Histologic examination of the sexual skin of the rhesus monkey during the period of swelling due to estrogen stimulation has revealed evidence of partial depletion of the tissue mast cells (1). A mucoprotein was noted in the intercellular spaces during this period. Chain and Duthie (2) identified this mucoid material as hyaluronic acid. Schiller and Dorfman studied the effects of several hormones (3a, 3b, 3c) on the turnover of hyaluronic acid and chondroitinsulfuric acid in rats. Topical application of estradiol to the skin of hairless rhino mice produced non-pitting edema, which histologically resembled the mucinous material seen in the sexual skin of the monkey (4). Schiff and Burns (5) studying biopsy specimens from the mucous membranes of patients undergoing tonsillectomy, noted an increased number of tissue mast cells and increase of tissue acid mucopolysaccharide in patients receiving 20 mg. of Premarin intravenously pre-operatively. There was a steady increase in both elements during the first 4 hours after surgery, and a decrease by 8 hours. These changes were not observed in the operated control group not given Premarin. The authors concluded that conjugated estrogen appeared to exert a protective effect on tissue mast cells with resultant increase in total cell count and increased mast cell granule storage.
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