like to report a hitherto unrecorded observation; that of Bowen's disease and renal vasculitis.
Report of a Case.—
A 69-year-old white married woman was admitted to the Mount Auburn Hospital, Cambridge, Mass, in cardiovascular shock with severe pain in the right costovertebral angle, hematuria, nausea, and vomiting. Exploratory laparotomy revealed a perforation of a right renal artery for which the kidney was removed. The nephrectomy specimen (Fig 1) showed an acute necrotizing arteritis of the interlobular arteries of the lower pole between the hilus and the renal pelvis. Microscopically there was necrosis with fibrinoid changes and microaneurysm formation. There was scattered scarring of the renal parenchyma, an occasional sclerotic vessel, but no diffuse arteritis. The glomeruli were essentially normal.She had rheumatoid arthritis for many years with typical hand deformity. Two years prior to her admission she received injections of an unknown "arthritis vaccine." She