bluuebunny/crossref_metadata_2025 huggingface dataset:
Purpuric Cutaneous Manifestations in Mitochondrial Encephalomyopathy
Authors: Horiguchi Yuji , Fujii Tatsuya , Imamura Sadao
Published: April 2015

A six‐month‐old boy with mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke‐like episodes (MELAS) syndrome developed repeated crops of purpuric macules on his soles and palms, which were histologically identified as hemorrhage into the dermis without inflammatory infiltrates. Transmission electron microscopy of the skin eruptions revealed various stages of endothelial degeneration in the dermal capillaries associated with consequent extravasation of erythrocytes. The degenerative change was characterized by swollen and vacuolated mitochondria which showed disintegration of their cristae. These morphological changes in the mitochondria of the endothelial cells resembled those seen in skeletal muscle fibers. Similar changes were also noted in other tissues of the skin, such as the axons of myelinated peripheral nerves and some of the keratinocytes in the epidermis. Although these fine structural features are difficult to differentiate from artifacts, abnormal mitochondria could result in functional disturbance particularly in the tissues that require relatively high kinetics, and thus contribute the symptoms of myopathy, encephalopathy, acidosis and stroke‐like episodes.
Cutaneous Porphyrias in China
Authors: Liao Kang‐Huang
Published: April 2015

In China, 78 cases of cutaneous porphyrias, together with 67 cases reported by other clinicians from 1979 to 1990, were reviewed. Of a total of 145 cases, 75.2% were EPP (109 cases), but only 28 cases (19.3%) were PCT. This prevalence differs from that in other parts of the world. The article discussed this disparity and some notable points. Early diagnosis of EPP using the fluorescence microscopic test for determination of RBC protoporphyrin is important. The complication of hepatobiliary aspects in PCT and EPP was noticed. Liver disease seems to be an important precipitating factor in China.
Anaplastic Large Cell Lymphoma, So‐called Ki‐1 Lymphoma: A Report of a Case of Long Course
Authors: Kanekura Takuro , Setoyama Mitsuru , Yotsumoto Shin‐ichi , Nishi Masayuki , Tashiro Masaaki
Published: April 2015

A 55‐year‐old female with a complaint of tumors on the right lower extremity was reported. The condition was diagnosed as anaplastic large cell lymphoma, so‐called Ki‐1 lymphoma, by its histological and immunohistochemical features. The clonal proliferation of the infiltrating cells of the skin lesions was confirmed by the analysis of T cell receptor gene rearrangement. The lesions have repeatedly occurred on the right lower extremity for more than ten years.

In this report, we also discuss the prognosis of anaplastic large cell lymphoma with or without skin lesions.
Tinea Corporis Due to Microsporum canis from an Asymptomatic Dog
Authors: Katoh Takuro , Maruyama Rhuji , Nishioka Kiyoshi , Sano Takao
Published: April 2015

The patient was a 19‐year‐old female student who purchased a puppy from a pet shop four weeks earlier. At the time of her first examination, an annular edematous erythema with adherent scales and vesicles surrounding its margin was seen on the left forearm. On direct examination of the vesicles, fungal elements were detected, and Microsporum canis was isolated. The puppy was a Pomeranian and was kept in the house at all times. No clinical lesions were seen on the puppy, and the Wood's lamp test was negative. However, M. canis was isolated from the animal by the hairbrush method. Symptoms disappeared after the patient was treated topically with terbinafine cream for three weeks. Although the dog received no treatment whatsoever, there was no evidence of the disease on the pet. Results of the hairbrush method performed on the pet two and three weeks later were negative, but, at five weeks, it was again positive. Human infection with M. canis from an asymptomatic dog was demonstrated in this case. Attention should be paid to preventing infections from animals without lesions.
Inhibition Spectra of Solar Urticaria: A Case Report and a Review of the Japanese Cases
Authors: Yamazaki Masashi , Kawada Akira , Noda Toshiaki , Shimizu Tatsuya , Hiruma Masataro , Ishibashi Akira
Published: April 2015

A 34‐year‐old Japanese female with solar urticaria is described, who had an episode of urticarial response when she was exposed to indoor fluorescent light first and sunlight later. The action spectrum was found to range from 480 to 520 nm with an inhibition spectrum above 650 nm in the visible light by both postirradiation and preirradiation. Injection of in vitro‐irradiated serum did not produce an urticarial wheal on the patient. In the Japanese literature, 17 cases of solar urticaria with inhibition spectra have been reported. The wavelength of the inhibition spectrum was longer than that of the action spectrum in each case.
Histochemical Detection of Burn‐induced Lipid Peroxidation in Sebaceous Glands of Rat Skin
Authors: Kitajima Toshiyuki , Hamanaka Hiroshi , Miyachi Yoshiki , Ono Yoko , Moriguchi Takahiko , Toyokuni Shinya , Imamura Sadao
Published: April 2015

Increased lipid peroxide levels both in skin and serum have been reported after cutaneous thermal injury. However, it still remains unclear where lipid peroxides are produced at the site of burned skin. In the present study, a histochemical method using cold Schiff's reagent was applied in order to detect the localization of lipid peroxide.

Schiff positivity was detected in sebaceous glands, and the extent of positivity seemed to correlate with the serum lipid peroxide levels. These results may suggest that lipid peroxides produced in sebaceous glands after thermal injury enter the blood stream and are partially responsible for the elevated serum lipid peroxide levels.
The ATPase‐staining of Langerhans Cells in Previously Stored Skin Tissues
Authors: Kim Young‐Keum , Miyauchi Hiroko , Horio Takeshi , Asada Yasuo
Published: April 2015

The ATPase‐staining of Langerhans cells is usually done on fresh, unfixed biopsy specimens. In the present study, we attempted to stain these cells in previously stored tissues of guinea pig skin. The ATPase activity disappeared after freezing or preservation in formalin or ethanol. In contrast, tissue specimens which had been stored in physiological saline at 4°C stained as well as fresh cells even after 14 days.
Dermatophytosis in Children and Adolescents: Epidemiological, Clinical, and Microbiological Aspects Changing with Age
Authors: Zienicke Helga C. , Korting Hans C. , Lukacs Andreas , Braun‐Falco Otto
Published: April 2015

During a four year period, a total of 84 cases of dermatophytosis were seen in patients from 0 to 17 years of age attending our out‐patient department. The sex distribution was about equal in preadolescents. Males predominated among adolescents. A peak incidence at early school age was due to cases of tinea capitis, mainly caused by Microsporum canis. A peak among adolescents was due to cases of tinea pedis, mainly caused by Trichophyton rubrum. In general, patients with Trichophyton rubrum infections were older than those with other types of dermatophytosis (p<0.05). Dermatophytosis due to Microsporum canis was most frequently seen in January and in September (p<0.01). Although onychomycosis due to dermatophytes was a comparatively rare disease, it did occur within all age subgroups. Entities which were very frequent in former times and which have become rare during the last decades, such as tinea capitis due to Trichophyton schönleinii, still contribute to the spectrum of dermatophytosis in childhood.
Lichen Nitidus: A Histologic and Electron Microscopic Study
Authors: Mihara Motoyuki , Nakayama Hidetoshi , Shimao Shuhei
Published: April 2015

A lesion of lichen nitidus in a 53‐year‐old man was examined by histology and electron microscopy. The histology showed typical features. The electron microscopy revealed primary changes in hydropic degeneration of basal cells which possibly indicated severe edema between the basal keratinocytes and in the subepidermal area. The basal keratinocytes themselves were not particularly altered, except for clustered micro‐vacuolar structures in a small portion of the peripheral cytoplasm. In one of the eight blocks observed, the cytoplasmic process of a mast cell was found between the basal keratinocytes, indicating that mast cells may possibly infiltrate the epidermis in lichen nitidus. Scattered mast cells in the dermis were also noted. Thus primary pathologic changes of lichen nitidus may be induced by severe edema, which was accompanied by inflammatory cells including mast cells, in the region of the dermal‐epidermal junction.
Monoclonal Antibody OKB19, Reactive with a B‐Lymphoid Differentiation Antigen (CD19), Binding to Basal Layer Keratinocytes of Normal Human Skin
Authors: Watanabe Shinichi , Ichikawa Eiko , Wagatsuma Keiko , Kawa Yohko , Takahashi Hisashi
Published: April 2015

Monoclonal antibody (moAB) OKB19 reacts with CD19 antigen, which is the broadest lineage‐specific surface marker on B‐lymphocytes. In frozen tissue sections, using an immunohistochemical technique, the OKB19‐positive cells in the basal layer were sharply demarcated from the negative suprabasal layers. In normal hair follicles, the OKB19 reactivity was also confined to one layer of the dermal side of the outer root sheath. However, this reactivity gradually disappeared in the lower areas. The inner surface of the lumina in the eccrine duct was weakly stained with OKB19. The basal keratinocytes were also stained with OKB19 in the lesional epidermis of the various dermatoses examined in this study, when the basal keratinocytes remained unaffected. Even in the hyperproliferative state of psoriasis, the OKB19 reactivity was confined to the basal layer. Several kinds of tumor cells derived from the skin were not stained with OKB19. No labeling was seen even in the basaloid cells of basal cell carcinoma, which are morphologically similar to basal keratinocytes. B4 and Leu‐12, other monoclonal antibodies reacting with CD19, did not recognize any keratinocytes in the normal human skin. MoAB OKB19, therefore, reacts with an antigen present on basal keratinocytes and provides a probe for the isolation of the basal keratinocyte subpopulation. Thus, this antibody should be useful in studies of not only B‐lymphocyte differentiation, but also normal and aberrant differentiation of the epidermal keratinocytes.
Lymphomatoid Papulosis: Clinicopathological Comparative Study with Pityriasis Lichenoides et Varioliformis Acuta
Authors: Erpaiboon Prayoon , Mihara Ichiro , Niimura Michihito
Published: April 2015

We have compared the clinical and histopathological features of 6 patients with lymphomatoid papulosis (LP) and 14 patients with pityriasis lichenoides et varioliformis acuta (PLEVA). There were some differences between the clinical features in the two diseases, including the size and appearance of skin lesions and the duration of the course of disease. Ki‐1 Ag positive, large, atypical, lymphoid cells were always seen in lymphomatoid papulosis; none of lymphoid cells of pityriasis lichenoides et varioliformis acuta demonstrated this antigen. We conclude that lymphomatoid papulosis and PLEVA, although sharing some common features, should be considered to be different clinical and immunopathological entities.
Immunohistochemical Differential Diagnosis between Lymphocytoma Cutis and Malignant Lymphoma in Paraffin‐embedded Sections
Authors: Toyota Noriaki , Matsuo Shinobu , Iizuka Hajime
Published: April 2015

A panel of monoclonal antibodies (Leucocyte Common Antigen [CD45], LN‐1 [CDw75], LN‐2 [CD74], LN‐3, L‐26, UCHL‐1 [CD45RO] and MT‐1) which identify B and T cell surface markers were applied to benign lymphocytoma cutis and malignant lymphoma of the skin in paraffin‐embedded sections.

In five cases of lymphocytoma cutis, both B and T cell markers were positive, consistent with the polyclonality of the proliferative lymphocytes. In contrast, in two cases of B cell lymphoma, only the B cell markers were positive, consistent with the monoclonality.

Furthermore, the immunohistochemistry clarified lymph follicle structures of lymphocytoma cutis. These were occasionally not evident in routine hematoxylin and eosin stained sections.

Thus an immunologic phenotyping study combined with other appropriate criteria for histologic evaluation and clonal gene rearrangement analysis appears to be useful in distinguishing reactive from neoplastic lymphoid lesions of the skin.
A Case Report of EMO Syndrome Showing Localized Hyperhidrosis in Pretibial Myxedema
Authors: Kato Naoko , Ueno Hiroo , Matsubara Miyao
Published: April 2015

We describe here a case of EMO syndrome, which is defined as a combination of exophthalmos, pretibial or localized myxedema, and hypertrophic osteoarthropathy. A 34‐year‐old Japanese man with Graves' disease developed the characteristic eye changes. He showed 22 mm protrusion of both eyes and hypertrophy of the right lateral rectus muscle as well as both superior rectus muscles by computerized tomography. He subsequently developed lightly erythematous, indurated, nonpitting, peau d'orange plaques and nodules on his lower legs. Finally, he developed Graves' acropathy with hypertrophic osteoarthropathy in the metacarpal bones. Histological examination of myxedematous skin showed typical deposition of mucin accompanied by changes in the amount and distribution of elastic fibers. In addition, the lesional skin showed localized hyperhidrosis, a rarely reported complication of pretibial myxedema. We speculate that this hyperhidrosis of the lesional skin was brought about by stimulation of peripheral sympathetic nerves by surrounding mucin deposition, in the setting of poorly controlled hyperthyroidism.
Leiomyosarcoma of the Skin with Generalized Metastases: Electron Microscopic and Immunohistochemical Study
Authors: Kinoshita Shinsuke , Hirai Akio , Izaki Seiichi , Kitamura Keijiro , Itoyama Shinji , Mukai Makio , Okamura Rieko
Published: April 2015

A 62‐year‐old woman with numerous (more than 50) tumors between 25 and 75 mm in diameter disseminated over most of her body surface is reported. Biopsied tissue specimens demonstrated that the tumors consisted mainly of spindle‐shaped cells with nuclear pleomorphisms and relatively high mitotic rates. They were irregularly arranged; they sometimes mimicked storiform‐ and palisading‐patterns.

Immunohistochemistry revealed that the tumor cells were positive for muscle‐specific actin, desmin, and myosin, but negative for S‐100 protein. Electron microscopy confirmed myofilaments and dense patches in the cytoplasm. The metastatic potential of such leiomyosarcoma of the skin is indicated.
Efficacy of Bimolane in the Malassezia ovalis Model of Psoriasis
Authors: Xu Bin , Noah Patricia W. , Skinner Robert B. , Bale George , Chesney Thomas McC. , Rosenberg E. William
Published: April 2015

Bimolane, an analog of razoxane has been used in China with comparable efficacy but less toxicity than razoxane in the treatment of psoriasis. In an attempt to characterize further its mode of action it was administered both systemically and topically in the Malassezia ovalis animal model of psoriasis.

Intravenous methotrexate and topical 0.1% betamethasone valerate were also used as positive control treatments.

The animal model of psoriasis was effectively treated by bimolane, both systemically and topically, and also by parenteral methotrexate and topical betamethosone valerate.

The time course of bimolane's effect with this model was different from methotrexate's suggesting the possibility of a different mode of action.

Because bimolane, like razoxane, is an ethylene diamino tetraacetate acid (EDTA) derivative, it is possible that its effects on this reaction relate to its chelating properties and that inhibition of complement activation is important to its mode of action.
Hair Growth on Nude Mice Due to Cyclosporin A
Authors: Watanabe Shinichi , Mochizuki Akihiko , Wagatsuma Keiko , Kobayashi Miyuki , Kawa Yohko , Takahashi Hisashi
Published: April 2015

One of the most common dermatological side effects of cyclosporin A (CsA) is dose‐dependent hypertrichosis. Similar hair growth was noted in nude mice in an attempt to increase the acceptance of human xenografts with CsA in the T‐cell‐deficient congenitally athymic nude (nu/nu) mice. The aim of the present study was to further investigate the stimulation of hair growth on nude mice not only by oral administration of CsA but also by topical and subcutaneous administration of CsA. Young BALB/c female nude mice were treated for 3 or 4 weeks with topical, oral, or subcutaneous applications of CsA dissolved in olive oil at various doses. The hair of CsA‐treated mice appeared to grow from 7 days after the treatment, even at low doses. Induced hair growth was dose‐dependent and became clearly obvious 3 weeks after the treatment. The stimulation of hair growth was not restricted to the site of topical application. The distribution of the new hair depended on the natural pattern of hair growth in the mice. However, there was no hair growth in the control mice which were given only olive oil. Histological examination revealed that there were no differences in the structures of skin and hair between the control and the CsA‐treated mice. Furthermore, the number of hair follicles did not remarkably increase after CsA treatment. The hair growth in the CsA‐treated mice stopped after cessation of the treatment and returned to the level of the control mice on day 14 after the end of the treatment. Subsequent retreatment with CsA resulted in further regrowth of the hair. However, old nude mice (9 months old) revealed no hair growth at the end of a 4‐week treatment with CsA.
Keratin Expression in Merkel Cells of Fetal Rat Skin
Authors: Nindl Margit , Nakagawa Hidemi , Ishibashi Yasumasa
Published: April 2015

The cytokeratin expression of Merkel cells in fetal rat skin was studied by light‐ and electron microscopy. Employing a pre‐embedding staining method, 2 monoclonal anti‐keratin antibodies (RCK‐102, MA‐902) were shown to stain Merkel cells specifically. Neighbouring keratinocytes were unstained. The staining reaction seems to be based on the expression of 52.5 kD cytokeratin.
AgNOR (Nucleolar Organizer Regions) Staining in Malignant Melanoma
Authors: Nagatani Tetsuo , Iemoto Gaijiro , Miyakawa Kanata , Ichiyama Shinichi , Takahashi Yasuhide , Uchiyama Mitsuaki , Nakajima Hiroshi
Published: April 2015

Nucleolar organizer regions (NORs) are loops of ribosomal DNA seen in nuclei, which are demonstrable as black dots (AgNOR) in tissue sections by silver (Ag) colloid staining. The number of such AgNORs is correlated with cellular activity and is an indicator of the degree of malignancy. In this study, 76 melanocytic lesions were analyzed by AgNOR staining, and the clinical and histopathological characteristics of malignant melanoma and melanocytic nevi were considered. Although the AgNOR counts for melanocytic nevi were significantly different from those in malignant melanoma, an obvious overlap between them was detected. The number of AgNORs in melanocytic nevi per cell was usually 1 or 2. On the other hand, the number of AgNORs per malignant melanoma cell was variable. Morphologically, malignant melanoma cells often showed dispersal of AgNORs throughout the nucleus as well as multiple nucleoli containing clustered AgNORs, whereas melanocytic nevus cells tended to have a regular nucleolus with tightly clustered AgNORs. The correlation between AgNOR count and pathological staging was uncertain, but a slight correlation between AgNOR count and thickness of the primary lesion was obtained. However, the AgNOR count in malignant melanoma was not a prognostic factor for the disease. Therefore, the AgNOR method is difficult to use for differential diagnosis between benign pigmented lesions and malignant melanoma. Nonetheless, an AgNOR count of more than two per cell favors a diagnosis of malignant melanoma.
Characterization of an Immortalized Human Cell Line Derived from Neonatal Foreskin Diploid Fibroblasts
Authors: Chiang Lien‐Chai , Chiang Wen , Chang Shui‐Feng , Chen Hour‐Young , Yu Hsin‐Su
Published: April 2015

A new human skin cell line, designated as CCFS‐1/KMC, immortalized from human neonatal foreskin diploid fibroblast cells, has been subcultured successfully in vitro for more than 500 passages. This anchorage‐dependent cell line possesses many common features of transformation such as morphological and cytoskeletal changes, hypotriploidy, infinite lifespan, increasing plating efficiency and saturation density, and decreasing serum requirement and population doubling time. Human papillomavirus (HPV) type 18 DNA was detected in the cell line before and after immortalization by the polymerase chain reaction (PCR) method. Tumorigenicity, however, was not demonstrated in vivo. The isoenzyme activity of the cell line shows activation of a placental form of alkaline phosphatase and a changing lactate dehydrogenase isoenzyme pattern that is different from transformation by carcinogens. Class I HLA and class II HLA antigens are constitutively expressed on this skin cell line. Here we report that these immortalized human fibroblasts derived from neonatal HPV‐18‐DNA‐contained diploid fibroblasts possess double minute chromosomes (DMs), a karyotypic aberration usually found in cancer cells.
The Effect of Human Anaphylatoxins and Neutrophils on Histamine Release from Isolated Human Skin Mast Cells
Authors: Kubota Yasuo
Published: April 2015

The concept of mast cell heterogeneity has been studied extensively. Recently developed techniques to enzymatically disperse skin mast cells from human skin have shown that skin mast cells are somehow different from those of other organs such as lung and intestine. In this report, we have isolated and partially purified human skin mast cells from human neonatal foreskins by collagenase and hyaluronidase digestion. These mast cells are morphologically intact by histological, immunohistochemical and electron microscopic criteria. These human skin mast cells secrete histamine significantly (max. net histamine release, 20~30%) in a dose‐related, temperature‐ and time‐dependent fashion following stimulation with purified human C5a and C3a (over the ranges of 5 × 10–8 M to 10–7 M and 3 × 10–7 M to 6 × 10–6 M, respectively).

On the other hand, interactions between human skin mast cells and other leukocytes have long been suspected of playing a very important role in cutaneous inflammation. Recently, a human neutrophil‐derived histamine‐releasing activity termed HRA‐N was partially purified. HRA‐N has been shown to cause human and rat basophil leukemia cells to degranulate. This study was also undertaken to assess the ability of HRA‐N to directly induce histamine release from isolated human skin mast cells. HRA‐N causes dose‐ and time‐dependent histamine release as do human anaphylatoxins. These results suggest that HRA‐N may lead to a better comprehension of allergic and inflammatory reactions and their modulation in the skin.
Churg‐Strauss Syndrome: Report of a Case without Preexisting Asthma
Authors: Chen Ko‐Ron , Ohata Yoshiyuki , Sakurai Misa , Nakayama Hideo
Published: April 2015

A 38‐year‐old male with no history of asthma, who initially presented with episcleritis and subsequently developed symptoms of systemic vasculitis with marked blood eosinophilia, was diagnosed as having Churg‐Strauss syndrome (CSS). Both the patient's skin lesions and pulmonary infiltrates revealed histologically proven vasculitis with predominantly eosinophilic infiltration.

All the symptoms of systemic vasculitis except the persisting peripheral neuropathy dramatically improved after corticosteroid was systemically used.

Since scattered non‐asthmatic cases of CSS have been reported recently, and three such patients have died of acute heart failure due to delayed diagnosis, absence of asthma should not be regarded as an absolute criterion for exclusion of the diagnosis of CSS. Earlier recognition of this disease is important, since earlier institution of steroid therapy can prevent the acute onset of fatal cardiac involvement during the course of this disease.
The Effects of Interferon‐β on Phorbol Ester or Calcium Ionophore‐induced Intercellular Adhesion Molecule‐I Expression in Epidermal Carcinoma Cells
Authors: Fujisawa Hiroshi , Naito Yukiko , Horiuchi Sanae , Baba Toru , Otsuka Fujio
Published: April 2015

Keratinocyte intercellular adhesion molecule (ICAM)‐I expression is induced by interferon (IFN)‐γ. It has been previously reported that IFN‐β suppresses IFN‐γ‐induced ICAM‐I expression in A431 cells, a human squamous cell carcinoma cell line. In this study, the suppresion mechanisms were investigated at the post second messenger level. Both 12‐O‐tetradecanoylphorbol‐13‐acetate (TPA) and calcium ionophore (A23187) induce ICAM‐I expression in A431 cells. ICAM‐I expression induced by either was not suppressed with cotreatment with IFN‐β. Furthermore, IFN‐β did not inhibit the translocation of protein kinase C (PKC) by TPA. It appears that the pathways involved in ICAM‐I expression induced by activation of PKC or increased in intracellular Ca+ are not affected by IFN‐β.
Cutaneous Leiomyosarcoma
Authors: Ikari Yuko , Tokuhashi Itaru , Haramoto Izumi , Morita Makoto , Chiba Toshiko , Shimoda Nagayoshi , Mizoguchi Masako , Seki Kenjiro , Tadokoro Mamoru , Ohya Kazumitsu
Published: April 2015

A child's head‐sized tumor on the upper back developed in a 43‐year‐old man. In spite of an extensive operation for the tumor, he died of multiple metastasis 15 months after the operation. Histologically, tumor cells proliferated throughout the dermal and subcutaneous regions, and a boxed‐in appearance was noted with silver staining. Because electron microscopic observations strongly suggested a smooth muscle origin, we diagnosed this case as cutaneous and subcutaneous leiomyosarcoma.
Eruptive Pruritic Papular Porokeratosis
Authors: Kanzaki Tamotsu , Miwa Norimasa , Kobayashi Taisuke , Ogawa Shigeru
Published: April 2015

Three cases of an unusual variant of porokeratosis (Mibelli) were described. Patients with disseminated superficial porokeratosis for some years suddenly developed intensively pruritic erythematous papules. Skin biopsies revealed that these papules contained cornoid lamellae on their tops. Pruritic papules subsided in several months, leaving slightly hyperkeratotic brown annular lesions which were shown to contain typical cornoid lamellae histopathologically. This type of porokeratosis has not been reported in the literature.
Primary Systemic Amyloidosis: An Unique Case Complaining of Diffuse Eyelid Swelling and Conjunctival Involvement
Authors: Iijima Shigeruko
Published: April 2015

A 52‐year‐old Japanese woman with the chief complaint of marked swelling of her upper eyelids and a mass over the bulbar conjunctiva is reported. She previously noticed frequent purpura after minimal trauma, which was resolved shortly after taking some ascorbic acid. Laboratory data showed Ig‐G κ type M‐protein in the serum and κ type Bence‐Jones protein in the urine by Immunoelectrophoresis. Systemic examination showed mild hepatosplenomegaly, 1st degree of AV block, and a mild increase in plasma cells in the bone marrow biopsy. Histologically, the whole dermis of the eyelid skin and conjunctiva was replaced by a large quantity of amorphous, eosinophilic substances, which were diffusely positive with Direct Fast Scarlet 4BS. Immunohistochemical staining was positive for anti‐amyloid P component antibody. Typical amyloid fibrils were proved by electron microscopy. She was finally diagnosed as primary systemic amyloidosis with diffuse swollen eyelids and conjunctival mass, symptoms which in primary systemic amyloidosis are very rare.
An Association of Acanthosis Nigricans and Crouzon Syndrome
Authors: Koizumi Hiroko , Tomoyori Takako , Sato Kazuko C. , Ohkawara Akira
Published: April 2015

An 11‐year‐old Japanese female having acanthosis nigricans associated with Crouzon syndrome is reported. Crouzon syndrome is a craniostenotic craniofacial malformation associated with premature closure of selective calvarial sutures, exophthalmos, maxillary hypoplasia, and a beak‐shaped nose. It is an autosomal dominant inherited disorder. Crouzon syndrome is one of the syndromes which may be associated with acanthosis nigricans. The association of acanthosis nigricans with Crouzon syndrome is assumed to be a rare abnormality, although the true frequency is uncertain. We have reviewed the reported cases of acanthosis nigricans associated with Crouzon syndrome and characteristics were discussed.
Clinicopathological and Immunohistochemical Study of Basal Cell Carcinoma with Reference to the Features of Basement Membrane
Authors: Kirihara Yoshinobu , Haratake Joji , Horie Akio
Published: April 2015

One hundred and thirty‐five cases of basal cell carcinoma (BCC) were investigated, focusing upon factors determining a postoperative prognosis. Out of the 135, nine tumors on the face recurred. All of these nine tumors were insufficiently extirpated at the initial operation, and showed micronodular or infiltrative patterns with stromal fibrosis. Dividing the degree of dermal invasion into four levels, all tumors with recurrence reached levels 3 and 4, the two deeper groups. The immunohistochemical study using anti‐laminin and anti‐type IV collagen antibodies showed various changes of staining pattern around tumor cell nests, such as attenuation, disruption, and thickening of basement membrane, in contrast with the normal thinly continuous staining around nontumorous control epidermis. The disruption of basement membranes was remarkable around the tumor cells showing a micronodular growth pattern, although the discontinuity of basement membrane was observed in all types of BCCs to a greater or lesser degree. Ultrastructural thickening, multiplication, or discontinuity of basement membranes were found in all 19 cases examined with a greater or lesser degree, although they were most frequently observed around the cell nests showing micronodular growth patterns. It was concluded that deep dermal and marginal invasions were the most ominous signs of recurrence of BCCs. Although the disruption of basement membranes might participate in the local aggressiveness of BCCs, especially in the tumor cells showing micronodular infiltrative growth, other factors may concern the recurrence of BCCs.
A Case of Neutrophilic Dermatosis (ND) Complicated by Cryofibrinogenemia (CFGN) and Myelodysplastic Syndrome (MDS)
Authors: Watanabe Ryoji , Iijima Masafumi , Otsuka Fujio
Published: April 2015

A case of neutrophilic dermatosis (ND) complicated by cryofibrinogenemia (CFGN) and myelodysplastic syndrome (MDS) is reported. Although the patient presented pancytopenia, the skin lesions were compatible with those of ND from the clinical and histopathological findings.

Further, immunofluorescence technique revealed cryofibrinogen (CFG) deposits on the walls of the blood vessels in the skin lesion, and a high titer of CFG components was disclosed in the patient's peripheral blood. In this case, CFGN may have been associated with MDS; hence CFG deposits probably played a role, at least in part, in the skin lesion formation. This is probably the first case of ND complicated by CFGN. And careful examination of an underlying disease is recommended in association with ND and/or CFGN.
A Case of Congenital Trichofolliculoma
Authors: Ishii Norihisa , Kawaguchi Hiroshi , Takahashi Kazuo , Nakajima Hiroshi
Published: April 2015

A case of congenital trichofolliculoma on the right cheek of a 3‐month‐old boy is reported. Trichofolliculoma usually appears in middle age; it is unusual in childhood. This is the first reported case of congenital trichofolliculoma.
Epidermal Changes in Active Vitiligo
Authors: Hann Seung Kyung , Park Yoon‐Kee , Lee Kwang‐Gil , Choi Eung Ho , Im Sungbin
Published: April 2015

Light and electron‐microscopic studies were performed on the vitiligo and adjacent, normal appearing skin from 97 patients with actively spreading vitiligo and 19 patients with stable vitiligo. The vitiliginous skin revealed complete loss of pigment and melanocytes. In addition to degenerative changes in melanocytes, vacuolar changes of basal cells, epidermal infiltration of lymphocytes, dermal infiltration of lymphocytes, and melanophages in the upper dermis were also seen in the normal appearing skin adjacent to vitiliginous skin. These epidermal and dermal changes are more prominent in the skin of actively spreading vitiligo than in stable vitiligo. These findings suggest that the adjacent, normal appearing skin of actively spreading vitiligo shows some characteristic histopathologic findings, especially in the epidermis, indicating that cellular immunity could be involved in the pathogenesis of vitiligo.
Angiosarcoma of the Thigh with Thrombosis in the Femoral Artery
Authors: Miyamoto Torn , Mihara Motoyuki , Iwasaki Kazumi , Mishima Erika , Shimao Shuhei , Miyamoto Hisashi
Published: April 2015

We report a case of angiosarcoma with some peculiar clinical features developing on the left thigh of a 63‐year‐old man. The early primary lesion was erythematous with necrotic areas. The initial biopsy specimen of the lesion indicated a benign angioproliferative process. However, the necrotic area enlarged rapidly, ulcerated with severe pain, and thus was widely excised. The excised specimen had a malignant histologic appearance, particularly in the fascia, and was diagnosed as angiosarcoma. Following local recurrence, the lesion was complicated by thrombosis of the femoral artery at the affected site. A similar cutaneous lesion subsequently arose on the right lower leg, and thrombosis developed in the right femoral artery. Both legs had to be amputated. There were no distant metastases.
Reticulate Acropigmentation of Kitamura: A Case Report
Authors: Erel Arzu , Ozarmagan Guzin
Published: April 2015

A Turkish female patient from Eastern Anatolia is described with the clinical and histopathological features of reticulate acropigmentation of Kitamura (RAK). The brother of the patient, who has similar clinical features, refuses to give a biopsy specimen. No similar lesions are noted on the other members of the patient's family. We have found the case worthwhile to report, since case reports on RAK from ethnic groups other than Japanese are still rare at present.
Melanocytic Neoplasia of the Sole: Diagnosis and Therapeutic Approach
Authors: Stefano Zurrida , Cesare Bartoli , Claudio Clemente , Fausto Chiesa , Aldo Bono , Natale Cascinelli
Published: April 2015

We examined retrospectively a series of 184 cases of melanocytic neoplasia of the sole observed and treated as out‐patients from January 1977 to December 1987, comparing clinical and histological diagnoses. The original clinical diagnoses were divided into nevi, pigmented lesions of suspected malignancy, cutaneous melanomas and others. Of the 170 cases diagnosed clinically as nevus none was of melanoma. The risk that a pigmented skin lesion diagnosed as clinically benign is melanoma is so low as not to constitute a clinical problem. It is concluded that systematic removal of sole nevi is unjustified. If, however, there is the smallest doubt concerning a sole lesion, it should be removed and examined histologically.
Levels of Serum IgE, Serum Soluble‐FcεRII, and FcεRII(+) Peripheral Blood Lymphocytes in Atopic Dermatitis
Authors: Kawai Keiichi , Kawai Kyozo , Kamei Nobuaki , Kishimoto Saburo
Published: April 2015

Levels of serum IgE, serum soluble‐FcεRII (S‐FcεRII), and FcεRII(+) peripheral blood lymphocytes (PBL) were examined in 73 patients with atopic dermatitis (AD) and 17 control subjects with no atopic disease, in order to investigate the correlation of these parameters with AD. AD patients showed increases in IgE, S‐FcεRII and FcεRII(+)PBL as compared with control subjects. In AD patients, levels of serum IgE and FcεRII(+)PBL increased as the extent of dermatitis became more severe, while levels of serum S‐FcεRII showed no correlation with the extent of dermatitis. In 8 of the 73 AD patients who showed an improvement in their symptoms with treatment with topical corticosteroids or antihistamine, IgE, FcεRII(+)PBL, and S‐FcεRII were measured before and after treatment. FcεRII(+)PBL correlated with disease activity; IgE and S‐FcεRII did not show any such correlation.

Patients with elevated IgE levels (IgE >5,000 U/ml) showed low levels of S‐FcεRII. Severely affected cases with a history of respiratory atopy also showed decreased S‐FcεRII levels. It is believed that S‐FcεRII binds to IgE in serum and may neutralize or down‐regulate IgE mediated allergic reactions. A low level of S‐FcεRII may cause an elevation of IgE and an exacerbation of the disease.
Optimization of Murine Keratinocyte Culture for the Production of Graftable Epidermal Sheets
Authors: Rouabhia Mahmoud , Germain Lucie , Bélanger François , Guignard Rina , Auger François A.
Published: April 2015

The aim of the present study was to optimize murine epidermal cell cultures in order to obtain graftable sheets. Newborn (1–3 days old) Balb/c mice skin were used to optimize culture media and plating cell concentration, then epidermal sheet production, and grafting.

Epidermal cells were plated at various concentrations in different culture media containing low (0.1 mM) or high (>1 mM) Ca2+ levels. After a 3 day culture at the 104 cells/cm2 plating cell concentration, the percentage of differentiated cells was more than 80% in the high Ca2+ culture medium and less than 50% with bulky cells in the low Ca2+ culture medium. Under these conditions confluence was not obtained. At the 105 cells/cm2 seeding inoculum, the percentage of confluence increased to 95–100% during the first 72 h of culture in both high and low Ca2+ culture media. Three‐day‐old culture showed stratified multilayer epidermal sheets in the high calcium medium, and monolayer epidermal sheets were present in the low calcium medium after seeding keratinocytes in fibronectin precoated flasks. Seven days after plating, post confluent cultures were composed of a high percentage of differentiated cells (90%) with an increase in shedding cells in the medium.

Considering the above morphological observations, sheets obtained with 105 cells/cm2 in MCDB‐153 (A), DME‐HAM (B) or GMEM (C) media after 3 days in culture were grafted. Twenty days after grafting, histological analysis of biopsies showed an epidermal structure and organization comparable to normal murine epidermis without hair follicles. Epidermal transplants showed a complete basement membrane, hemidesmosomes, and tonofilament bundles. Sheets obtained after seven day culture in all media showed lower coverage of the wound bed.

These studies point out the importance of the plating cell and Ca2+ concentrations, and the culture time for murine keratinocyte confluence and differentiation to obtain graftable epidermal sheets.
Organ Culture of Human Hair Follicles Derived from Different Areas of the Body
Authors: Kondo Shigeo , Hozumi Yutaka , Sato Noriaki , Aso Kazuo
Published: April 2015

Whole human hair follicles derived from the scalp, chin, axilla, and pubis were organ cultured. The hair follicles were dissected from excised normal skin pieces and placed in 1.0 ml of incubation medium in a closed 5 ml glass tube under an atmosphere of air + 5% CO2. The tube was rolled at 15 rpm and 36°C. The hair follicles from each area of the body grew linearly for about 6 days, both in serum‐plus and serum‐free media with or without fibroblast growth factor (FGF). The growth rates were slightly slower in serum‐free media than in serum‐plus media. No significant differences in the growth rates of hair follicles in organ culture were seen in different areas of the body. FGF did not affect the growth rate or the culture term of the hair follicles in vitro.

This is the first report of human hair follicles derived from chin, axilla, and pubis growing well for about a week in organ culture.
An Epidemiological Study of Methicillin‐resistant Staphylococcus aureus (MRSA) Isolated from Medical Staff, Inpatients, and Hospital Environment in One Ward at Our Hospital
Authors: Nishijima Setsuko , Sugimachi Tomoko , Higashida Toshiaki , Asada Yasuo , Okuda Kazuyuki , Murata Kenjiro
Published: April 2015

Methicillin‐resistant Staphylococcus aureus (MRSA) is one of the most important causative microorganisms for nosocomial infections. Recently, the incidence of isolation of MRSA has been increasing every year in Japan and is, notably, much more frequently found in inpatients than in outpatients. Therefore, we have done epidemiological studies of MRSA isolated from medical staff, inpatients, and the hospital environment in one ward of our hospital. Thereafter, we examined the antibiotic susceptibility (ABPC, DMPPC, CET, CMZ, IPM, GM, MINO, OFLX, EM, CLDM, VCM), phage typing, and coagulase typing of these MRSA MRSA were isolated more frequently from anterior nares of inpatients than from doctors and nurses. MRSA were isolated more frequently from the environment near carriers of MRSA

Coagulase type II and phage type N.T. (not typable) were the dominant types of MRSA in our hospital (69% and 61%). MRSA strains were resistant to most antibiotics with a few exceptions (VCM, IPM, CMZ, CET).

The high isolation frequency of MRSA in our hospital seems to suggest that inpatients who are carrying MRSA spread MRSA throughout the hospital environment and that the anterior nares of inpatients are the major MRSA harbor.
A Case of Contact Dermatitis Due to Methylprednisolone
Authors: Aramoto Yoko , Uemura Tomoko , Akiyoshi Emiko , Murata Yasuko , Kawashima Makoto
Published: April 2015

A 46‐year‐old woman developed contact dermatitis on her face after application of an ointment containing 0.1% methylprednisolone and 0.35% fradiomycin. Her patch test result was positive with methylprednisolone, but not with fradiomycin. No cross‐reactions were observed after conducting patch tests with 17 different topical corticosteroids including prednisolone.
Acne Fulminans and 13‐Cis‐Retinoic Acid
Authors: Choi Eung Ho , Bang Dongsik
Published: April 2015

We report a case of acne fulminans occurring during treatment with 13‐cis‐retinoic acid for cystic acne. Continuing the treatment with 13‐cis‐retinoic acid without systemic steroid eventually cleared the systemic manifestations and skin lesions. We review the literature and discuss its pathogenesis.
Immunohistochemical Characterization of Cellular Infiltrates in Squamous Cell Carcinoma and Bowen's Disease Occurring in One Patient
Authors: Terao Hiroshi , Nakayama Juichiro , Urabe Atsumichi , Hori Yoshiaki
Published: April 2015

We investigated populations of the infiltrating cells in Bowen's disease (BD) and squamous cell carcinoma (SCC), both of which arose in the same patient, using the Avidin‐Biotin‐peroxidase complex method with eight monoclonal antibodies. T lymphocytes were most predominant among infiltrating cells; NK cells, B cells, and monocytes were rarely seen in either BD or SCC. Analysis of subsets of the infiltrating T lymphocytes revealed that the number of suppressor/cytotoxic (s/c) T cells was twice that of helper/inducer (h/i) T cells in BD, while the number of s/c T cells was lower than that of h/i T cells in SCC. The immunohistochemical results in the present case differed from those of predominant infiltration of h/i T cells and of s/c T cells in three other reports of BD and SCC.

These results suggest that the population of the cellular infiltrates may be modulated by the nature of tumors and by the immuno‐competent state of the hosts.
Fulminant Dermatomyositis after Removal of a Cancer
Authors: Abraham Zeev , Rozenbaum Michael , Glück Zahava , Feuerman Eleasar J.
Published: April 2015

Dermatomyositis developed suddenly in a diabetic patient with CREST syndrome after the removal of a malignant tumor. Scrupulous physical examination excluded further systemic or cutaneous involvement. We raise certain still unsolved aspects regarding the association between dermatomyositis and neoplastic disorders.
Inhibitory Effect of the Leukotriene B4 Receptor Antagonist against Hypomagnesic Diet‐induced Dermatitis in Hairless Rats
Authors: Hanada Katsumi , Mitsuhashi Yoshihiko , Hashimoto Isao
Published: April 2015

In vivo experiments have shown that magnesium deficiency elicits characteristic skin lesions in the hairless rat. However, the mechanism of the involvement is not clarified. From the results of previous studies, a product derived from arachidonic acid, but not via the cyclooxygenase pathway, has been considered as an etiological cause.

In this study, the inhibitory effect of newly produced leukotriene B4 (LTB4) receptor antagonist (LTBRA) against these skin manifestation was examined in hairless mutants given a hypomagnesic diet. Control animals with treatment of LTBRA developed eruptions on their bodies with increasing serum levels of LTB4, but LTBRA‐treated animals did not suffer from the cutaneous disorder. Increased serum levels of LTB4 in control rats were significantly higher than those in the pre‐treated condition. The diminution of skin lesions by LTBRA strongly indicated that magnesium deficiency dermatitis may involve a lipoxygenase‐mediated metabolite of arachidonic acid, presumably LTB4, and that the cutaneous changes in hairless rats fed with hypomagnesic diet might provide an easily identifiable indicator of LTB4‐mediated dermatitis.
The Induction of Ornithine Decarboxylase in Human Epidermis Is Independent of Lipoxygenase and Cyclo‐oxygenase Pathways
Authors: Arnold Wim Peter , Pennings Benno J.H. , van de Kerkhof Peter C.M.
Published: April 2015

In vivo studies in rodents suggest that prostaglandins and/or leukotrienes are involved in the epidermal induction of ornithine decarboxylase (ODC). Recently, we have shown that, in human epidermis, prostaglandins are not involved in this process. Here we report the role of leukotrienes in epidermal ODC induction in human skin. Topical flufenamic acid (DignodolinR), vehicle, or nothing was applied under plastic occlusion to three sites on the backs of healthy volunteers. This was followed 1 h later by SellotapeR stripping. After renewed application and occlusion for 8 h, biopsies were carried out for the estimation of ODC levels. There were no significant differences in the levels of ODC between the flufenamic acid treated and control sites. To confirm this finding, test sites were irradiated with 3 MED of UVB. This was immediately followed by the application of flufenamic acid, vehicle, or nothing to the three irradiated sites. After 8 h, biopsies were taken, and the levels of ODC were again similar in the flufenamic acid‐ and the vehicle‐treated sites. The data indicate that, following SellotapeR stripping or UVB irradiation, neither lipoxygenase nor cyclooxygenase products contribute to the in vivo induction of ODC in human epidermis.
Two Cases of Fabry's Disease: A Hemizygote with a Point Mutation in the α‐Galactosidase A Gene and His Relative
Authors: Inaoki Makoto , Otsuki Norio , Ishise Syozo , Ueda Yoshimichi , Sakuraba Hitoshi
Published: April 2015

A 34‐year‐old Japanese male had leg pain, edema of the legs, hypohidrosis, whorl‐like opacities of the bilateral cornea, bilateral subcapsular cataracts, and chest discomfort on exercise. He had no characteristic angiokeratomas but did have telangiectases. The electrocardiogram revealed high voltage. The echocardiogram revealed mild mitral regurgitation. The α‐galactosidase A activity in cultured lymphoblasts was deficient (0.5 nmol/h/mg protein). Electron microscopic examination of the skin revealed lamellar cytoplasmic inclusions in the endothelial cells, pericytes, and fibroblasts. He had a G—A transition at nucleotide 982 in the coding sequence of the α‐galactosidase A gene which resulted in a glycine to arginine amino acid substitution at residue 328. His uncle also had leg pain, edema of the legs, hypohidrosis, and chest pain on exercise. He had no characteristic angiokeratomas but did have telangiectases. Cardiovascular examination revealed hypertrophic cardiomyopathy and stenoses of coronary arteries. Electron microscopic examination of the skin revealed lamellar cytoplasmic inclusions in the endothelial cells, pericytes, and fibroblasts.