bluuebunny/crossref_metadata_2025 huggingface dataset:
Primary Cutaneous Meningioma on the Scalp: Report of Two Siblings
Authors: Miyamoto Toru , Mihara Motoyuki , Hagari Yoshitaka , Shimao Shuhei
Published: April 2015

Primary cutaneous meningioma (PCM) is a rare tumor whose pathogenesis is quite obscure. We reported PCMs occurring on almost the same occipital region of two siblings studied by histology, immunohistochemistry, and electron microscopy. Both lesions were attached to duras, but extracranial. One lesion was histologically diagnosed as meningothelial meningioma; its tumor cells showed electron microscopically interdigitating cytoplasmic processes with junctional complexes. The other was interpreted as fibroblastic meningioma; its tumor cells were arranged linearly in a stepping‐stone arrangement and had small dense bodies in the cytoplasm. The tumor cells stained positively with anti‐vimentin antibody. Both lesions had adenomatous hyperplasia of the eccrine glands. Although the histologic and electron microscopic features of these two lesions slightly differed from each other, their pathogenesis was essentially considered to be acoelic or rudimentary meningocele.
Low Expression of Adhesion Molecules in a Case of Cutaneous T‐cell Lymphoma
Authors: Miyazawa Megumi , Takahashi Sanami , Kawaguchi Hiroshi , Nagatani Tetsuo , Higuchi Mitsuhiro , Matsuzaki Toshiko , Iemoto Gaijiro , Kim Shu‐Taku , Baba Naoko , Miyamoto Hideaki , Nakajima Hiroshi
Published: April 2015

A case of cutaneous T‐cell lymphoma (CTCL) with low expression of the adhesion molecules lymphocyte function‐associated antigen‐1 (LFA‐1), intercellular adhesion molecule‐1 (ICAM‐1), and very late antigen‐4 (VLA‐4) is described. The patient was a 90‐year‐old man with red round homogeneous tumors on his scalp, trunk, and extremities. He had no history of definite erythema or plaque stage. A biopsy sample taken from a tumor revealed massive infiltration of atypical lymphocytes in the reticular dermis and subcutis with a definite clear zone. The atypical lymphocytes were medium‐sized with slightly convoluted nuclei. Immunohistochemically, the infiltrates showed the phenotype of so‐called memory T cells. On the basis of these features, the case was diagnosed as CTCL. Expression of LFA‐1, ICAM‐1 and VLA‐4 on the infiltrates was 9%, 13% and 11%, respectively, which is much lower than that in classic mycosis fungoides. This finding suggests that loss of these adhesion molecules may contribute to loss of epidermotropism in the advanced stage of CTCL.
Saphenous Vein Graft Donor Site Dermatitis in Japan
Authors: Kato Naoko , Ueno Hiroo
Published: April 2015

Four cases of saphenous vein graft donor site dermatitis are reported from Japan for the first time. The patients were four Japanese men aged from 57 to 69. They noted pruritic eruptions along the lower extremity scar after coronary artery bypass graft surgery using the autogenous saphenous vein. The eruptions appeared mainly on and around the lower end of the venectomy scars from 1.5 to 9 months after graft operations performed at three different hospitals. All four patients showed an objective sensory deficit of the saphenous nerve around the saphenous vein incision scar, although none of them complained of saphenous neuralgia subjectively. Histologically, two patients showed mild epidermal acanthosis, spongiosis, intraepidermal blisters, and perivascular infiltration of lymphocytes and a few eosinophils around dermal blood vessels. The eruption responded well to topical corticosteroids in all cases, although it recurred again in two patients. The entity is characterized by a subacute (belatedly appearing, then slowly disappearing) dermatitis and a mild sensory deficit of the saphenous nerve. Apparently, mild impediment of the saphenous nerve due to an ablational procedure of saphenous venectomy can play a role in causing saphenous vein graft donor site dermatitis.
Reticular Erythematous Mucinosis Syndrome Associated with Psoriasis‐like Eruptions
Authors: Izumi Tatsua , Tajima Shingo
Published: April 2015

We report a case of reticular erythematous mucinosis syndrome associated with psoriasis‐like eruptions. Although the two skin diseases are clinically distinct, they may be related in some ways.
Measurement of Skin Elastic Properties with a New Suction Device (I): Relationship to Age, Sex and the Degree of Obesity in Normal Individuals
Authors: Ishikawa Takeshi , Ishikawa Osamu , Miyachi Yoshiki
Published: April 2015

We measured skin elastic properties (distension ability, retraction ability, and the skin elasticity) of 4 different body sites, finger, hand, forearm, and chest, in 191 normal individuals by means of a new suction device and investigated the correlation of skin elastic properties with sex, site, age, and the degree of obesity. Neither sex nor the degree of obesity were correlated with skin elastic properties. The skin elastic property of the chest was significantly higher than those of the other three sites. Decrease in the skin elasticity of the hand, forearm and chest were associated with aging. This simple and non‐invasive device can provide an objective method for evaluating skin elastic property.
Increased Serum Level of Interleukin‐6 in Patients with Psoriatic Arthritis and Thrombocytosis
Authors: Yasumoto Shinichiro , Imayama Shuhei , Hori Yoshiaki
Published: April 2015

The role of elevations of serum cytokines in psoriasis is a provocative issue. We report two patients with psoriasis who had episodes of fever, arthritis, and general fatigue. Their symptoms seemed to be associated with increases in serum levels of interleukin (IL)‐6, which paralleled the severity of clinical symptoms as well as elevated serum titers of C‐reactive protein (CRP) and platelet counts. Since IL‐6 is a multipotential cytokine with B‐cell activating, T‐cell activating, and thrombocytopoietic functions, the symptoms and abnormal laboratory findings in these patients may have been related to their increased serum levels of IL‐6. Monitoring the serum level of this cytokine may thus be useful in evaluating the clinical status of patients with psoriatic arthritis.
Skin Tags as Markers of Diabetes Mellitus: An Epidemiological Study in India
Authors: Thappa Devinder Mohan
Published: April 2015

To ascertain whether skin tags (ST) are associated with a higher risk for diabetes mellitus (DM), 35 patients with ST were screened out of 5000 consecutive patients visiting our dermatology clinic. The study group ranged in age from 35 to 73 years, with a mean of 52.03. Twenty‐six of the patients were men, and nine, women. The risk of getting ST was found to increase with age, but this risk decreased after the fifth decade. The neck was invariably involved, followed by the eyelids, axillae and groin. Of the cases, 62.8% (22 patients) had DM. Four new cases of DM were found among this group. All the diabetic patients in this study population had noninsulin dependent DM. The frequency of DM in ST patients was found to increase with age, however, it was statistically insignificant. No correlation was found between localisation, size, color, or number of ST and the presence of DM. The frequency with which ST had been found to co‐exist with DM in this population is significant, and ST may serve as a marker for DM.
Malignant Schwannoma Arising in Patients with Von Recklinghausen's Disease: Report of Two Cases and the Comparison of Mast Cells between Benign and Malignant Portions
Authors: Demitsu Toshio , Murata Satoru , Kiyosawa Tomoharu , Yamada Tomoko , Sato Hisao , Hiraga Takeshi , Yamane Yasuhiro , Yaoita Hideo
Published: April 2015

We described two cases of malignant schwannoma arising in patients with von Recklinghausen's disease and examined the mast cells infiltrated into histologic sections. One of the two cases histologically revealed apparent mast cell infiltration in some areas of malignant schwannoma as well as in the benign neurofibroma. The malignant lesion demonstrated significantly increased percentages of degranulated mast cells over the benign lesion using FITC‐avidin staining. In an electron microscopic study, mast cells in the malignant lesion displayed empty granules, piecemeal degranulation, and canaliculi structures suggesting activation. These findings were not observed in the benign lesion. The other patient histologically showed no mast cells in the malignant lesion, although the benign neurofibroma in the patient disclosed numerous mast cells. The first patient had neither recurrence nor distant metastasis. On the other hand, the second patient without mast cells in the histology had multiple distant metastases.

These findings raise questions about the role of mast cells in malignant schwannoma.
Successful Treatment of Vitiligo with a Sex Steroid‐Thyroid Hormone Mixture
Authors: Muto Masahiko , Furumoto Hiroko , Ohmura Akiko , Asagami Chidori
Published: April 2015

Four patients with generalized vitiligo were successfully treated by oral administration of a sex steroid‐thyroid hormone (Metharmon‐F®, 2 tablets daily). Histopathologically, the repigmented skin showed increased numbers of melanocytes and melanin granules in the keratinocytes.
A Case of Drug Eruption Caused by the Crude Drug Boi® (Sinomenium Stem/Sinomeni Caulis et Rhizoma)
Authors: Okuda Tomoki , Umezawa Yoshinori , Ichikawa Makiko , Hirata Masako , Oh‐i Tsunao , Koga Michiyuki
Published: April 2015

We report a case of drug eruption caused by the crude drug Boi®. A 41‐year‐old female patient had been diagnosed with chronic rheumatoid arthritis in the department of internal medicine. After ingestion of a decoction of the crude drug Boi® for the alleviation of arthralgia, a slight fever developed, which was followed by systemic edematous erythema with itching. HPLC showed that the main components of the crude drug Boi® are sinomenine and magnoflorine. The results of patch tests were negative for all oral drugs that the patient had been taking. Oral ingestion tests showed that the patient showed positive reactions to the as‐is Boi® boiling‐water decoction and 1/10‐volume sinomenine. Based on this, the drug eruption was judged to be caused by sinomenine. It is considered the first time that the causative component of a drug eruption was confirmed by oral ingestion tests with components of a crude drug of Kampo medicine (Sino‐Japanese traditional medicine).
The Epidemiology of Non‐Melanoma Skin Cancer: Who, Why and What Can We Do about It
Authors: Marks Robin
Published: April 2015

Non‐melanoma skin cancer (NMSC) comprised of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) are the most common cancers in humans in many countries. Sunlight plays a major part in the development of these tumours which appear predominantly on areas of the most frequently exposed skin.

The site distribution for BCC and SCC is not the same, with SCC being most common on the sites of very heavy exposure and BCC becoming more common on areas of only moderate exposure, e.g. upper trunk in men and women and lower leg in women.

Incidence rates of NMSC, where they are being recorded, show rises over time. Mortality rates, on the other hand, have been dropping most of this century until they have been levelling out recently. The case fatality rate due to SCC appears to be between 1–2%. The malignant transformation rate of actinic keratoses to SCC appears to be very low.

Studies on similar populations at different latitudes allow estimates to be made of increases which might occur with increasing exposure to ultraviolet radiation (UVR) over a life time. These have been used to estimate the possible increases in NMSC due to stratospheric ozone depletion.

Finally, recent studies on the reduction of existing actinic keratoses and prevention of new ones with regular use of sunscreen augurs well for prevention of NMSC in the future.
Alopecia Areata in Korea (1982–1994)
Authors: Ro Byung In
Published: April 2015

I clinically studied 905 patients with alopecia areata (AA) who visited the Department of Dermatology, College of Medicine, Chung Ang University, from January of 1982 to February of 1994. The purpose of the study was to evaluate the clinical manifestations and compare the effects of treatment with intralesional injection of triamcinolone acetonide suspension and immunotherapy with dinitrochlorobenzene (DNCB) or diphenylcyclopropenone (DPCP). The results were as follows: 1) The incidence of AA among all out‐patients (59,970) was 1.5% (905 cases), and the ratio of males to females was 1.3:1 (512:393). 2) The age distribution showed high incidences in the third (41.8%) and fourth decades (20.0%). 3) The family history was contributory in 104 cases (11.5%). 4) The relapse rate was 17.5% (158 cases). 5) Almost half of the patients had a solitary lesion (408 cases, 46.7%). 6) The most common site of predilection was the occipital region of the scalp in both male and female patients. 7) Associated diseases were seborrheic dermatitis, atopic dermatitis, hepatitis, hypertension, open heart surgery, thyroid disease, pulmonary disease, and vitiligo in order of frequency. 8) The effect of treatment on the patients who had bald patches less than 50 cm2 was not significantly statistically different between intralesional injection of triamcinolone acetonide and immunotherapy with DNCB or DPCP. 9) In cases with bald areas more than 50 cm2, including alopecia totalis and universalis, DNCB or DPCP immunotherapy showed better therapeutic effects than did intralesional injection of triamcinolone acetonide.
Regulatory Effects of Gamma‐Interferon on IL‐6 and IL‐8 Secretion by Cultured Human Keratinocytes and Dermal Fibroblasts
Authors: Maruyama Kohji , Zhang Jian‐Zhong , Nihei Yoshimichi , Ono Ichiro , Kaneko Fumio
Published: April 2015

Gamma‐interferon (IFN‐γ) is produced by T cells and plays an important role in immunological and inflammatory processes. To determine the effects of IFN‐γ on interleukin (IL)‐6 and IL‐8 secretion, normal human keratinocytes (NHKs), human squamous cell carcinoma cell line (HSC‐1) cells, and human dermal fibroblasts (HDFs) were incubated with 100 U/ml of recombinant (r) IFN‐γ in the presence of various stimulants. HSC‐1 cells and HDFs spontaneously secreted both IL‐6 and IL‐8 into the culture medium. NHKs secreted detectable levels of IL‐8, but not of IL‐6, and IL‐8 secretion increased over 20 fold by stimulation with 10 nM of phorbol 12‐myristate 13‐acetate (PMA). rIFN‐γ inhibited IL‐8 secretion in both HSC‐1 cells and PMA‐stimulated NHKs. On the other hand, it enhanced IL‐1α‐ and TNFα‐induced IL‐8 secretion in NHKs. In HDFs, rIFN‐γ inhibited IL‐8 secretion, but enhanced secretion of IL‐6, regardless of whether they were stimulated with IL‐1α or PMA. These results suggest that IFN‐γ has different regulatory effects on IL‐6 and IL‐8 secretion in NHKs and HDFs, depending on the stimulus.
Induction of the 72‐kD Heat Shock Protein in Human Skin Melanoma and Squamous Cell Carcinoma Cell Lines
Authors: Muramatsu Tsutomu , Kobayashi Nobuhiko , Tada Hideyuki , Hatoko Mitsuo , Shirai Toshihiko
Published: April 2015

Heat shock proteins (HSPs) or stress proteins comprise a characteristic group of proteins synthesized in cells exposed to heat or other environmental stimuli. Of the many HSPs, the 72‐kD heat shock protein (HSP72) is the most stress‐inducible one. In the present study, we examined the effects of heat, chemicals (azetidine and sodium arsenite), ultraviolet (UV) light, and γ‐ray irradiation on the induction of HSP72 in cultured human skin melanoma cell lines (P‐39 and G‐361), a human skin squamous cell carcinoma cell line (HSC‐1), and an SV40‐transformed human lung fibroblast cell line (WI38VA13) as a control. In these cell lines, heat treatment induced HSP72 more rapidly and intensely than did chemical exposure. Compared with the SCC cell line, the two melanoma cell lines produced less HSP72 with heat treatment. UVC irradiation (20 J/m2) induced HSP72 only in the WI38VA13 cells. After γ‐ray irradiation, no HSP72 induction was detected in any of the cell lines examined. These observations suggest that, in cultured cells, inducibility of HSP72 depends not only on the inducer but also on the origin of each cell line.
Image Analysis of Nailfold Capillaries in Patients with Undifferentiated Connective Tissue Syndromes
Authors: Ohtsuka Tsutomu , Yamakage Akio , Tamura Taeko
Published: April 2015

Several studies have reported patients that show nailfold capillary abnormality without fulfilling any of the criteria for rheumatic diseases. Our objective was to define how many patients with undifferentiated connective tissue syndrome (UCTS) have nailfold capillary abnormalities and to determine the correlation between capillary abnormality and clinical findings. We analyzed videograph images of nailfold capillaries in 75 patients with UCTS, comparing them with 22 normal controls (NL) and 55 patients with systemic sclerosis (SS), using standardized canonical discriminant analysis. Sixty patients with UCTS showed the SS type pattern and 15, the NL type pattern. The SS type pattern in patients with UCTS significantly correlated with Raynaud's phenomenon, telangiectasia, and anti‐nuclear antibody. The UCTS patients with nailfold capillary abnormalities correlated with symptoms of SS have a possibility of progressing to SS. The follow up study of these patients will show whether progression to SS occurs.
A Case of Pretibial Myxedema Associated with Graves' Disease: An Immunohistochemical Study of Serum‐derived Hyaluronan‐associated Protein
Authors: Shishido Mari , Kuroda Kei , Tsukifuji Reiko , Fujita Masaru , Shinkai Hiroshi
Published: April 2015

The myxomatous materials in cutis from a patient with pretibial myxedema (PTM) with Graves' disease were found to be mainly hyaluronic acid (HA), which had accumulated extensively in the upper dermis. Fibroblasts were increased in number in the mid to lower dermis. To clarify the mechanism of the deposition of HA in the dermis, we employed an antibody against serum‐derived hyaluronan‐associated protein (SHAP). This immunohistochemical study disclosed that the greater part of the fibroblasts in the mid to lower dermis stained positively, while the fibroblasts surrounded by fairly large amounts of HA in the upper dermis stained faintly or not at all. From these results, we suspect that the accumulation of HA progresses from the upper to the low dermis and that the interaction of fibroblasts and SHAP leads to development of the physiophathological cutaneous changes seen in our case.
A Case of Subacute Necrotizing Fasciitis
Authors: Imamura Yuzo , Kudo Yoshiko , Ishii Yoshiteru , Shibuya Hiromi , Takayasu Susumu
Published: April 2015

We report a 48‐year‐old woman who developed necrotizing groin fasciitis with insidious onset. Before she visited us, she had been unsuccessfully treated with several kinds of antibiotics by other doctors for one month, because of a small ulcer covered by blackish necrotic tissue. She was referred to us because of high fever, an ulcer on the left labium majus, and a cellulitis‐like lesion with severe pain on the lower abdomen. Methicillin‐resistant Staphylococcus aureus (MRSA), Streptococcus intermedius, and Bacteroides uniformis were isolated from the wound. After aggressive debridement on the eighth day after admission of the whole indurated area and the fascia of the underlying muscle, healthy granulation tissue covered the defect, and the wound was finally closed with a skin graft. Long‐term administration of antibiotics along with insufficient and delayed surgical treatment were considered to have caused the full development of this disease.
Granulomatous Pigmented Purpuric Dermatosis
Authors: Saito Ryuzo , Matsuoka Yoshitaka
Published: April 2015

We report two cases of brown pigmentation accompanied by hemorrhagic papules. A 61‐year‐old woman and a 53‐year‐old woman presented with brown pigmentation accompanied with hemorrhagic papules occurring bilaterally from the dorsal aspect of the feet to the lower legs. The clinical picture was of pigmented purpuric dermatosis, but histopathologically, they were hemorrhagic granulomatous inflammation of the upper dermis. As no systemic granulomatous lesions were observed, these cases were considered to be granulomatous pigmented purpuric dermatosis.
Successful Treatment of Molluscum Contagiosum in the Immunosuppressed Adult with Topical Injection of Streptococcal Preparation OK‐432
Authors: Inui Shigeki , Asada Hideo , Yoshikawa Kunihiko
Published: April 2015

A 37‐year‐old Japanese woman received an anticancer drug for 5 years following resection of mammary cancer and then developed widespread mollusca contagiosa, which we considered to be caused by immunosuppression induced by the chemotherapy. Because OK‐432 (penicillin‐treated and heat‐treated lyophilized powder of a substrain of Streptococcus pyogenes A) was expected to be effective for immunosuppression, we tried its topical injection. The skin lesions disappeared almost completely within three months. OK‐432 therapy is considered hopeful for treating viral skin diseases, even in immunosuppressed patients.
Acquired Blaschko Dermatitis: Acquired Relapsing Self‐Healing Blaschko Dermatitis
Authors: Lee Ho Jung , Kang Won Hyung , Hann Seung Kyung
Published: April 2015

Acquired Blaschko dermatitis is a rare disease with acquired unilateral relapsing inflammatory linear lesions along Blaschko's lines. Histopathology reveals spongiotic dermatitis. “Blaschkite de l'adulte” and “acquired relapsing self‐healing Blaschko dermatitis” have been suggested as names for this condition. Our patient was a 27‐year‐old man with a 6 month history of repeated, unilateral, slightly pruritic, discrete and grouped erythematous papules and papulovesicles on the left side of the upper limbs and trunk along Blaschko's lines. Histologic examination showed subacute spongiotic dermatitis. The condition showed excellent improvement after treatment with systemic corticosteroid for 2 months.

Only a few cases have been reported. We propose a new designation and describe a patient who represents the first reported case of acquired Blaschko dermatitis in Korea.
Two Cases of Intravascular Papillary Endothelial Hyperplasia Developing on the Sole
Authors: Kato Haruhisa
Published: April 2015

Two cases of intravascular papillary endothelial hyperplasia (IPEH) are described. Each patients was a 49‐year‐old Japanese woman with a tender eruption on the sole. Histologically, the lesions proved to be IPEH. One of them had the typical histological appearance of IPEH, and the other showed a venous thrombus associated with histological manifestations of organization and recanalization. Newly formed vascular channels were seen at the periphery of the thrombus. These findings favored the hypothesis that IPEH usually results from peculiar organization of a thrombus.
Detection of Autoantibody against 97‐kD Antigen by Immunoblot, but not by Indirect Immunofluorescence, in a Patient with Linear IgA Bullous Dermatosis
Authors: Ohno Haruhiko , Muramatsu Tsutomu , Shirai Toshihiko
Published: April 2015

A case of linear IgA bullous dermatosis in an 85‐year‐old man is reported. Direct immunofluorescence (IF) of the lesional skin showed linear deposition of IgA and weak deposition of IgG at the basement membrane zone. Although no circulating autoantibody was detected by indirect IF, immunoblotting analysis using NaCl‐separated normal human epidermal extracts revealed a circulating IgA antibody which bound to the 97‐kD antigen.
Prurigo Nodularis Associated with Advanced Gastric Cancer: Report of a Case
Authors: Funaki Mikio , Ohno Tomoya , Dekio Satoshi , Jidoi Joji , Nakagawa Chikage , Kin Seikon , Tamura Katsuhiro
Published: April 2015

In a male Japanese patient, prurigo nodularis (PN) appeared in association with gastric cancer. The cutaneous pruriginous lesions dramatically improved soon after total gastrectomy without any treatment for the skin lesions. Peripheral eosinophilia seen before the operation also rapidly disappeared. These data suggest that some cytokines involved in gastric cancer might have played an important role in the development of PN in our patient.
Multiple Nodular Lesions Seen in a Patient with Neurocutaneous Melanosis
Authors: Sasaki Yuko , Kobayashi Seiichiro , Shimizu Hiroshi , Nishikawa Takeji
Published: April 2015

Neurocutaneous melanosis is a rare congenital syndrome characterized by the presence of large or multiple congenital melanotic nevi and benign or malignant pigment cell tumors of the leptomeninges. A 2‐month‐old female infant was referred to our department with widespread pigmented nevi, numerous blackish‐brown, elevated, firm nodules, eye lesions, temporal bone defect, and generalized convulsion. The sizes of the nodules were from 0.5 to 3 cm; they were either white, black brown or red, and some of them were eroded and bleeding.

Magnetic resonance imaging using gadolinium contrast (MRI‐Gd) demonstrated hydrocephalus, defect of the temporal bone, and T1‐short and T2‐long areas near the cerebrum and the thoracic vertebra (Th 4–5), suggesting the presence of melanosis in the central nervous system. Biopsy specimen of a firm, black nodule of a pigmented lesion on her shoulder revealed sheets of nevomelanocytes in the dermis with a few mitoses and large atypical cells that were positive for HMB‐45 and formaldehyde‐induced green specific fluorescence. Although this histological architecture is compatible with that of congenital nevi, occasional occurrence of atypical mitoses in the dermis may consitute an early stage of malignant melanoma. To make a definite diagnosis, however, long‐time follow‐up and repeated skin biopsy are considered necessary.
Lentiginous Melanocytic Hyperplasia Overlying Dermatofibroma
Authors: Toda Sunao , Heasley Diane D. , Carlson J. Andrew , Mihm Martin C.
Published: April 2015

There are occasional reports of proliferative epidermal changes overlying dermatofibromas. We report the first case to our knowledge of a dermatofibroma with overlying lentiginous melanocytic hyperplasia.
Activity of Eleven Kampo Formulations and Eight Kampo Crude Drugs against Propionibacterium acnes Isolated from Acne Patients: Retrospective Evaluation in 1990 and 1995
Authors: Higaki Shuichi , Nakamura Motokazu , Morohashi Masaaki , Hasegawa Yoshinori , Yamagishi Takayoshi
Published: April 2015

We reviewed the susceptibility of Propionibacterium acnes to eleven Kampo formulations and to eight Kampo crude drugs that had been studied by examining their minimum inhibitory concentrations (MIC) in 1990 and 1995. P. acnes strains were most sensitive to Oren‐gedoku‐to (OGT) among these Kampo formulations. Coptidis Rhizoma (CR) and Phellodendri Cortex (PC) inhibited the growth of P. acnes significantly among the eight Kampo crude drugs examined. The patterns of distribution of MIC of Kampo formulations and Kampo crude drugs to P. acnes in this study were almost the same as in our previous report in 1990. No significant increases in MIC of Kampo formulations and Kampo crude drugs to P. acnes were observed.

We speculated that Kampo crude drugs such as CR and PC, were better than minocycline or erythromycin from the point of view of a progressive increase in MIC to P. acnes. CR and PC, which were each an ingredient of OGT, might contain some components with strong antibacterial activity to P. acnes.
Three Cases of Linear Lichen Planus Caused by Dental Metal Compounds
Authors: Sasaki Go , Yokozeki Hiroo , Katayama Ichiro , Nishioka Kiyoshi
Published: April 2015

Three cases of linear lichen planus on the lower extremities unaccompanied by mucous lesions are described. Dental metal compounds were thought to be the precipitating factor in all cases. Skin lesions did not respond to topical steroid ointment or antihistaminies. Two cases showed a positive patch test reaction to gold (HAuCl4) and a positive lymphocyte stimulation test to gold compound (Gold sodium thiomalate). One case showed a positive patch test reaction to mercury (HgCl2), but a negative lymphocyte stimulation test. Suspected metal compounds were demonstrated in their dental materials. Removal of gold materials in one case gradually improved the lesions within 6 months with a transient erythematous swelling of the face shortly after removal of the metal. Both of these cases responded to oral disodium chromoglycate therapy. These results suggest that metal compound specific T cells might be responsible for the development of linear lichen planus.
Induction of the Low‐Molecular‐Weight Stress Protein HSP27 in Organ‐Cultured Normal Human Skin
Authors: Muramatsu Tsutomu , Hatoko Mitsuo , Tada Hideyuki , Kobayashi Nobuhiko , Shirai Toshihiko
Published: April 2015

To examine the inducibility of 27‐kD‐molecular‐weight heat shock protein (HSP27) in human skin, an indirect immunofluorescence (IF) study was performed on organ‐cultured normal human skin by using a monoclonal antibody specific for HSP27. After heat treatment at 45°C for 1 h, nuclear IF was observed in the epidermal cells. When the organ‐cultured skin explants were exposed to 10.0 μg/ml or 100.0 μg/ml 8‐methoxypsoralen (8‐MOP) for 1 h and then irradiated with UVA (320–400 nm), positive nuclear IF was also observed 6 h after UVA irradiation. Considering these results with the previous reports about HSP72, it appears that, in human skin, HSP27 as well as HSP72 plays an important role in resisting various environmental stresses.
Serum Concentration of 5‐S‐Cysteinyldopa in Pediatric Patients with Giant Pigmented Nevi
Authors: Hanawa Yoko , Wakamatsu Kazumasa , Ikeda Shigeo
Published: April 2015

The serum concentrations of 5‐S‐cysteinyldopa (5‐S‐CD) in pediatric patients with giant pigmented nevi (GPN) were investigated and compared with those of pediatric patients with small‐ or medium‐sized congenital nevi (CN), or non‐melanocytic benign skin tumor (control group). Serum 5‐S‐CD levels in the GPN group (N=21), particularly in patients less than 5 years old, were significantly higher(highest concentration 38.4, mean ± S.D. 16.6 ± 9.4 nmol/L) than those in the CN (N=22) or control groups (N=26). Serum 5‐S‐CD levels in the CN group were not significantly different from those in the control group. There was a significant correlation between the serum 5‐S‐CD level and size (surface area) of the GPN. There was a significant inverse correlation between the serum 5‐S‐CD level and age in the CN and control groups, but not in the GPN group. Serum 5‐S‐CD levels were transiently elevated immediately after treatment of patients with GPN with a combination of skin abrasion and cryotherapy with solid carbon dioxide.

These results suggest that serum 5‐S‐CD levels in the GPN group reflected the 5‐S‐CD derived from GPN, particularly in patients less than 5 years old. This indicates that melanogenesis may be accelerated in infant patients in the GPN group.
Acne Fulminans Coexisting with Pyoderma Gangrenosum‐like Eruptions and Posterior Scleritis
Authors: Kurokawa Shigeko , Tokura Yoshiki , Nham Nguyen Xuan , Sudoh Harumi , Wakita Hisashi , Furukawa Fukumi , Takigawa Masahito
Published: April 2015

A 30‐year‐old Japanese man presented with an erythematous, papulonodular eruption on his face and upper trunk, which rapidly progressed into severely exuberant, ulcerative lesions with a confluent tendency. His other symptoms included a high fever and general malaise. Complete blood cell counts showed neutrophilia with increased percentages of myelocytes and metayelo‐cytes. The systemic administration of corticosteroids improved his skin lesions, leaving scars and milia. During tapering of corticosteroids, however, the patient developed posterior scleritis of his eyes and pyoderma gangrenosum‐like eruptions on the lower legs. Our patient's history suggests that pyoderma gangrenosum‐like eruptions and posterior scleritis are disorders associated with acne fulminans.
Macrophage Colony‐Stimulating Factor (M‐CSF) Inhibits the Decrease in the Amount of rRNA and IAβ mRNA in Cultured Epidermal Langerhans Cells of the Mouse
Authors: Koyama Yoh‐ichi , Marunouchi Tohru
Published: April 2015

Macrophage colony‐stimulating factor (M‐CSF) is a keratinocyte‐derived cytokine whose function in skin is not completely clarified. We investigated its effects on Langerhans cells by examining the amount of IAβ mRNA, β‐actin mRNA and rRNA per cell, and compared them with the effects of other cytokines such as granulocyte/macrophage colony‐stimulating factor (GM‐CSF) and tumor necrosis factor‐α (TNF‐α). After culture for 24 h in the absence of exogenous cytokines, rRNA in Langerhans cells decreased steeply while β‐actin mRNA increased. IAβ mRNA also decreased sharply. These decreases in the amount of rRNA and IAβ mRNA were limited when cytokines were added to the culture medium (in order of efficiency M‐CSF>GM‐CSF>TNF‐α), but M‐CSF was less potent than GM‐CSF in up‐regulating β‐actin mRNA (GM‐CSF>M‐CSF, TNF‐α). The effect of M‐CSF, but not that of GM‐CSF, was restricted by simultaneous treatment of cells with TNF‐α. None of these effects engendered a change in the viability of the Langerhans cells in a 24‐hr culture. Reverse‐transcribed polymerase chain reaction analysis demonstrated that c‐fms, the gene of the M‐CSF receptor, was expressed in Langerhans cells, implying the physiological importance of M‐CSF in vivo. A protein kinase C activator, TPA, up‐regulated the amount of IAβ mRNA, while a protein kinase C inhibitor, H‐7, suppressed the effects of all three cytokines. These results suggest that M‐CSF, in conjugation with TNF‐α and GM‐CSF, plays an important role in controlling the physiological state of Langerhans cells, probably through the activation of protein kinase C.
Effects of Transforming Growth Factor β1 in the Hair Cycle
Authors: Mori Osamu , Hachisuka Hiroshi , Sasai Yoichiro
Published: April 2015

Hair follicle growth is thought to be regulated by a complex interplay of stimulatory and inhibitory signals. From among such signals, we examined the effects of transforming growth factor β1 (TGFβ1) on the murine hair growth cycle.

Quantitation of TGFβ1 per wet tissue weight was performed at different stages of the hair cycle. TGFβ1 was extracted with 10 mM HCl, and its level was measured with ELISA. The level of TGFβ1 did not change markedly during the hair cycle. Immunohistochemical observations revealed that hair follicle cells and epidermal cells were negative for TGFβ1 at all stages of the hair cycle. Mast cells in the dermis were positive throughout the cycle. To confirm whether TGFβ1 inhibits the proliferation of hair follicles, we injected it subcutaneously. TGFβ1 inhibited the proliferation of hair follicles. Our observations suggest that TGFβ1 is at least partly responsible for regulating hair follicles as a negative growth factor.
Expression of E‐Cadherin in Skin Carcinomas
Authors: Tada Hideyuki , Hatoko Mitsuo , Muramatsu Tsutomu , Shirai Toshihiko
Published: April 2015

In this study, we investigated the expression of E‐cadherin in 31 cases of human skin carcinoma including basal cell carcinoma (BCC), squamous cell carcinoma (SCC), Paget's disease, Bowen's disease (invasive type), and trichilemmal carcinoma, by immunohistochemical staining using a monoclonal antibody specific for E‐cadherin. Similar to the E‐cadherin expression in normal epidermis, E‐cadherin was strongly expressed in all samples of BCC on the cell borders, whereas marked decrease or loss of E‐cadherin expression was found in the tumor cells of SCC, Paget's disease, and Bowen's disease (invasive type). On the other hand, E‐cadherin expression of trichilemmal carcinoma was slightly reduced. Considering the clinical and histological features of these skin carcinoma, the reduction of E‐cadherin expression is considered to be associated with the invasion and metastasis of human skin carcinoma.
Bacteroides fragilis Pyomyositis in a Patient with Multiple Myeloma
Authors: Katagiri Kazumoto , Shibuya Hiromi , Takayasu Susumu
Published: April 2015

Pyomyositis is a bacterial infection with abscess formation affecting large skeletal muscles. It is predominantly caused by Staphylococcus aureus. The disease is common in tropical areas, but rare in temperate climates. We report a patient with multiple myeloma who developed a giant elastic tumor on the right thigh and a hen egg‐sized tumor on the right upper arm. MR imaging revealed cystic spaces in the femoral quadriceps and brachial biceps muscles. A large amount of pus with foul smell was removed by incision, drainage and aspiration of the two tumors. The lesions were successfully treated with intravenous administration of antibiotics. Repeated bacterial cultures yielded only Bacteroids fragilis. To our knowledge, this is the first report of pyomyositis due to Bacteroides fragilis.
A Case of Tick Bite from Amblyomma testudinarium on the Glans Penis
Authors: Yamada Yoshitaka , Dekio Satoshi , Jidoi Joji , Isobe Akio , Shiwaku Kuninori , Yamane Yosuke
Published: April 2015

A tick which bit the glans penis of a 40‐year‐old Japanese man was surgically excised together with the skin where the bite occurred. It was identified as Amblyomma testudinarium through the taxonomical investigation of its morphological characteristics. To our best knowledge, our patient is the sixth tick bite from this species of tick recorded in the Chugoku District of Japan.
Measurement of Skin Elastic Properties with a New Suction Device (II): Systemic Sclerosis
Authors: Ishikawa Takeshi , Tamura Taeko
Published: April 2015

We previously reported the skin elastic properties of normal subjects as measured by a newly developed suction device (6). In the present report, we examined the skin elastic properties of 62 patients with systemic sclerosis (SSc), clinically diagnosed as limited or diffuse type. We measured the skin elastic properties on the forearm and chest and investigated correlations with disease type and clinical skin score. Patients with the diffuse type SSc showed significantly lower values than those with the limited type SSc or normal subjects in distention and retraction ability at the chest and forearm.

This suction device is clinically useful for the objective evaluation of skin elastic properties in diffuse systemic sclerosis.
Hereditary Onset of Multiple Seborrheic Keratoses: A Variant of Leser Trélat Sign?
Authors: Yamamoto Toshiyuki , Yokoyama Akiko
Published: April 2015

A 79‐year‐old man in a cancer‐prone family developed disseminated seborrheic keratoses over his trunk and extremities over a few decades without rapid increase. His son, mother, and one of his brothers, who died of gastric cancer, also had numerous seborrheic keratoses for a long time. He had a biliary tract cancer. Histologic examination showed hyperproliferation of basaloid cells branching downwards, as if induced by surrounding stroma. No decrease of the number of seborrheic keratoses after surgical operation has been observed. Examination for the localization of epidermal growth factor receptor (EGF‐R) and HER‐2/neu oncoprotein by immunohistochemistry revealed positive staining on the epithelial strands branching downwards on the specimens of seborrheic keratoses. A different pattern of expression was demonstrated in normal seborrheic keratosis. These findings suggest that some unidentified growth factors may be involved in the induction of visceral and/or cutaneous neoplasms in this family.
Contact Dermatitis Due to Topical Steroids with Conceivable Cross Reactions between Topical Steroid Preparations
Authors: Oh‐i Tsunao
Published: April 2015

Steroids are usually employed to inhibit inflammation. However, allergic contact dermatitis has been reported with topical steroids. We have experienced contact dermatitis due to active ingredients of topical steroids in 11 patients. Therefore, we make it a rule to carry out the patch test with as many topical steroids as possible. Five patients were confirmed to be positive to several corticosteroids in the patch test. Papers on patients allergic to steroids indicate that some patients react to several. It is difficult to evaluate whether the reaction is caused by multisensitivity or by cross reaction. However, even if steroids differ in type, they may often cause cross reactions when they have a common chemical structure. Considering this chemical structure, we tried to classify steroids reported to cause allergy in patients into the following four types:

The type recognizing betamethasone and/or dexamethasone. Regardless of whether the methyl group at the C‐16 position of the D ring is on the α or β side, the size of the blocking group of the hydroxy residue seems to be associated with the reaction.

The type in which a chlormethylketone group at the C‐17 position of the D ring seems to be associated with the reaction.

The type in which a cis‐diaxial‐diol side chain in the α side of C‐16 and C‐17 positions of the ring D or its ketal blocking group seems to be associated with the reaction.

The type in which the size of the ester protecting the hydroxy group at the C‐17α position seems to be associated with the reaction.

In patients showing a reaction, there may be receptors recognizing each steroid. If the steroid administered is changed, the receptor appears to recognize the changed steroid in a relatively short period. Thus the receptor may not be constant.
Alteration of Human Melanoma Gangliosides by IFN‐γ, IL‐2, and IL‐4
Authors: Ando Iwao , Komine Mayumi , Otsuka Fujio , Kukita Atsushi
Published: April 2015

In lesions of malignant melanoma, melanoma cells are exposed to various cytokines produced by inflammatory reactions. As a result, transformation of melanoma cells is expected to occur. We studied alterations in human melanoma cell line ganglioside composition after exposing melanoma cell lines to interferon (IFN)‐γ, interleukin (IL)‐2, and IL‐4 by biochemical methods. IFN‐γ increases the ratio of a‐series gangliosides and the ratio of GM3/GD3. This suggests an alteration of immunoreactivity, a decrease in ganglioside sialyltransferase II activity, and an decrease in the malignant character of these cells. The alteration of the ganglioside profile varied among cytokines and cell lines. The progression of malignant melanoma may be influenced by reciprocal interactions between the melanoma cells and the host immune system.
Tissue Distribution of a Melanoma‐Associated Antigen Immunogenic in Patients with Melanoma as Analyzed by Polyclonal Antibodies to Recombinant Peptide Antigen
Authors: Kako Satoru , Hayashibe Kazuhito , Ichihashi Masamitsu
Published: April 2015

This study aimed to detect in vivo expression of human melanoma‐associated antigen D‐1, which was identified by screening an expression cDNA library constructed from mRNA extracted from cultured melanoma cells with sera from patients with melanoma. The tissue distribution of D‐1 antigen was then analyzed. Murine anti‐D‐1 recombinant peptide polyclonal antibodies were raised by immunization of in vitro synthesized D‐1 peptide against Balb/c mice and applied immunohistochemically on paraffin‐embedded tissue specimens. D‐1 antigen was found to be restrictedly expressed on melanoma cells, but not on normal melanocytes, adjacent keratinocytes, fibroblasts, lymphocytes and adnexal structures of skin. The reactivities of anti‐D‐1 antibodies did not correlate with histogenesis of the lesions, their ability to produce melanin, and/or their primary or metastatic nature. There was no positive reactivity of anti‐D‐1 antibodies with other skin tumors, including squamous cell carcinoma, basal cell epithelioma, seborrheic keratosis, and nevus cell nevus. Further, cytoplasmic expression of D‐1 antigen in melanoma cells was observed only in a certain subgroup of patients with melanoma. This indicates that the cell surface expression of D‐1 peptide requires specific transporting proteins, such as HLA molecules.
Relationship between N‐Acetyltransferase (NAT) Activity and Liver Protoporphyrin Level in Experimental Porphyria
Authors: Watanabe Masahisa , Irifune Hiroko , Ohgami Taro , Nonaka Shigeo
Published: April 2015

The results of our previous studies demonstrated that isonicotinic acid hydrazide (INH) can aggravate griseofulvin (GF)‐induced protoporphyria in mice. To elucidate this phenomenon, we studied the relationship between liver protoporphyrin (PP) levels and N‐acetyltransferase (NAT) activity, which is known to be a major catabolic enzyme of INH metabolism in the liver.

The results revealed a significant correlation between liver PP levels and NAT activity in the mice fed 0.1% GF and 0.05% INH. In this group, mice with high NAT activity developed severe protoporphyria. There was no correlation, however, between liver PP levels and NAT activity in the mice fed GF alone or INH alone.

The result suggested that INH metabolites formed by NAT enhance the hepatotoxicity of GF in mice.
Topical Spironolactone Reduces Sebum Secretion Rates in Young Adults
Authors: Yamamoto Ayako , Ito Masaaki
Published: April 2015

The effects of topically applied spironolactone on the sebum secretion rates (SSR) of young adults were investigated. SSR was expressed as the ratio of wax esters/[cholesterol + cholesterol esters] (WE/[C + CE]) and the amount of sebaceous lipids (squalene, triacylglycerol and wax esters). Topical spironolactone 5% gel applied to the right cheeks of the subjects produced a significant reduction in the SSR at 12 weeks (4 weeks after termination of application), but not at 8 weeks (the end of treatment). Untreated “control” areas (the left cheeks of the subjects) showed no significant change during the study. None of the subjects experienced skin rash or signs of local irritation. This results suggests that topical spironolactone may be effective in the treatment of acne patients with high SSR
Two Cases of Atypical Bullous Disease Showing Linear IgG and IgA Deposition in the Basement Membrane Zone
Authors: Kawahara Yoshie , Hashimoto Takashi , Watanabe Kyoko , Kurihara Seiichi , Matsuo Itsuro , Nishikawa Takeji
Published: April 2015

Patients showing coexistent linear IgG and IgA deposition along the basement membrane zone on direct immunofluorescence have been described as either bullous pemphigoid, epidermolysis bullosa acquisita, linear IgA bullous dermatosis, or cicatricial pemphigoid, depending on the clinical features and laboratory findings. In the present report, we describe two cases showing atypical clinical features distinct from those of other known bullous diseases. No circulating antibodies were detected by indirect immunofluorescence of normal human skin. Indirect immunofluorescence of 1 M NaCl split skin revealed IgG and/or IgA antibodies reactive with the dermal side of the split. Immunoblotting of normal human epidermal and dermal extracts showed no apparent reactivity with known autoantigens. The results suggest that there may be a unique and distinct bullous disease with linear IgG and IgA deposition at the basement membrane zone.
Successful Treatment of Mucosal Melanosis of the Lip with Normal Pulsed Ruby Laser
Authors: Hanada Katsumi , Baba Takako , Sasaki Chiaki , Hashimoto Isao
Published: April 2015

Melanosis of the lip is not rare in Orientals. Although it causes cosmetic problems, treatment of this pigmentary disorder is often neglected because a satisfactory tool for complete removal of mucosal melanosis has not yet been developed. The pulsed ruby laser, which has a wavelength of 694 nm and a short pulse duration of 1–2 msec, selectively damages pigmented cells in the skin. In this study, six Japanese patients with labial melanosis, manifested as labial lentigo and Peutz‐Jeghers syndrome, were successfully treated with the pulsed ruby laser. The therapy achieved rapid results without producing changes in mucosal texture or recurrence after operation