bluuebunny/crossref_metadata_2025 huggingface dataset:
Gangliosides Inhibit the Proliferation of Human T Cells Stimulated with Interleukin‐4 or Interleukin‐2
Authors: Morioka Naoko , Furue Masutaka , Tsuchida Tetsuya , Ishibashi Yasumasa
Published: April 2015

T cell growth factors such as interleukin‐2 (IL‐2) and interleukin‐4 (IL‐4) act as potent comitogenic factors for purified human T cells in the presence of phorbol myristate acetate (PMA). We investigated the effects of gangliosides on the IL‐4‐driven or IL‐2‐driven proliferation of human T cells, using these comitogenic assays. Bovine brain gangliosides inhibited the proliferation of human T cells activated by PMA + IL‐4 or PMA + IL‐2. These inhibitory effects were dose and time‐dependent and were significant at concentrations higher than 50 μM. PMA + IL‐2 stimulation was more sensitive to the inhibitory effects of gangliosides (I50=77.2 μM) than PMA + IL‐4 stimulation (I50=105.9 μM). Differential inhibitory effects were also examined among the panel of various gangliosides. GD1b and GT1b showed the most potent inhibitory actions in each assay; the inhibitory effect of GD1a was somewhat less potent than GD1b or GT1b. GM2 and GD3 were only weakly inhibitory, and the inhibitory effect of GM3 was almost negligible. These findings suggest that gangliosides may play an immunomodulatory role by interfering with IL‐4 or IL‐2‐driven proliferation of human T cells.
Acneiform Eruption Induced by Lithium Carbonate
Authors: Kanzaki Tamotsu
Published: April 2015

A 26‐year‐old female developed a severe acneiform eruption on her face, chest and back soon after she started taking lithium carbonate for psychosis. Histopathological examination revealed it to be folliculitis, rather than true acne. The eruption continued for six months but was resolved three months after discontinuing the drug. It has not reappeard in the following 3 years.
Immunolocalization of Desmoglein I (“Band 3” Polypeptide) on Acantholytic Cells in Pemphigus Vulgaris, Darier's Disease, and Hailey‐Hailey's Disease
Authors: Setoyama Mitsuru , Hashimoto Ken , Tashiro Masaaki
Published: April 2015

Acantholysis is defined as loss of coherence between epithelial cells and is histologically shown in several bullous diseases.

It was postulated that desmoglein I, one of the major transmembrane glycoproteins of the desmosome, may adhere to the attachment plaque inside the cell and contribute to desmoglea outside the cell.

In this study we used a well characterized antibody against desmoglein I for immunofluorescence and immunoelectron microscopic techniques on 2 cases each of pemphigus vulgaris and Darier's disease and one case of Hailey‐Hailey's disease.

In the normal epidermis desmosomes were demonstrated in dotted or rim‐like patterns along cell periphery on immunofluorescence study. In pemphigus vulgaris dotted or rim‐like patterns were still identified in many acantholytic cells, particularly in early phase of acantholysis. In Darier's disease and Hailey‐Hailey's disease, dotted or rim‐like patterns were already lost in early acantholysis and immunoreactive desmoglein I proteins were observed diffusely in the cytoplasm. Immunoelectron microscopy confirmed these immunofluorescence observations.

It was suggested that in pemphigus vulgaris desmoglein I is unlikely to be the primary site of acantholysis because dotted or rim‐like patterns of immunoreactive desmoglein I are relatively preserved on lesional cells, whereas in genodermatoses such as Darier's disease and Hailey‐Hailey's disease primary abnormalities of desmosomes may be involved in their acantholysis.
Morphological Characterization of Hemangiomatous Tumors Derived from a Novel Murine Vascular Endothelial Cell Line (F‐2)
Authors: Tsujioka Kaoru , Toda Ken‐Ichi , Maruguchi Yukiya , Miyachi Yoshiki , Imamura Sadao
Published: April 2015

Hemangiomatous tumors were induced in Balb/c nude mice by inoculating F‐2 cells (5 times 106) from a novel tumorigenic murine endothelial cell line which had been established and maintained in our laboratories. These tumors were morphologically investigated in the course of development. Subcutaneous hemorrhage was observed at the inoculation site within 12 hours after the injection of F‐2 cells, followed by development of skin tumors of various sizes at the same sites. They were dome‐shaped, glossy surfaced, black, soft tumors. Mice finally died of massive blood loss due to internal and/or external hemorrhage (on day 10–77). Light microscopically, F‐2 cells formed aggregates immediately after inoculation and then branched into a network of channels and cysts containing erythrocytes. Thereafter, spongiform structures composed of various sizes of cysts appeared with subsequent formation of a single large blood‐filled cyst lined by one or two layers of thin cells. Under an electron microscope, F‐2 cells, possessing large amounts of cytoplasm, formed narrow spaces which were occasionally incomplete with ambiguous basal lamina at the early stages. However, later, in large cysts, they became attenuated, tightly connected, and produced complete lumen surrounded by a basal lamina. Immuno‐histological demonstration of H‐2 K, D antigen showed that tumors induced by F‐2 cells mainly consisted of the inoculated F‐2 cells. These results indicate that F‐2 presents a good experimental system for investigation of vascular endothelial cell tumorigenesis and differentiation.
Penetration of Lysophosphatidylcholine into the Dermis
Authors: Uchida Yoshikazu , Ogawa Tadatomo , Ohta Masao , Kondo Mitsuo , Takada Shigeo , Yamamura Masaichi
Published: April 2015

The ability of Lysophosphatidylcholine (LPC) to penetrate into the dermis and its degradation were investigated in vivo using hairless rats. Phosphatidylcholine (PC) was used as a control. Radioactively labelled LPC and PC were applied on the surface of skin, and the radioactivities of the epidermis and dermis were measured at 8, 24, and 48 hours. The recoveries of radioactive materials of LPC and PC within the area of epidermis and dermis at 8 hours were 0.21% and 0.25%; at 24 hours, 0.68% and 0.31%; and at 48 hours, 0.42% and 0.92%. No radioactivity was detected in serum. The radioactive substances which had penetrated were identified as LPC, PC, diglycerides, and free fatty acids. It was also found that topical application of LPC did not change the structure of skin as seen by microscopical examination.

These findings indicate that a small amount of LPC can penetrate without the damaging skin structure and is enzymatically degraded into several lipids. Since LPC has bactericidal and antiviral activity, this substance could be an useful agent for dermatological use.
Late Phase Allergic Reaction to a CT Contrast Medium (Iotrolan)
Authors: Kanzaki Tamotsu , Sakagami Hiroshi
Published: April 2015

A 46‐year‐old male developed wide‐spread erythema and edema after intravenous injection of a CT contrast medium (iotrolan). The skin eruption appeared at 6 h, reached a maximum at 9 to 12 h, and faded within 36 h after injection. A challenge with an intradermal injection of the agent provoked the same reaction where the eruption had originally appeared, but had no effect on previously unaffected regions. Histopathologic examination revealed a perivascular infiltration of small round cells, and a few neutrophils, and eosinophils in the dermis and focal spongiosis in the epidermis. This is the first report of a late phase allergic skin reaction induced by iotrolan.
Experimental Production of DLE Lesion with a Single Exposure to UVB (2.7 MEDs) Radiation
Authors: Higuchi Dousei , Ogura Yukari , Watanabe Hideyoshi , Takiuchi Iwao
Published: April 2015

Keratotic erythematous lesions developed on the face, ears, neck, and upper back of a 38‐year‐old man. The patient had a history of photosensitivity to sunlight manifested by the development of new lesions. One week after an MED (2.7 mJ/cm2) was determined using UV‐B light, persistent erythema with fine scales were observed at test sites irradiated over 72 mJ/cm2. These lasted for at least 2 months. A biopsy specimen obtained from the test site irradiated at 72 mJ/cm2 showed liquefaction degeneration of the basal cell layer. Within the upper part of the dermis, perivascular and disseminated lymphocytic infiltrates were seen. However, when irradiated again under the same conditions 7 and 12 months after the initial phototest, no persistent erythema was observed.
Trigeminal Trophic Syndrome
Authors: Tada Joji , Ueda Masumi , Abe Yoshiko , Fujiwara Hideki , Arakawa Kenzo , Arata Jirô
Published: April 2015

Three Japanese patients with trigeminal trophic syndrome, a rare dermatosis in Japan, were reported. Cutaneous lesions were a long‐standing ulcer and destruction of the right ala nasi in case 1, a persistent deep ulceration on the forehead after a small trauma in case 2, and development of small, discrete ulcers on the right forehead during the treatment of a postherpetic neuralgia in case 3. A protective device was very effective in one patient.
Milialike Idiopathic Calcinosis Cutis and Syringoma in Down's Syndrome
Authors: Kanzaki Tamotsu , Nakajima Masaru
Published: April 2015

A 6‐year‐old girl with Down's syndrome presented milialike whitish small papules on her hands and feet and periorbital syringoma. Histopathological examination of the hand lesion revealed small localized calcium deposits and syringoma in the adjacent upper dermis. This is a very rare but typical case of calcinosis cutis with syringoma in a patient with Down's syndrome.
A Case of Cutaneous Metastases of Gastric Carcinoma Showing Peculiar Clinical Features
Authors: Miyashita Mitsuo , Honjo Michio , Suzuki Hiroyuki , Yamagami Hiroaki , Shioda Atsuo , Arakawa Yasuyuki , Matsuo Yutaka
Published: April 2015

A 52‐year‐old male patient presented with multiple cutaneous nodules on the face, trunk, and upper extremities. Examination of a skin biopsy specimen disclosed numerous signet ring cells throughout the dermis. Histopathologic examination of the stomach, along with gastroscopy, revealed that the cutaneous metastases were of gastric origin.

The metastatic skin lesion on the shoulder and the back of the patient grew relatively rapidly, showing an erysipelas‐like lesion followed by prominently large tumor masses. The clinical appearance seen in our case is thought to be rare.

Radiotherapy and chemotherapy appeared to be effective in reducing some tumors and the swelling on the anterior of the neck, and in prolonging life.
Differentiation Disorders of Keratinocytes in Seborrheic Keratosis (Acanthotic Type)
Authors: Fujisawa Hiroshi , Naito Yukiko , Muraki Ryouichi , Baba Torn
Published: April 2015

Since the differential disorder of keratinocytes in seborrheic keratosis remains to be elucidated, the differentiation of seborrheic keratosis (acanthotic type) was examined immunohistochemically using a lectin and two anti‐keratin monoclonal antibodies. A lectin, peanut agglutinin (PNA), and anti‐keratin monoclonal antibody, 34betaB4, recognize the whole epidermis except for the basal layer in the normal epidermis. In seborrheic keratosis (acanthotic type), cells unstained with either PNA or 34betaB4 were found throughout the entire tumor. In the upper part of the tumor, some cells appeared to undergo keratinization without expressing the differential markers recognized by PNA or 34betaB4. Another anti‐keratin monoclonal antibody, 34betaE12, stained the tissues in the same way as in the normal epidermis. Thus it was indicated that, in seborrheic keratosis (acanthotic type), although differentiation was partially maintained, some cells might undergo maturation without expressing the differentiation markers recognized by PNA or 34betaB4.
Factor XIIIa Expression in Pseudo‐Kaposi Sarcoma
Authors: Murakami Yoshiyuki , Nagae Shonosuke , Hori Yoshiaki
Published: April 2015

A 39‐year‐old man had pseudo‐Kaposi sarcoma on his left foot. A biopsy specimen obtained from a cutaneous lesion showed increased numbers of vascular spaces, proliferation of fibroblast‐like spindle cells, and deposition of hemosiderin in the dermis. Immunohistochemically, proliferative fibroblast‐like spindle cells around the vessels were positive for anti‐factor XIIIa antibody. Excessive heat radiation was detected from the skin lesions by thermography.
Chalazion Coexisting with Dacryolithiasis
Authors: Nishimura Masayuki , Hori Yoshiaki
Published: April 2015

A 41‐year‐old woman presented with a painless hard subcutaneous nodule in the right upper eyelid. The lesion was diagnosed clinically as pilomatricoma and removed surgically. Histological examination disclosed a granulomatous lesion composed mainly of mononuclear cells with a foamy appearance and multinucleated giant cells with some admixture of granulocytes, plasma cells, and lymphoid cells. Lipid droplets and dilated ductal structures containing an eosinophilic fibrillar substance were observed in and around the granulomatous lesion. In addition, an intraductal dacryolith was seen near the granulomatous lesion. We finally diagnosed this case as chalazion; the coexisting dacryolithiasis was considered to be involved in the pathogenesis of chalazion.
H1 Histones Contribute to Candidacidal Activities of Human Epidermal Extract
Authors: Kashima Masato
Published: April 2015

In the study of the purification of candidacidal cationic proteins from human epidermis by using high performance liquid chromatography, it was found that these proteins were composed of several groups. Among them, the most active group was purified. The amino acid compositions of this protein group were almost the same as those of human splenic H1 histones. The results of immunoblotting suggested that the proteins were human epidermal H1 histones. The killing speed of the epidermal H1 histone was very rapid, 8 μg of the protein killed 90% of Candida tropicalis (1 times 105 CFU) within 10 minutes. The cidal activity increased in lower pH conditions and decreased at higher ionic strengths. Because nuclei of the epidermis disintegrate in the granular layer, it is suggested that, in this layer, nuclear histones may be released from the nuclei. My immunohistochemical results suggest that H1 histones may contribute to form a barrier which inhibits candida from invading deeper than the granular cell layer in cases of skin candidial infection.
Intralesional Human Leukocyte Interferon Treatment Alone or Associated with IL‐2 in Non‐AIDS Related Kaposi's Sarcoma
Authors: Ghyka Gregory , Alecu Mihai , Halalau Florin , Coman Gabriela
Published: April 2015

Patients with classical European Kaposi's sarcoma were treated by intra‐ and peritumoral injections of human alpha leukocyte interferon (IFN) (12 cases) or, alternatively, with IFN and naturally synthesized IL‐2 (8 cases).

All the patients were HIV negative with tumors which had been present for at least six months. In each patient, one tumor received 1 ml (50,000 IU) IFN alone or alternatively associated with 1 ml IL‐2 twice a week for 4–6 weeks; another nodule situated 10–12 cm away was considered as a control and remained uninjected. The clinical follow‐up revealed that, in the same patient in the same anatomical area, the treated nodule was cured in all the investigated cases; the untreated one was not. These data strongly suggest that IFN is the factor responsible for the involution and final cure of these Kaposi tumors treated by perilesional inoculations. Association with IL‐2 (and certainly also other interleukins) increases the beneficial clinical activation of the tumor involution.

Histological examination showed that important histopathological changes occur in the treated nodules: complete disappearance of the Kaposi's aspect, fibrosclerous modifications progressively replacing the fibroblasts characteristic of Kaposi's sarcoma, abundant infiltrations of leukocytes, especially lymphocytes and necrotic patches, often with hemorrhagic centers. IL‐2 association seems to especially induce this last type of histological phenomenon.
Inoculation Lupus Vulgaris
Authors: Sehgal Virendra N. , Jain Sanjiv , Gupta Rakesh
Published: April 2015

An 11‐years‐old girl with lupus vulgaris on the right buttock following inoculation is described. The diagnosis was formed by the history, morphological characteristics, Mantoux test, histopathology, and was supported by an affirmative response to short course intensive chemotherapy (6 months). This route of infection acquires special significance with the worldwide‐spread of HIV infection.
Langerhans Cells, Inflammation Markers and Human Papillomavirus Infections in Benign and Malignant Epithelial Tumors from Transplant Recipients
Authors: Viac Jacqueline , Chardonnet Yvette , Euvrard Sylvie , Chignol Marie Christine , Thivolet Jean
Published: April 2015

Organ transplant recipients frequently develop warts which progress toward premalignant or malignant lesions after a rather long grafting period. The local immune responses of such lesions (warts, condyloma acuminata, actinic keratoses, Bowen, basal and squamous cell carcinomas) was studied in 32 frozen skin specimens taken from 15 male transplant recipients and compared to similar lesions from the normal population. We studied the expression of T cell subsets, Langerhans cell phenotype, HLA class 1 (β2‐microglobulin), HLA class 2 (DR antigen), and intercellular adhesion molecule 1 (ICAM 1). The presence of HPV infection was also considered, using in situ hybridization with biotinylated probes in order to examine the correlation with immunological markers. In the dermis, the lesions from grafted patients showed a moderate to intense inflammatory reaction of HLA‐DR‐positive cells. Most of these cells were CD4+ and CD8+ without any predominance of a single T cell subset. In the epidermis, most lesions were characterized by a reduced number of CD1‐positive cells; this was concomitant with a decrease or a loss of β2‐microglobulin expression by epithelial cells. HLA‐DR antigen was not expressed by keratinocytes or tumoral cells in any specimen; ICAM 1 antigen was observed in a few cases. The expression of these markers was similarly modified with or without the presence of HPV DNA. Conversely, most lesions from non‐immunocompromised patients, except warts, showed intense inflammatory reactions, with a predominance of CD4‐positive cells and large foci of ICAM 1‐positive cells. Expression of activation markers by keratinocytes occurred mainly in condylomas and squamous cell carcinomas. In the normal population, HPV infection was only detected in papilloma lesions. These data indicate, in lesions from grafted patients, a lack of effective immune response with partial inhibition of activation markers expressed by keratinocytes. It is conceivable that immunosuppressive treatment with solar exposure may also be responsible for the local immune deficiency and thus for the conversion of benign warts toward malignant lesions in grafted patients.
Detection of Selenium in Generalized and Localized Argyria: Report of Four Cases with X‐ray Microanalysis
Authors: Matsumura Tetsuri , Kumakiri Masanobu , Ohkawara Akira , Himeno Hiroshi , Numata Tsunemi , Adachi Riri
Published: April 2015

Electron microscopic and X‐ray microanalytic studies were performed on four cases of argyria; one generalized and three localized. Deposition of electron dense granules was predominantly found on elastic fibers and around basal laminas of secretory portions of eccrine glands, although the amount of deposition was much less in the case of generalized argyria. In all four cases, X‐ray microanalysis revealed that the depositions consisted mainly of silver, selenium, and sulfur. The importance of selenium in the detoxification of heavy metals was discussed.
Malignancy and Interstitial Pneumonitis as Fatal Complications in Dermatomyositis
Authors: Hidano Akira , Torikai Sayori , Uemura Tomoko , Shimizu Satoru
Published: April 2015

By sending questionnaires to the major dermatological clinics in Japan, we examined the outcome and causes of death in 182 cases of dermatomyositis (DM) observed between 1983 and 1987. The mortality rate in adults was 26.7%. Associated malignancy occurred in 47 cases (25.8% of adults), and 16 of them died of neoplasms. In contrast to 43 carcinomas, only 1 patient died of lymphoma. Associated interstitial pneumonitis (IP) appeared in 31 cases. IP started simultaneously or within 6 months after the diagnosis of DM in the majority of these cases. Of the 13 fatal cases due to IP, 8 died of respiratory failure within two months of the onset of lung disease. In the malignancy group, periungual erythema was noted in a higher proportion. Raynaud's phenomenon was more frequently noted in the IP group. DM overlapped with other collagen diseases in 14 cases.
Reduction of Environmental Mites Improved Atopic Dermatitis Patients with Positive Mite‐patch Tests
Authors: Kubota Yumiko , Imayama Shuhei , Hori Yoshiaki
Published: April 2015

During a series of studies on the involvement of house dust mite antigens in 183 cases of atopic dermatitis, we observed an improvement in two patients following the removal of mites from their environment by means of a thorough housecleaning and replacement of the mattress. Both patients manifested the typical clinical skin lesions of atopic dermatitis and had similar laboratory findings. Although the serum IgE concentrations and specific IgE to Dermatophagoides pteronyssinus and Dermatophagoides farinae were each relatively low, the results of patch tests with these antigens were positive. Thus, a regimen aimed at reducing the presence of house dust mites can produce clinical improvement in a subset of patients with atopic dermatitis who show contact hypersensitivity to mite antigens on skin testing, but negative results on IgE (RAST; radioallergosorbent technique) testing.
A Case of Lymphadenosis Benigna Cutis of the Earlobe: An Immunohistochemical Study
Authors: Murata Yasuko , Toyoda Hiroyuki , Nogita Toshitatsu , Kawashima Makoto , Hidano Akira , Kasajima Takeshi
Published: April 2015

We report a 38‐year‐old woman who developed an erythematous nodule on her earlobe after wearing pierced‐type 18‐carat gold earrings. Biopsy specimens revealed dense cellular infiltration predominantly composed of lymphocytes and plasma cells in the dermis and subcutaneous tissue with formation of lymph follicles. Morphological and immunohistochemical analyses were compatible with lymphadenosis benigna cutis.
Superficial Epithelioma with Sebaceous Differentiation
Authors: Kato Naoko , Ueno Hiroo
Published: April 2015

In 1980, Rothko, Farmer, and Zeligman first described the disease entity “Superficial epithelioma with sebaceous differentiation” as a histologically distinct, rare, benign lesion. We report here the first Japanese case fitting this description. The patient is a 38‐year‐old Japanese woman, who had a small, yellow, flat‐topped, well‐defined plaque on her right upper eyelid. Histologically, the lesion was a multilobular, superficial, dermal tumor with numerous broad attachments to the overlying epidermis. The overall configuration was a plate‐like proliferation of tumor cells with well‐defined borders. The tumor cells were basically uniform basaloid cells with single or clustered sebocytes in the upper part of the tumor and multiple well differentiated sebaceous lobules in the middle and lower parts of the tumor. Multiple cystic spaces were formed in the lobules. Differential diagnosis of several tumors with sebaceous differentiation is discussed.
The Ultrastructural Histopathology of Eosinophilic Pustular Folliculitis
Authors: Horiguchi Yuji , Mitani Tsuneo , Ofuji Shigeo
Published: April 2015

The follicular skin lesions of a patient with eosinophilic pustular folliculitis were investigated by electron microscopy. Pustules in the outer root sheath contained acantholytic keratinocytes with numerous microvilli and features of desmosomal cleavage. The infiltrating eosinophils and neutrophils exhibited autolytic or degenerative changes rather than degranulation. The aggregated tubulo‐vesicular structures were associated with the debris of autolytic eosinophils. Multiple, tiny, bubble‐like structures enclosed within a membrane were frequently seen in the intercellular space. The intercellular space of the outer root sheath was widened with decreased desmosomal adhesion between the keratinocytes, but no intracellular edema was detectable. The infiltrating lymphocytes, predominantly T‐cells with convoluted nuclei, extended cytoplasmic processes to adjacent keratinocytes. Apposition of T‐lymphocytes and Langerhans cells was noted. Some keratinocytes in the outer root sheath contained large, sebaceous lipid droplets. No obvious virus particles or other pathogenic agents were detected. It is possible mat T‐lymphocytes and other immunosurveillance cells are involved in the pathomechanism of eosinophilic pustular folliculitis.
Tsutsugamushi Disease in the Central Part of Japan
Authors: Kanno Yuko , Taniguchi Yoshiki , Sakamoto Takayoshi , Shimizu Masayuki , Ando Katsuhiko
Published: April 2015

Two cases of tsutsugamushi disease misdiagnosed initially as drug eruption were reported. Clinical symptoms of both cases disappeared dramatically after starting minocycline. Statistical examinations were performed on 29 cases of tsutsugamushi disease, including those observed in Mie Prefecture since 1982. Half of them were seen in the last 2 years. The onset was predominantly recorded in November (59%). Presumptive sites of infection were forests (63%) and fields (21%). No patients were infected along river‐banks.
“Giant” Senile Sebaceous Hyperplasia
Authors: Kato Naoko , Yasuoka Atsushi
Published: April 2015

Although the usual size of senile sebaceous hyperplasia is 2 to 3 mm in diameter, we report one “giant” nodular case on the face. The patient is a 75‐year‐old Japanese man with a dome‐shaped, skin‐colored nodule on his right cheek. The lesion was 10 mm in diameter and had multiple small umbilications on its surface. He also had several small, yellow‐colored, asymptomatic papules with central umbilication on his cheeks. Histologically, the giant nodule and the papule on the right cheek showed the same architectural pattern, a sharply demarcated hyperplasia of grouped mature sebaceous glands with a sebaceous converging duct, whose opening to the surface epithelium corresponded to the clinical umbilication. The reason for the giant growth of this senile sebaceous hyperplasia in our case is obscure; the patient had not been stressed by inductive agents or factors such as systemic corticosteroid and hemodialysis except for electrocoagulation on the lesion. In spite of the extraordinarily large size of the nodule, the conservative proliferating pattern seemed to show the benign hyperplastic character of senile sebaceous hyperplasia.
A Case of Intravascular Malignant Lymphomatosis (Angiotropic Large‐cell Lymphoma) Presenting Memory T Cell Phenotype and Its Expression of Adhesion Molecules
Authors: Setoyama Mitsuru , Mizoguchi Shimako , Orikawa Tamiko , Tashiro Masaaki
Published: April 2015

A case of intravascular malignant lymphomatosis (angiotropic large cell lymphoma), T cell type was reported. The patient, a 59‐year‐old woman, had reddish or violaceous indurated macules scattered over the entire body surface. Neither lymphadenopathy nor hepatosplenomegaly was recognized.

A chest Roentogenogram, whole body CT scan, and 67Ga‐citrate scintigraphy yielded normal findings. Serum anti‐HTLV‐1 antibody was negative.

Histopathologically, lesions showed intravascular large mononuclear cell proliferation associated with occasional fibrin thrombi formation in the dermis to subcutis.

Immunohistochemically, the large mononuclear cell immuno‐phenotype had a memory T cell character. Also, both lymphocyte function‐associated antigen‐1s, CD11a and CD18, and intercellular adhesion molecule‐1 were demonstrated on the tumor cells and vascular walls in the lesions.

To our knowledge, the present case is the fourth case of intravascular malignant lymphomatosis in the T cell lineage.
Eosinophil Phenotypes in Bullous Pemphigoid
Authors: Tsuda Shingo , Miyasato Minoru , Iryo Kayoko , Nakama Takekuni , Kato Keiko , Sasai Yoichiro
Published: April 2015

Eosinophil phenotypes were investigated in peripheral blood and skin lesions from eight patients with bullous pemphigoid (BP). By Nycodenz density gradients fractionation, blood eosinophils were divided into two phenotypes; normodense (>1.080 g/ml) and hypodense (>1.080 g/ml). Increased numbers of hypodense eosinophils were observed in the blood from all patients with BP. Immunocytochemical observations, using an EG2 monoclonal antibody to react with the secretion form of eosinophil cationic protein (ECP), revealed that EG2 was expressed in 86 ± 3% of hypodense phenotypes and 3 ± 2% of normodense phenotypes. Ultrastructurally, hypodense eosinophils were characterized by numerous spheroidal granules, each with a lytic crystalloid core. These indicate that the hypodense phenotype represents a cell in an activated state. Only eosinophils with immunocytochemical and morphological characteristics similar to hypodense phenotypes infiltrated around the basement membrane zone in involved skin of BP. Furthermore, direct adherence of eosinophils associated with degranulation into basal keratinocytes was seen at the sites of blistering lesions. Bullous fluids contained higher concentrations of ECP than sera as determined by a radioimmunosorbent assay; thus hypodense (activated) eosinophils may directly damage the basal keratinocytes by releasing their granule proteins, subsequently leading to dermo‐epidermal separation.
Palindromic Morphea: Multiple Recurrence of Morphea Lesions in a Case of Systemic Sclerosis
Authors: Mizutani Hitoshi , Tanaka Hideyuki , Okada Hiroaki , Mizutani Tomoko , Shimizu Masayuki
Published: April 2015

We report an unusual scleroderma case. A 45‐year‐old woman had recurrent morphea lesions over 10 times in 6 years. She had had preceding inactive systemic scleroderma. New morphea lesions developed cyclically on various portions of her body and improved within 2 years. Interestingly, new lesions have developed on once involved skin as well as uninvolved skin. No exacerbation of systemic scleroderma was induced by outbeaks of new morphea lesions. We could not find a similar case in the literature and named it “Palindromic morphea” because of its unique clinical course.

D‐penicillamine treatment had a limited effect. Minimal oral predonisolone (5 mg/day) completely suppressed the multiple recurrence of the morphea lesions and enhanced improvement of the sclerosis.
A Unique Case of Cutaneous Calcinosis with Transepidermal Elimination
Authors: Majima Makiko , Kanai Takako , Oh‐i Tsunao
Published: April 2015

A case of cutaneous calcinosis with unique clinical and histological features which occurred on the cheek of a 14‐year‐old girl, is reported. Our case had no abnormal findings in laboratory data. Serum calcium and phosphate were normal, there was no underlying disease, and the possibility of self‐inflicted dermatoses was denied. Transmission electron microscopy and X‐ray microanalysis showed calcium and phosphate deposited around collagen fibers, which were eliminated from the epidermis.
Trichilemmal Cyst: Report of a Case in Which the Cyst Was Connected with the Epidermis by an Epidermal Canal
Authors: Dekio Satoshi , Jidoi Joji
Published: April 2015

An 87‐year‐old Japanese woman with a trichilemmal cyst (TC) on the subnasal area is described. Histopathological examination revealed that the cyst was connected with the overlying epidermis by an epidermal canal. This has suggested that the pathogenesis of TCs could be that they originate from the isthmus or lower portion of the hair follicle.
Blood Vessels and Immunoreactive Substance P‐Containing Nerve Fibers in Rat Skin Treated Topically with Clobetasol Propionate, a Corticosteroid
Authors: Oura Hajimu , Takeda Katsuyuki , Daikoku Shigeo
Published: April 2015

After applying topically a cream (0.1 ml) containing corticosteroid (clobetasol propionate), on rat back skin, we examined the morphological alterations of blood vessels, substance P‐containing nerve fibers, and cutaneous mast cells. After 3, 6, 10, 15, 30, and 60 min and 4 h, the skin treated was cut out with a sharp knife after killing the animals. The skin pieces were processed into conventional histological sections cut vertically and examined by staining immunohistochemically with anti‐substance P serum, by staining with toluidine blue for mast cell granules, and by estimating morphometrically the average areas of vascular cavity and the number of substance P fibers in the dermis. In the dermis and subcutaneous tissue of untreated skin, we found many immunoreactive SP‐containing nerve fibers and mast cells in close association. Three to ten min after the treatment, the average area of the vascular cavities steadily increased, and SP‐positive fibers became less frequent in the dermis. In concomitant with those events, cutaneous mast cells discharged their granules. Thereafter, the average area of vascular cavities gradually decreased to a minimum at 4 h after the treatment. In contrast, both SP‐containing fibers and mast cells reestablished their initial states after the same duration.
Photosensitivity in Atopic Dermatitis: Demonstration of Abnormal Response to UVB
Authors: Keong Chin‐Huai , Kurumaji Yuko , Miyamoto Chizu , Fukuro Shuhei , Kondo Seiji , Nishioka Kiyoshi
Published: April 2015

It is a well‐known fact among clinicians that sunlight may exacerbate atopic dermatitis (AD), but little is known beyond that. In a preliminary study investigating this phenomenon, 19 patients with AD were selected for phototests. All of them had a normal minimal erythema dose (MED). However, 3 patients (15.7%) demonstrated abnormal cutaneous responses 24–72 h after provocation with ultraviolet light B (UVB). None of the patients had a positive response to pure ultraviolet light A (UVA) irradiation of up to 9 J/cm2. The photobiological results of this study confirm the existence of photosensitivity in AD and indicate that UVB wavelengths are responsible for it.
Triple Cancers in the Urogenital Area of a Patient with Aplastic Anemia
Authors: Sato Kazuko C. , Furuta Yasushi , Takasu Tsuyoshi , Nagashima Kazuo , Fukaya Toru , Koizumi Hiroko , Ohkawara Akira , Yamashiro Katsushige , Kawashima Kunihiro , Yoshida Tetsunori
Published: April 2015

Three epithelial neoplastic lesions, perineal Bowenoid papulosis, uterine cervical carcinoma, and bladder transitional cell carcinoma, which occurred in a mildly immunosuppressed patient who had aplastic anemia were studied for human papillomavirus (HPV) infection. In the Bowenoid papulosis, HPV type 16 DNA was identified by polymerase chain reaction (PCR) and by in situ hybridization (ISH). In contrast, in the uterine cervical carcinoma, HPV 16 was not detected, although possibly another unidentified type of HPV in the lesion was suggested by the ISH findings. In the bladder transitional cell carcinoma, neither papillomavirus genus‐specific (PGS) antigen nor HPV DNA was found.
Ingrown Toenails: An Evaluation of Elevating the Nail Bed‐Periosteal Flap
Authors: Umeda Tadashi , Nishioka Kiyoshi , Ohara Kazunori
Published: April 2015

Many procedures to correct ingrown toenails are available; however, they cannot avoid recurrence and nail deformities. We have performed a procedure which corrects ingrown toenail without reducing the width of the nail plate by elevating the nail bed‐periosteal flap. Sixty patients were observed for longer than six months and exhibited excellent results. Only two cases of incurvated nails (2) required re‐operation.
Lichen Planus Annularis: An Immunohistochemical Study
Authors: Ohta Yukinori , Yonemoto Kohzoh , Asai Toshiko , Yaguchi Atsushi
Published: April 2015

Lichen planus annularis is a relatively rare skin manifestation of lichen planus. The mechanisms in the formation of annular lesions are not fully understood. We reported here a 57‐year‐old female with this disease. The eruption initially occurred as lichen‐papules, then enlarged (bean‐sized, umbilicated small plaques), and finally developed annular manifestations. We performed immunohistochemical examinations of specimens taken from different types of eruptions.

In all specimens, HLA‐DR was expressed in the focal keratinocytes adjacent to the dermal HLA‐DR positive cell infiltration. Both in the initial papule and in the final annular lesion, expression of ICAM‐1 was present only in the keratinocytes above the dermal cell infiltration, similar to HLA‐DR. It is of interest that, in the umbilicated small plaques, the peripheral epidermis other than the central site extensively reacted to ICAM‐1. LFA‐1 expression was most prominent in the mononuclear cells impinging on the dermo‐epidermal junction in all specimens. In addition, in the periphery of the umbilicated small plaques, which showed no bandlike dense cell infiltration nor degeneration of basement membrane, TNF‐alpha, but not LFA‐1, was positive in the infiltrated cells of the upper dermis.

These results suggest that expressions of ICAM‐1 and TNF‐alpha in the peripheral keratinocytes and dermal infiltrated cells are important molecular events in the mechanisms of formation of the annular lesions.
Restriction of Cicatricial Pemphigoid Antigens to the Lamina Densa: Confirmation by Indirect Immunoelectron Microscopy
Authors: Horiguchi Yuji , Tanaka Toshihiro , Akioka Narumi , Tachibana Takao , Azumi Hiroko , Furukawa Fukumi , Imamura Sadao
Published: April 2015

Circulating anti‐basement membrane zone (BMZ) antibodies in a patient with cicatricial pemphigoid (CP) were examined using an indirect immunofluorescence test, indirect immunoperoxidase electron microscopy, and Western blot analysis. An indirect immunofluorescence test on salt‐split skin revealed that the anti‐BMZ antibodies reacted solely to the dermal side at the separating epidermal‐dermal interface, and indirect immunoelectron microscopy on intact skin indicated localization of the corresponding antigens (CP antigens) over the lamina densa and within the lower half of the lamina lucida; there were no CP antigens beneath a melanocyte. Indirect immunoelectron microscopy on salt‐split skin demonstrated that the CP antigens were partly dissociated from, but restricted to, the lamina densa. Western blot analysis showed no differences in molecular weight between the CP antigens and bullous pemphigoid (BP) antigens. CP antigens, as detected by this patient's serum, appear to be constituted of molecules quite similar to BP antigens, but with different epitopes. CP antigens may be shed from basal cells and locate in the area of anchoring filaments, where they play a role in connecting basal cells to the underlying lamina densa.
The Comparison of Sun Protection Factor Values with Different Light Sources
Authors: Noda Toshiaki , Kawada Akira , Hiruma Masataro , Ishibashi Akira , Arai Seiichi
Published: April 2015

Sun protection factors (SPFs) were evaluated with three light sources (sunlight, a xenon arc solar simulator, and fluorescent lamps) in indoor and outdoor studies. Two types of light, UV‐A+B and UV+Visible, were obtained from the solar simulator. The untanned backs of twenty‐four healthy male volunteers were used as test sites. A broad spectrum sunscreen containing SPF 6, according to the manufacturer, was used. The sunscreen tested was applied at 2 mg/cm2. The actual SPF values were 4.8 with sunlight, 6.0 with UV‐A+B, 4.9 with UV+Visible, and 11.8 with fluorescent lamps. There were no significant differences between the SPF values with sunlight and those with the solar simulator; the SPF value for fluorescent lamps was significantly higher. The SPF with UV‐A+B of the solar simulator was similar to that with sunlight; the use of this light served to reduce pain on tested subjects. Therefore, UV‐A+B from the solar simulator seems to be the most appropriate artificial light source for evaluating sunscreens.
Proteus Syndrome: Report of the First Japanese Case with Special Reference to Differentiation from Klippel‐Trenaunay‐Weber Syndrome
Authors: Hagari Yoshitaka , Aso Miki , Shimao Shuhei , Okano Tohru , Kurimasa Akihiro , Takeshita Kenzo
Published: April 2015

This is the first report of a Japanese girl with Proteus syndrome. She presented with growth acceleration and precocious development of the left breast as well as macrodactyly, hemihypertrophy, a subcutaneous preaxillary mass, portwine stains, connective tissue nevi, and a depigmented macule. All these abnormalities were confined to the left side of her body. Although most of the manifestations fit those of Proteus syndrome, the presence of the portwine stains and hemihypertrophy also suggested Klippel‐Trenaunay‐Weber syndrome. The findings in our patient suggest that the most important characteristic distinguishing Proteus syndrome from Klippel‐Trenaunay‐Weber syndrome is the presence of functional abnormalities such as a growth spurt and precocious breast development. Proteus syndrome may be genetically different from the Klippel‐Trenaunay‐Weber syndrome.
Electron Microscopic X‐ray Microanalysis of Metals Deposited in Oral Mucosa
Authors: Kanzaki Tamotsu , Eto Hikaru , Miyazawa Shichiro
Published: April 2015

A 35‐year‐old woman exhibited bluish‐brown discoloration of her buccal mucosa suggesting malignant melanoma. Histopathological examination revealed that the pigment was not melanin but caused by metal deposits. Electron microscopically, metallic particles were located on the lamina densa of basal laminae at mucosal epithelium, nerve fibers, and bloodvessels and on the microfilaments of elastic fibers as well as in macrophages and fibroblasts. Electron microscopic point X‐ray microanalysis revealed that these metallic particles were composed of Ag, Se, Fe, Co, Cu, and S. Analysis suggests that these metals were derived from dental amalgam and that the discoloration was caused by amalgam tattoo.
Enhancing Effects of Fluorescein on β‐Lactam Rash II: Enhancing Effects of Fluorescein on Generalized Rash Induced by β‐Lactam Antibiotics in Guinea Pigs
Authors: Ikezawa Zenro , Sugihara Yoshiki , Ueno Junko
Published: April 2015

Healthy volunteers, who were receiving intravenous injections of cefclidin (CFCL) with frequent concomitant use of fluorescein (F) and oxybuprocain (O) in the eyes for measurement of ocular tension, developed drug eruptions at the high frequency of 66.7%. The injection of CFCL alone induced the eruptions at an incidence of 2.8%. The cause of this high eruption rate was thought to be the simultaneous treatment with F and/or O. Therefore, we conducted experiments with CFCL‐induced generalized rash (GR) in guinea pigs. Guinea pigs treated with F and O during both the phases of immunization and intraperitoneal elicitation developed CFCL rashes at a high frequency. This CFCL‐rash was augmented by the treatment with F during either phase, but not by the treatment with O. Skin testing induced delayed type hypersensitivity (DTH) reaction to O in some animals, but the DTH to F was not induced in animals immunized with F in complete Freund's adjuvant. Furthermore, F augmented rashes induced not only by CFCL but also by other β‐lactam antibiotics such as cefsulodin and sulbenicillin.

Accordingly, it is likely that F played a dominant role in the high incidence of drug eruptions during the volunteer trials with measurement of ocular tension.
Aneuploidy in Chronic Actinic Dermatitis
Authors: Bingsen Qiu , Kanghuang Liao , Hongzhen Ni
Published: April 2015

DNA content and cell cycle distributions in paraffin‐embedded blocks of 19 skin biopsy specimens from 17 patients with chronic actinic dermatitis (CAD) [8 patients showed typical actinic reticuloid (AR)] were estimated by DNA cytometry. Sixty‐three percent (12/19) of the skin specimens showed aneuploidy. In the 4 cases with the highest DNA indices (DI), ranging from 1.65 to 1.88 (mean: 1.84), the proportions of cells in S and G2/M phases were increased, ranging from 15–48% (mean: 20%) and from 64–76% (mean: 70.5%), respectively. In 8 cases with DI ranging from 1.15–1.75 (mean: 1.5), the proportion of cells in S‐phase was also increased, ranging from 30–90% (mean: 81.1%). Histologically, it seems likely that the relatively high frequency of aneuploidy, DI, and proportions of cells in the S and/or G2/M phases were not proportional to epidermal or vascular endothelial hyperplasia, but they might be related to dermal lymphoid infiltration.
Angiokeratoma of the Clitoris: A Subtype of Angiokeratoma Vulvae
Authors: Yamazaki Masashi , Hiruma Masataro , Irie Hiroya , Ishibashi Akira
Published: April 2015

A 24‐year‐old married woman had an angiokeratoma of the vulva measuring 3 × 3 × 4 mm localized at the clitoris. The nodule was noticed when she was pregnant with her first child. This tumor grew with occasional tenderness and bleeding during pregnancy, but its size did not change after delivery. The growth of this tumor might be attributable to an increase in venous pressure or serum progesterone levels; therefore this disorder might be classified as a subtype of angiokeratoma of the vulva. This is the first case of angiokeratoma localized at the clitoris.
Expression of CA 50 in Normal Human Skin: Comparative Study of CEA and CA 19‐9
Authors: Inaba Youichi , Egawa Kiyofumi , Kageshita Toshiro , Ono Tomomichi
Published: April 2015

Normal skin specimens from different body sites were estimated for the expression of CA 50 in comparison with CA 19‐9 and CEA. Expression of CA 50 and CA 19‐9 was observed in the ductal system and a small part of the secretory portion of eccrine units, but never in any other skin components including apocrine units. CEA was expressed on the ductal and a small part of the secretory portion of apocrine units as well as on those of eccrine units. However, the expression pattern and intensity in eccrine units were different from those of CA 50 or CA 19‐9.

We concluded that CA 50 was strongly expressed in the normal ductal system of eccrine units and hence could be standardized to stain the eccrine ductal portion and that immunohistochemical comparative studies with CA 19‐9 or CEA might be a good methodological technique for discriminating an eccrine or apocrine origin for some skin disorders.
Localized Basaloid Follicular Hamartoma
Authors: Kato Naoko , Ueno Hiroo , Nakamura Junnosuke
Published: April 2015

We report a 39‐year‐old Japanese woman with a 30 × 10 mm, skin‐colored, soft, hairless, irregularly elevated plaque in the left retroauricular area. Histologically, it consistently showed features of atypical hair follicles; some showed immaturely developed basaloid epithelial islands invaginated with condensed stromal cells, and others were replaced or associated with solid strands, branching cords, or lace‐like networks of undifferentiated basaloid cells. Although the clinical appearance of a typical localized basaloid follicular hamartoma is a plaque of alopecia, this case seems to be a variant, because the histological findings are so characteristic of the entity. The relationship of basaloid follicular hamartoma to other hair‐follicle derived tumors is also considered.