bluuebunny/crossref_metadata_2025 huggingface dataset:
Immunopathological Aspects of Etretinate Therapy in Lichen Planus
Authors: Simon Miklós
Published: April 2015

Biopsy specimens of involved and uninvolved skin were studied in 8 patients suffering from generalized lichen planus (LP) before and after successful etretinate treatment using murine monoclonal antibodies against several cell surface markers of effector and/or accessory cells of the immune system. In contrast to untreated LP‐lesions, in biopsies obtained after etretinate therapy from healed involved skin a markedly disintegrated HLA‐DR expression on keratinocytes and intraepidermal Langerhans cells and a nearly total loss of suppressor/cytotoxic T lymphocytes at the dermo‐epidermal interface were found. Our data emphasize the key position of the class II antigen expression on various immunocompetent cells, as a marker for a cell‐mediated immune reaction, on the other hand, stress the involvement of keratinocytes, Langerhans cells and suppressor/cytotoxic T lymphocytes in the pathogenesis of LP.
Immunohistochemical Study of Lysozyme in Various Benign Sweat Apparatus Tumors
Authors: Katsumata Michio , Ezoe Kazuhiko
Published: April 2015

We investigated the existence of lysozyme in various sweat apparatus tumors by adopting the avidin‐biotin‐peroxidase complex method. Positive reactions for lysozyme were found in four cases of apocrine cystadenoma, hidradenoma papilliferum, and an apocrine sweat apparatus benign tumor resembling “apocrine spiradenoma”, all of which derive from apocrine sweat apparatus. On the other hand, in ten cases of syringoma, eccrine hidrocystoma, clear cell hidradenoma, eccrine spiradenoma, and eccrine poroma, which derive from eccrine sweat apparatus, no positive stainings for lysozyme were obtained. In four out of five cases of mixed tumor of the skin, the apocrine type exhibited positive results. Two cases of syringocystadenoma papilliferum were negative for lysozyme. The investigation of lysozyme in various sweat apparatus tumors is useful in determining the direction of differentiation in these tumors.
Unusual Varicella Zoster Virus Infection in a Patient with Colon Carcinoma and Evans Syndrome
Authors: Hata Seiichiro , Tamaki Toshiharu
Published: April 2015

A 53‐year‐old Japanese woman with Evans syndrome and colon cancer had two episodes of herpes zoster. The first painful vesicular rashes involved the right lower abdomen and buttock and healed in one month. After one more month, a second attack occurred on the right thigh and leg and developed into generalized hemorrhagic lesions, which became crusted in about 90 days. The patient died 131 days after the second attack, when the lesions had almost subsided. Varicella‐zoster virus (VZV) was isolated on the 59th day of the second attack. Her intracutaneous reactions to VZV antigen was negative, but the humoral antibodies were continuously positive.
A Case of Pyoderma Vegetans Associated with Acne Conglobata
Authors: Fujita Masaru , Okamoto Shoji
Published: April 2015

A 41‐year‐old man visited our clinic because of vegetating plaques resembling pemphigus vegetans on his sacral and perianal areas. He had also suffered from acne conglobata since adolescence. A biopsy specimen taken from the perianal area showed marked acanthosis, exocytosis, and inflammatory infiltrates in the dermis, but no acantholysis. Direct and indirect immunofluorescent tests were negative for anti‐intercellular antibodies. Bacterial cultures from the lesions showed many different types of organisms. We diagnosed the case as pyoderma vegetans and discussed the relationship between pyoderma vegetans and other pyoderma.
Adenylate Cyclase System in Fetal Rat Keratinizing Epidermal Cells (FRSK Cells) and SV40‐transformed Human Keratinocytes
Authors: Takahashi Hidetoshi , Tamura Toshiya , Tsutsui Masato , Iizuka Hajime
Published: April 2015

The adenylate cyclase system of FRSK cells, a cultured cell line of fetal rat epidermal keratinocytes, and SV40‐transformed human keratinocytes was investigated. Stimulators of the human epidermal adenylate cyclase, epinephrine, adenosine, and prostaglandin E2 increased cyclic AMP levels of these cells. There were marked differences in the stimulatory effects; while epinephrine revealed a much stronger effect than the other stimulators in FRSK cells, epinephrine and prostaglandin E2 revealed similarly marked effects in SV40‐transformed cells. Histamine had little or only slight effect on the cyclic AMP levels of these cells. Cholera toxin and forskolin, which work on the stimulatory guanine nucleotide binding protein (Gs) and the catalytic component of adenylate cyclase, respectively, also increased cyclic AMP levels. Northern blot hybridization analysis revealed that both FRSK cells and SV40‐transformed human keratinocytes express mRNAs for the beta2‐adrenergic receptor, as well as the stimulatory and inhibitory guanine nucleotide binding proteins (Gs and Gi, respectively). The presence of Gs as well as Gi were confirmed by cholera toxin‐, and pertussis toxin (IAP)‐induced ADP‐ribosylation of membranous proteins of these cells. Our results indicate that both FRSK cells and SV40‐transformed human keratinocytes express the fundamental components of the adenylate cyclase system. These cell lines might be useful tools for the analysis of the adenylate cyclase system in epidermal keratinocytes.
Infiltration of Melanoma Cells into the Type I Collagen Gel
Authors: Kono Takeshi , Furukawa Masayoshi , Tanii Tsukasa , Taniguchi Shoji , Mizuno Nobuyuki , Ishii Masamitsu , Hamada Toshio
Published: April 2015

Melanoma cells were cultured on type I collagen gel, and the infiltration of those cells into the gel was observed. B16 murine melanoma cells initially adopted a spherical form on the gel, but they assumed a dendritic form after infiltration into the interior. The degree of infiltration increased very rapidly and was time‐dependent. No correlations between the growth rate or melanogenic activity and infiltrative potential were observed. When Syrian hamster and human melanoma cell lines were cultured, the degrees of infiltration varied. This culture system using collagen gel is considered to be a useful in vitro model of tumor cell invasion.
Treatment of PUVA‐ and Retinoid‐PUVA‐resistant Severe Psoriasis with Systemic Cyclosporin A
Authors: Takashima Akira , Morita Akimichi , Tsuji Takuo
Published: April 2015

Twenty patients with severe psoriasis were treated with the oral administration of 5 mg/kg/day of cyclosporin A (CyA) for 12 weeks. These patients had either failed to respond to or had become unresponsive to conventional treatments including PUVA, UVB, or combinations of etretinate and PUVA or UVB. Complete clearance and marked improvement were observed in 12 (60%) and 4 patients (20%), respectively. The average score of the Psoriasis Area and Severity Index (PASI) was 26.2 before treatment, decreasing to 18.3 in 2 weeks, 8.2 in 6 weeks, and 5.1 in 12 weeks of CyA treatment. There was a tendency for patients with lower blood levels of CyA to show smaller decreases in their PASI scores. In four patients who received skin biopsies, histological improvement was noted within 10 days of treatment; epidermal thickness had decreased by 32%, intraepidermal mitoses by 66%, and parakeratosis had disappeared almost completely. No clinical side effects or alterations in laboratory values were observed that required cessation of CyA. Exacerbations of psoriasis occurred in 11 of 16 patients within 6 weeks after stopping treatment. These results suggest that CyA could be the first choice of treatment for resistant severe psoriasis.
Acquired Perforating Dermatosis: Comparison of an Acquired Perforating Dermatosis and Perforation as an Incidental Histologic Finding
Authors: Kato Naoko
Published: April 2015

A 66‐year‐old Japanese woman with a rare acquired perforating disorder, usually called adult‐type reactive perforating collagenosis, is reported. The patient had poorly controlled diabetes mellitus with retinopathy under oral diabetic medication. She was found to have multiple papules and umbilicated nodules on the trunk and four extremities when she was admitted and examined for the origin of jaundice and severe pruritus of sudden onset. In the biopsy specimen, collagen fibers were observed to be eliminated from the dermis through epidermal tunnel‐like perforations. No elastic fibers were eliminated, and serial sectioning of the specimen could not prove follicular perforation. Adenocarcinoma of the biliary duct was found to be the cause of the jaundice with pruritus. Although such cases are usually classified as acquired reactive perforating collagenosis of adult onset, proposed reclassification for acquired perforating disorders is discussed. Another case which also showed perforation and transepithelial elimination of both collagen and elastic fibers as an incidental histologic finding is described. Such elimination seems to be a not uncommon step in the formation of pruriginous eruptions. Therefore, these cases should be differentiated from acquired‐type characteristic perforating disorders.
A Combined Case of Desmoplastic Trichoepithelioma and Nevus Cell Nevus
Authors: Fukui Yoshimasa , Ono Hiroki , Umemura Tadahiro , Hasegawa Morimasa
Published: April 2015

A 41‐year‐old woman with desmoplastic trichoepithelioma associated with pigmented nevus presented. Pigmented nevus had been present on her face at birth. She had received cryotherapy and dermabrasion at a small part of the pigmented nevus. As a result of the therapy, the discoloration disappeared. The lesion lately increased and became hard. Histologically, the lesion was composed of two distinctive but intimately mixed cellular components; nevus cells and basaloid cells. In the pigmented lesion, basaloid cells were not present. To our knowledge, this is the first reported case of desmoplastic trichoepithelioma associated with nevocellular nevus in Japan.
Proliferating Cell Nuclear Antigen/Cyclin in Cultured Human Keratinocytes
Authors: Okada Natsuko , Miyagawa Sachiko , Steinberg Mark L. , Yoshikawa Kunihiko
Published: April 2015

Expression of proliferating cell nuclear antigen (PCNA)/cyclin in cultured human keratinocytes was studied using an antibody from an SLE patient as the reagent. By indirect immunofluorescence staining, SV40‐transformed human keratinocytes expressed PCNA/cyclin in 40~45% of the cells as a nuclear granular fluorescence. After synchronization of these cells, their nuclear distribution pattern during the S phase was sequential and showed a clear correlation with DNA synthesis. Primary cultured keratinocytes grown in high Ca# medium expressed PCNA/cyclin in 10~15% of the cells with a similar staining pattern. These positively stained cells were confined to the basal and immediate suprabasal layers of the stratified culture sheet. The keratinocytes disaggregated by trypsin were separated according to cell size through a screen of Nitex monofilament cloth. The cells smaller than 15 µm in diameter synthesized abundant PCNA/cyclin, while the larger cells expressed very low levels. These results indicate that the expression of PCNA/cyclin correlates with DNA synthesis in cultured keratinocytes, but is not associated with their differentiation process.
Expression of Interleukin 1 in Burn Scars
Authors: Sawada Yukimasa , Takahashi Masaaki , Nomura Kazuo
Published: April 2015

A histochemical study using a Biotin‐Streptavidin procedure for demonstrating interleukin 1 (IL‐1) in burn scar specimens is described. Among seventeen scar specimens, five positive reactions to IL‐1 were observed in the epidermis. No positive reactions in the dermal tissue, however, were detected. The twenty specimens of normal skin used as controls showed no positive reaction in either the dermis or the dermis.
A Comparative Study of Fluorescence in Malignant Melanoma and Nevocellular Nevus Using a Fluorescence Microscope and Formalin‐fixed Specimens
Authors: Shukuwa Tetsuo , Nonaka Shigeo , Yoshida Hikotaro
Published: April 2015

Fluorescence in malignant melanoma cells was investigated. The specimens from 18 cases of malignant melanoma and 26 cases of nevocellular nevus, which were fixed with formalin and embedded in paraffin wax, were studied by the fluorescence microscopic method.

On the fluorescence microscope, the malignant melanoma cells emitted intense fluorescence from the cytoplasm. The nevus cells with large amounts of melanin granules showed moderate fluorescence. The tumor cells of melanoma in situ and nevus cells with few melanin granules emitted little fluorescence. Not only malignant melanoma cells but also nevus cells in the formalin fixed specimens had various degrees of fluorescence. Many cases of malignant melanoma emitted intense fluorescence, but this was rarely found in nevocellular nevus. This method is also useful in differentiating melanoma from nevocellular nevus.
Treatment of a Case of Mycosis Fungoides and One of Parapsoriasis en Plaque with Topical PUVA Using a Monofunctional Furocoumarin Derivative, 4,6,4'‐Trimethylangelicin
Authors: Morita Akimichi , Takashima Akira , Nagai Morihito , Dall'Acqua Francesco
Published: April 2015

A case of plaque stage mycosis fungoides and one of parapsoriasis en plaque were treated with topical PUVA therapy using a monofunctional furocoumarin derivative, 4,6,4'‐trimethylangelicin (TMA). Both patients showed complete clearance of eruptions within 16 treatments. The therapeutic effectiveness of TMA was confirmed by the fact that those eruptions exposed to UVA alone, without TMA application, showed slower and less significant improvement. Histologically, dermal infiltrates of mycosis cells and associated epidermotrophism disappeared almost completely in response to TMA PUVA. No side effects or changes in values in laboratory examinations were observed during treatment.
Gold Sodium Thiomalate (GTM) Induces Hypersensitivity to Thiomalate, the Thiol Carrier of GTM
Authors: Ikezawa Zenro , Kitamura Kazuko , Nakajima Hiroshi
Published: April 2015

A case of the gold sodium thiomalate (GTM)‐induced eruptions with thiomalate (TM) hypersensitivity was reported. A 61‐year‐old Japanese woman developed lichenoid and seborrheic dermatitis (SD)‐like eruptions with alopetia, when the total dosage of GTM administered for rheumatoid arthritis became 110 mg. The eruptions slowly disappeared with pigmentation after discontinuance of the GTM therapy, and the resumption resulted in the development of similar eruptions. She showed a positive reaction to GTM in an intradermal test. She also showed a positive response to TM, which is the thiol carrier of GTM, in the patch test, but a negative one to metallic gold. After administration of auranofin (AF), she also developed the SD‐like eruptions with hypersensitivity to metallic gold as well as AF on patch testing, but did not develop the lichenoid ones. Our animal experiments revealed an almost complete cross reaction between GTM and TM, but only a partial one between GTM and aurothioglucose, which have dissmilar structures in the carrier part for gold. Probable roles of hypersensitivity to TM and metallic gold, which are metabolites of GTM, were discussed, respectively, in the genesis of the GTM‐induced lichenoid eruptions and the AF‐induced SD‐like eruptions.
SH Abundant Body in Infantile Digital Fibromatosis
Authors: Kanamori Masashi , Hashimoto Kenji , Tanaka Hideyuki , Shimizu Masayuki
Published: April 2015

A case of infantile digital fibromatosis was studied with regard to the distribution of ‐SH groups and SS linkages, using N‐(7‐dimethylamino‐4‐methyl‐3‐coumarinyl) maleimide (DACM) stain. Tumor cells showed a strong fluorescence in the cytoplasm from the ‐SH stain. A brilliant ‐SH fluorescence was also homogenously present on the intracytoplasmic inclusions. SS reactivity was negative. Although further studies should be necessary to ascertain this finding, the DACM stain may make a simple and objective diagnostic method of infantile digital fibromatosis.
Dermal Nerve Sheath Myxoma
Authors: Yamashita Noriko , Minami Shoichiro , Yu Masaaki , Miyazaki Takao , Sagami Seiichiro
Published: April 2015

A case of dermal nerve sheath myxoma on the left palm of 26‐year‐old Japanese man is presented. We examined this tumor by light and electron microscopies. On light microscopic examination, this tumor was characterized by a multilobulated myxoid tumor composed of stellate cells in an abundant mucous matrix. This histological feature resembled previously reported cases of dermal nerve sheath myxoma. On electron microscopic examination, the findings of these tumor cells were similar to those of the perineurial cells. These microscopical examinations have provided evidence for an origin from perineurial cells rather than Schwann cells.
Intradermal Spitz Nevus Differentiated from Reticulohistiocytic Granuloma by Immunoreactivity to S‐100 Protein
Authors: Kato Naoko , Ueno Hiroo
Published: April 2015

A firm, dark reddish, smooth surfaced nodule on the forearm of a 16‐year‐old boy was diagnosed as a Spitz nevus with the aid of a strong positive reactivity to S‐100 protein. Histological examination revealed an intradermal epithelioid cell tumor with prominent multinucleated giant cells, suggesting the diagnosis of reticulohistiocytic granuloma. However, immunoperoxidase staining of the tumor cells showed strong positive reactivity to S‐100 protein and vimentin; it was negative for lysozyme and alpha‐1 antitrypsin. Although a few melanosomes in the tumor cells seen in electron microscopic examination provided crucial proof for the diagnosis of Spitz nevus, the positive reactivity to S‐100 protein in ordinary formalin‐fixed, paraffin‐embedded tissues proved to be very useful in the differentiation of Spitz nevus from tumors of histiocytic origin, especially those of the mononuclear phagocytic system.
A Possible Pathogenesis for Blackfoot Disease
Authors: Chen Gwo‐Shing , Asai Toshiya , Suzuki Yuhsuke , Nishioka Kiyoshi , Nishiyama Shigeo
Published: April 2015

Blackfoot disease (BFD) is an endemic peripheral vascular occlusive disease found among the inhabitants of the southwest coast of Taiwan. The clinical features of BFD are similar to those of Buerger's disease. Pathology shows arteriosclerosis obliterans and thromboangiitis obliterans. The high arsenic content of artesian well water in the area is regarded as the main causal factor of this disease. Therefore, the purpose of this study was to observe the toxic effects of various arsenic concentrations on cultured human umbilical vein endothelial cells (HUV‐EC). The methods of this study included cell growth assay, 51Cr‐release assay, and staining of Factor VIII related antigen (FVIII‐RAg) and Ulex europaeus agglutinin I (UEA‐I) binding sites of HUV‐EC. The following data were obtained: 1) no obvious cytotoxicity in 51Cr‐release assay; 2) inhibition of the synthesis of both FVIII‐RAg and UEA‐I binding sites when the arsenic concentration was above 100 ng/ml; 3) dose‐dependent inhibition of growth of HUV‐EC by any concentration of arsenic. At a higher concentration of more than 100 ng/ml, arsenic inhibited endothelial cell proliferation and glycoprotein synthesis, whereas it only inhibited the proliferation at a lower concentration of less than 50 ng/ml. It is suggested that arsenic, at both higher and lower concentrations, may damage endothelial cells. Such damage may play an important role in the pathogenesis of BFD.
Cutaneous Involvement as a Presenting Feature of Monocytic Leukemia: Morphological and Immunohistochemical Studies
Authors: Watanabe Shinichi , Fujimura Mami , Kashima Masato , Mizoguchi Masako , Takahashi Hisashi , Fujita Akira
Published: April 2015

The clinical and pathological findings in a patient with monocytic aleukemic leukemia presenting initially as multiple monoblastic tumors of the skin is described. The patient was a 35‐year‐old Japanese woman, who had first noticed multiple, asymptomatic, reddish‐brown papules on her trunk. Asymptomatic enlargements of several lymph nodes were present in the bilateral cervical and axillary areas. There was no hepatosplenomegaly, sternal tenderness, bruising, or bleeding. The skin and lymph node biopsies were originally interpreted as malignant lymphoma. The diagnosis of acute monocytic leukemia was established when bone marrow involvement was detected.

Immunohistochemical observation of the skin eruptions revealed the following: Positive staining with lysozyme was noted in almost half of the infiltrating atypical cells. Most of the infiltrating cells reacted positively with antisera to Leu‐M5 and some of them reacted to Leu‐M1. The helper T cell antibody, Leu‐3a+3b, showed weak positive staining of most infiltrating cells. However, there were no reactions with antisera to Leu‐6, Leu‐7, Leu‐14, CALLA, OKT 6, OKT 8, OKT 16, OKB 19, OKM 14, βF1, or δTCS1. OKM 5‐positive keratinocytes were observed in some parts of the upper epidermis, although no OKM 5 expression could be detected on any tumor cells.

Cytochemistry, immunohistochemistry, and electron microscopy can aid in the diagnosis of monocytic leukemia. This case illustrates the importance of using an expanded panel of monoclonal antisera in certain hematopoietic tumors.
Laboratory Observations of Haemaphysalis longicornis Neumann after a Human Bite
Authors: Maeoka Yoshiaki , Baba Shunichi , Suzuki Hiroyuki
Published: April 2015

A case of a tick bite with Haemaphysalis longicornis Neumann is reported. The tick was found on the left lower abdomen of a 62‐year‐old female. The tick bite occurred in Fuchu city, a suburb of Tokyo. This paper presents laboratory observations of the process of Haemaphysalis longicornis Neumann laying eggs and becoming larvae after biting a human. The results of our observations include the size of female adult (length: 7.5 mm, width: 5.2 mm, weight: 96 mg) after blood sucking, preoviposition period (7 days), oviposition period (24 days), number of eggs (760 eggs), egg size (length: 0.58~0.62 mm, width: 0.39~0.42 mm), size of unfed larva (length: 0.45~0.5 mm, width: 0.45~0.5 mm) and unfed larva period until death, which ranged from 10 to 62 days.
Subclass Characteristics of IgG Autoantibodies in Bullous Pemphigoid and Pemphigus
Authors: Shirakata Yuji , Shiraishi Satoshi , Sayama Koji , Miki Yoshiharu
Published: April 2015

Immunoglobulin (Ig) G subclasses in anti‐basement membrane zone (BMZ) autoantibodies found in the sera of bullous pemphigoid (BP) and in anti‐intercellular substance (ICS) autoantibodies of pemphigus were investigated using immunofluorescent (IF) staining. In BP, IgG4, IgG1, and IgG2 were detected in 13, 5 and 6 of 15 patients, respectively; IgG3 was not detected. In pemphigus, IgG4 was detected in all of 10 patients, IgG1 in 7, IgG2 in one, and IgG3 in one patient, respectively. In both BP and pemphigus, the most prominent subclass in intensity of IF staining was IgG4. Although one BP and one PV patient had only IgG4 autoantibodies, C3 deposition was detected.

The quantification of IgG subclasses in the sera of the patients was performed by enzymelinked immunosorbent assays (ELISA). Serum levels of IgG4 in both BP and pemphigus were elevated approximately 3‐fold over those in normal controls; those of whole IgG and IgG1–3 were not significantly elevated. Using direct IF staining, the deposition of C3 at the BMZ and at the ICS was demonstrated in 9 of 10 BP and in 3 of 8 pemphigus patients, respectively.

The prominent IgG subclasses of anti‐BMZ and anti‐ICS antibody were IgG4, a non‐complement‐fixing antibody, suggesting that the deposition of C3 in the lesional skin occurred via the alternative pathway, or that small amounts of IgG1–3 subclass autoantibodies activated the classical pathway.
Co‐culture of Human Hair Follicles and Dermal Papillae in a Collagen Matrix
Authors: Arase Seiji , Sadamoto Yasushi , Katoh Shouji , Urano Yoshio , Takeda Katsuyuki
Published: April 2015

Human hair follicles, either alone or in combination with dermal papillae, were cultured in a collagen matrix. When plucked hair follicles were cultured alone, spike‐like structures composed of outer root sheath cells started growing around the follicle and then radiated into the gel. When isolated dermal papillae were embedded close to the follicles, spikes started growing earlier and grew more rapidly than without the papillae. In cultures of excised follicles from which the dermal papilla had been removed, epithelial cells (possibly hair bulb cells) started growing out from the bulbous portion and then also formed spikes. In the presence of a papilla, the spikes elongated toward the papilla, finally reaching and surrounding it. These findings suggest that dermal papilla cells produce a factor(s) that enhances growth of follicular epithelial cells and also attracts those cells.

In cultures of whole excised follicles, two major characteristic patterns of cellular growth were recognized. When the dermal papilla remained inside the bulb in contact with the hair bulb matrix, the hair matrix cells proliferated and differentiated in the normal manner, resulting in elongation of the hair shaft and follicle. But when the papilla was detached from the hair bulb matrix, epithelial cells proliferated from the bulbous portion and finally formed hair follicle‐like structures. Thus, attachment of the dermal papilla to the hair bulb matrix in the bulbous portion appears to be necessary for growth of the hair and follicle in the normal manner.

Our model may be useful for examining the interaction between follicular epithelial cells and dermal papillae and for studying the growth of hair and follicles in vitro.
Psoriasiform Intradermal Test Reaction to ABPC in a Patient with Psoriasis and ABPC Allergy
Authors: Saito Sumi , Ikezawa Zenro
Published: April 2015

We experienced a case of psoriasis with ABPC allergy which showed a psoriasiform intradermal test reaction to ABPC. A 22‐year‐old man with a history of psoriasis since the age of 17 was admitted to our department because he developed erythrodermic psoriasis after oral administration of ABPC. About 1 year later, he again developed erythroderma after administration of ABPC. Intradermal testing with 2% ABPC was performed. We found infiltrating erythema at day 2, followed by a gradually increasing psoriasiform reaction at 6 days on the site of ABPC skin test. We examined the infiltrating cells in the skin test reaction immunohistochemically. Most of the infiltrating cells in the dermis were activated helper/DTH‐type T cells. Among the infiltrating cells in the epidermis, we observed more cytotoxic/suppressor‐type T cells than helper/DTH‐type T cells. A possible role of a DH reaction to ABPC in inducing the psoriatic lesion is discussed in relation to the pathomechanisms of psoriasis.
Epidermolysis Bullosa Atrophicans Generalisata Mitis
Authors: Yamada Yoshitaka , Dekio Satoshi , Jidoi Joji , Ishimoto Takako , Yoshioka Takafumi
Published: April 2015

A male adult epidermolysis bullosa atrophicans generalisata mitis (EBAGM) patient with renal dysfunction is described. The abnormal urological findings were improved together and healing of the generalized skin erosions occurred. To our best knowledge, he is the 3rd EBAGM patient with urological abnormalities in the world.
Pleomorphic Adenoma of the Lip
Authors: Narita Hajime , Kobayashi Taisuke , Kanzaki Tamotsu
Published: April 2015

A case of pleomorphic adenoma in the upper lip is reported. A 61‐year‐old male had a tumor at the left side of the upper lip for 8 years. The tumor was surgically excised without recurrence. Histopathologically, the tumor was a typical pleomorphic adenoma with keratinization and glandular differentiation of tumor cells and fibroblastic, mucinous, hyalinized, and cartilagenous stroma.
Treatment of Cutaneous T‐cell Lymphomas (CTCL) with Extracorporeal Photochemotherapy
Authors: Nagatani Tetsuo , Matsuzaki Toshiko , Kim Shu‐taku , Baba Naoko , Osawa Junko , Sugiyama Asami , Komatsu Hitoshi , Ichiyama Shinichi , Takahashi Yasuhide , Miyamoto Hideaki , Nakajima Hiroshi , Shimoda Nagayoshi
Published: April 2015

Since August of 1988, we have treated seven CTCL patients with extracorporeal photochemotherapy, including two with tumor‐stage mycosis fungoides (MF) showing mucinous degeneration, two with plaque‐stage MF, and two with erythrodermatous MF. One was withdrawn just after the first trial. For each patient, the phenotypes of peripheral blood lymphocytes were analyzed by flow cytometry in terms of the percentages of OKT11, OKT3, OKT4, Leu9, OKT8, B1, Tac, OKT9, OKIal, Leu7, Leu3a/4B4, and Leu3a/2H4 cells. These parameters were compared with the clinical responses according to skin score. The two patients with tumors died, but the five patients without tumors did not. Three of the 6 patients responded to the treatment. Side effects that are often associated with standard chemotherapy, such as bone marrow suppression, gastrointestinal symptoms and hair loss, were not observed. One cardiovascular event (1 patient) occurred. No significant changes in T‐cell subsets were seen during the course of therapy. These preliminary data suggest that extracorporeal photochemotherapy may be effective for CTCL other than tumor‐stage MF.
Poikiloderma‐like Lesions on the Neck in Atopic Dermatitis: A Histopathological Study
Authors: Mukai Hideki , Nishioka Kiyoshi , Kamimura Kimio , Katayama Ichiro , Nishiyama Shigeo
Published: April 2015

Reticulate pigmentation with or without skin atrophy, depigmentation and telangiectasia is frequently encountered on the neck of severe cases of adult type atopic dermatitis. These skin changes were graded clinically into 3 stages. Based on histological features, hyperplasia of the sebaceous gland, dilated tortuous capillaries, and mild degeneration of elastic fibers were noted in stage I lesions. Lesions of both stages II and III contained increased melanin in the basal cell layer with incontinence of pigment, remarkable destruction and degeneration of elastic fibers, proliferated and dilated capillaries, and deposition of mucinous substances. The numbers of mast cells in papillary dermis were significantly increased in late stage I and stage II lesions. Poikiloderma‐like lesions on the neck could be attributable to chronic inflammation and delay of wound healing process, possibly caused by long‐standing topical corticosteroid therapy.
Topical PUVA, Etretinate, and Combined PUVA and Etretinate for Palmoplantar Pustulosis: Comparison of Therapeutic Efficacy and the Influences of Tonsillar and Dental Focal Infections
Authors: Matsunami Eriko , Takashima Akira , Mizuno Nobuyuki , Jinno Takuzo , Ito Hirotaka
Published: April 2015

Twenty patients with palmoplantar pustulosis (PPP) were treated with topical PUVA, oral etretinate (Re), or combined PUVA and etretinate (Re‐PUVA). Re and Re‐PUVA treated sites improved and/or cleared more rapidly than PUVA treated sites. Complete clearance was observed in six of ten sites treated with Re‐PUVA, two of ten with Re, and one of ten sites with PUVA within 12 weeks. UVA‐control sites failed to be cleared within 12 weeks. Remission periods after stopping the treatment were 1.5 ± 0.5 weeks (n=2) with Re, 10.5 ± 11.4 weeks (n=6) with Re‐PUVA, and one year (n=1) with PUVA. These results overall suggested that Re‐PUVA is the most effective treatment for PPP.

Tonsillar focal infection (TFI) and dental focal infection (DFI) were found in 6/20 and 17/20 patients, respectively. However, the presence of focal infection (FI), TFI and/or DFI, did not appear to interfere with the therapeutic activities of Re and/or PUVA, because the complete clearance rates and remission periods in FI(+) patients were comparable with those in FI(—) patients.
A Case of Sclerosing Lymphangitis of the Lip
Authors: Inamura Kei‐ichi , Suzuki Yuhsuke , Nishioka Kiyoshi , Nishiyama Shigeo
Published: April 2015

A 62‐year‐old woman noted a cord‐like swelling on the inner surface of her upper lip. A cross‐section of the lesion showed a radial‐shaped lumen surrounded by a thickened fibrous wall. Immunohistochemical staining with the anti‐factor VIII‐related antigen (FVIII‐RAg) antibody was negative on the luminal surface and swollen wall, although the vasa vasorum in the swollen wall were positive. The lesion was thus considered to be of lymphatic origin; that is, it derived from a lymphatic collecting vessel. For the present case, the term ‘lymphangiopathia obliterans’ is considered appropriate. This is the second report of such a lesion appearing on the lip in the literature.
Mal de Meleda‐like Palmoplantar Keratoderma
Authors: Iio Tomoe , Shiraishi Satoshi , Sayama Koji , Miki Yoshiharu
Published: April 2015

A 38‐year‐old Japanese man was seen for severe palmoplantar keratoderma, extending to the dorsal aspects with red rims. He had had spontaneous amputations of the toes and surgical amputation of the right lower leg because of squamous cell carcinoma of the right sole. The clinical symptoms suggested those of mal de Meleda, except for the absence of consanguinity and of granular layers in the epidermis. The keratoderma improved with oral etretinate treatment.
Fixed Drug Eruption Due to Pipemidic Acid
Authors: Miyagawa Sachiko , Yamashina Yukio , Hirota Sachiko , Shirai Toshihiko
Published: April 2015

A 71‐year‐old woman with fixed drug eruption caused by pipemidic acid is reported. The patient developed typical lesions on rechallenge with pipemidic acid, but not with nalidixic acid, an analogue of pipemidic acid.
Experimental Cutaneous Protothecosis in Mice: Epithelioid Cell Granuloma Formation
Authors: Horiuchi Yasuhiro , Tomizawa Nobuko , Higuchi Iwao , Nagasaka Kouichi
Published: April 2015

Prototheca wickerhamii, isolated from skin biopsy specimens of a patient with cutaneous protothecosis, were cultured in Sabouraud's medium and inoculated in the skin of 8 ICR albino mice and 3 BALB/c mice. Only in 3 ICR albino mice and 3 BALB/c mice were organisms found in skin tissue, as confirmed by identification of organisms by staining with periodic acid‐Schiff (PAS) stain and culture. Histologic findings from affected nodular skin lesions indicated epithelioid cell granuloma and histiocytic cell infiltrates in the dermis and subcutaneous tissue.
Lyme Borreliosis
Authors: Carlberg Hans , Naito Shuichi
Published: April 2015

The skin diseases Erythema (chronicum) migrans (ECM, EM), Lymphadenosis benigna cutis (LABC), and Acrodermatitis chronica atrophicans (ACA) have long been described in northern Eruope, and dermatologists are very familiar with these manifestations, which have been successfully treated with penicillin for about 40 years without the causative agent being known. Certain neurologic symptoms could be linked to tickbites during the 1920's and later also to EM. In 1977, Steere et al. reported a new form of inflammatory arthritis, mainly in school children in the community of Lyme, Connecticut, U.S.A., which they could also associate with preceding erythema and tickbites. Five years later, Burgdorfer was able to isolate Borrelia spirochetes from Ixodes ticks, which are known to be vectors of Lyme disease as well as of EM and ACA. The following year, Borrelia spirochetes were also isolated from Ixodes ticks and from skin lesions of patients in Sweden and Germany. These findings resulted in a large number of reports of new discoveries related to this infection, which is now known under the names of tick‐borne or Lyme borreliosis and, in the U.S., also as Lyme disease or Lyme arthritis. It has proven to be a great imitator disease, mainly through its involvement of the neurological system, and to be far more widespread than previously thought. The full course of the disease is not yet known, however it is clinically, like another spirochetosis, syphilis, divided into early and late stages. Manifestations involve mainly the skin, the joints, the nervous system (Neuroborreliosis), and the heart. Antibiotic treatment is effective, especially in the early stages. Like syphilis, the disease can be self‐healing without treatment.

People who are exposed to ticks should be aware of the risk of contracting this disease, also in Japan where Ixodes ticks have been shown to be carriers of Borrelia spirochetes. Cases, particularly of EM, but also with neurological symptoms, have already been diagnosed in Hokkaido, Honshu, Shikoku, and Kyushu.

As Lyme borreliosis is now proven to exist in Japan, it is beneficial for dermatologists to know about the various presentations of this disease. This paper will briefly summarize the historical background, the clinical stages, the diagnosis, and the treatment of Lyme borreliosis, with a summary of the present situation in Japan.
Towards a Better Understanding of Cellular Events in Mycosis Fungoides: An Immunohistochemical Study
Authors: Tosca Androniki , Ifantis Andreas , Kalmanti Maria , Panagiotopoulos Anthony , Stratigos John
Published: April 2015

In the present work, we have attempted to pay special attention to epidermal and dermal cellular events in Mycosis fungoides (MF). In the epidermis, the two dendritic cell populations, CD1+ and OKM5+, HLe‐1+, the adhesion molecules OKM5 and DR on the surface of epidermal cells (Ecs), and cytoskeletal proteins were studied. CD1+ dendritic epidermal cells were generally more abundant than OKM5+, HLe‐1+ ones with no interrelationship in their presence. OKM5+, HLe‐1+ dendritic cells prevailed in the second stage plaques. The staining pattern with anti‐spectrin polyclonal antibody gradually presented increased intensity from Pre‐MF to tumor stage. The activation‐proliferation related immunophenotype was also examined, as well as other useful markers, in an attempt to correlate their presence in different stages of MF. Special emphasis was given to the staining pattern with the epidermal growth factor receptor (EGF‐R) monoclonal antibody against three targets: epidermal, endothelial, and lymphoid cells. The presence of Ki‐67 proliferation marker in suprabasal epidermal layers and lymphoid cells in the dermal infiltrate was also of interest.
A Case of Erythromelanosis Follicularis Faciei with a Unique Distribution
Authors: Seki Taisuke , Takahashi Shozo , Morohashi Masaaki
Published: April 2015

A 16‐year‐old Japanese boy with erythromelanosis follicularis faciei (EFF) with an unusual distribution is described. The clinical features of classic EFF consist of reddish‐brown discoloration of the skin with fine follicular hyperkeratosis in the preauricular areas, and occasionally on the temples and the lateral aspects of the neck. The present case is unique in that similar lesions also occurred on the auricles and eyebrows. Both light and electron microscopic findings of the lesions were consistent with the diagnosis of EFF.
Characterization of Circulating Lymphocytes by Monoclonal Antibodies in Donovanosis
Authors: Sehgal Virendra N. , Sharma Hemant K. , Sharma Vinay K.
Published: April 2015

In 65 donovanosis patients, 53 ulcerogranulomatous, 10 hypertrophic, and 2 sclerotic, the hematological profile and quantitation of circulating blood lymphocyte subpopulations were studied with monoclonal antibodies and an indirect immunofluorescence technique to assess the immunological under‐currents of the disease. The ulcerogranulomatous variant had increases in both total leucocyte and absolute lymphocyte counts. Total T‐lymphocytes, CD4, CD8, CD22, and CD4/CD8 ratio were all significantly elevated. The hypertrophic variant, in contrast, showed a significant elevation only in the CD4/CD8 ratio.
Topical Psoralen Photochemotherapy for Atopic Dermatitis: Evaluation of Two Therapeutic Regimens for Inpatients and Outpatients
Authors: Yoshiike Takashi , Sindhvananda Jirot , Aikawa Yosuke , Nakajima Sumino , Ogawa Hideoki
Published: April 2015

Forty‐seven adolescent and adult patients suffering from long‐standing atopic dermatitis (AD) too severe to respond to conventional therapies were treated with topical psoralen photochemotherapy (PUVA) and relatively low doses of ultraviolet (UV) irradiation. For practicality and convenience, two different therapeutic regimens were implemented; short‐term hospitalization with almost daily irradiation (inpatient group, n=23) and weekly irradiation combined with topical corticosteroids which had failed to manage symptoms before initiating the treatment (outpatient group, n=25). Excellent therapeutic effects were achieved in 72% of the inpatients after 5–38 (mean 18.2) times of irradiation (mean cummulative dose; 44.7 J/cm2). In addition, 56% of outpatients responded excellently to the treatment after 6–22 (mean 13.0) times (mean cummulative dose; 25.8 J/cm2). In fact, 16 of the inpatients and 10 of the outpatients achieved almost complete remission. The duration of remission in these patients was 1–25 months (mean 6.3 months) in the inpatients and 1–6 months (mean 3.0 months) in the outpatients.

Peripheral blood eosinophils significantly decreased after the treatments. A follow‐up study showed a delayed decrease in serum IgE levels. In contrast, the specific IgE to house dust antigens and the water holding capacity of stratum corneum did not vary after treatment.
Heterogeneity of Clinical Features of Pseudoxanthoma Elasticum: Analysis of Thirteen Cases in Oita Prefecture from a Population of 1,240,000
Authors: Katagiri Kazumoto , Fujiwara Sakuhei , Shinkai Hiroshi , Takayasu Susumu
Published: April 2015

Thirteen cases among 16,260 patients seen at our department during the nine years from 1981 were diagnosed as pseudoxanthoma elasticum (PXE). The sex and age distributions were similar to those so far reported in the literature. There were two cases of the autosomal dominant type. One patient had skin lesions typical of PXE in association with Ehlers‐Danlos syndrome. In two of three patients with cutis laxa‐like lesions, eruptions of elastosis perforans serpiginosa were present. In three cases, we failed to detect deposition of calcium in typical skin lesions in either an early or a late stage by histochemical staining, in spite of the presence of slightly degenerated elastic fibers.
Normolipemic Papuloeruptive Xanthomatosis in an Infant
Authors: Horiuchi Yasuhiro , Ito Atsushi
Published: April 2015

A 8‐month‐old boy showed several yellow to brownish yellow, papular and/or nodular eruptions predominately on the face. Initial clinical and histologic findings indicated possible juvenile xanthogranuloma or papular xanthoma. Since his second year, the papulonodular lesions have gradually merged into large confluent plaques, particularly on the face, nape, and axillae. Consequently, it was considered that his condition had terminated in diffuse plane xanthoma. Serum lipid panels showed normolipemia. Finally, a diagnosis of papuloeruptive xanthomatosis with normal lipid metabolism and no associated systemic disorders was made. The patient's papulonodular lesions have continued to involute spontaneously since the age of three.
Development of the Hair in the Rat: In vivo and in Transplanted Tissue
Authors: Kanno Yoshiyuki , Takeda Katsuyuki , Daikoku Shigeo
Published: April 2015

Differentiation of the hair was examined in the head skin of rat embryos aged from days 12.5 to 18.5 of gestation.

In 12.5‐day‐old embryos, the skin consisted of single layered epidermis and underlying loose connective tissue. On day 17.5 of gestation, the epidermis appeared to have a two or three layered epithelium, and the subepidermal connective tissue gave rise to an overlying dense tissue, into which blood capillaries arose from the deeper layer. The epidermis showed partial thickenings, where basal cells were arranged perpendicular to the surface of the epidermis. Beneath the epidermal thickenings, a number of connective tissue cells appeared to have accumulated and occasionally were accompanied by blood capillaries. In sequential development of the skin, the thickenings protruded as cords to the underlying dermal tissue and formed hair follicles covered with a connective tissue sheath.

Skin obtained from 12.5‐day‐old embryos was transplanted singly or with cerebral cortex into the third ventricle of adult male rats. Thirty days after the transplantation, hairs and sebaceous glands had developed from the grafted skin. Hair growth tended to be more prominent in the cotransplanted skin grafts. However, no nerve fibers immunoreactive for substance P or calcitonin gene‐related peptide (CGRP) were found in the grafted skin, although these fibers appeared in the dermis at the end of gestation in vivo.

These results showed that the skin of 12.5‐day‐old embryos was able to induce hair growth in the third ventricle without accompanying peripheral neuronal fibers or blood capillaries, although the effects of connective tissue cells could not be ruled out
An Ultrastructural Study of the Response of Normal Skin to Epicutaneous Application of Leukotrience B4
Authors: van de Kerkhof Peter C.M. , Peereboom‐Stegeman Jennie H.J. Copius , Boeijen Jennie
Published: April 2015

The ultrastructural appearance of normal skin following epicutaneous application of leukotriene B4 (LTB4) was studied using transmission electronmicroscopy.

The acute phase (first 24 h) after LTB4 challenge is characterized by extravasation of polymorphonuclear leukocytes (PMN) and endothelial changes such as focal necrosis, formation of fenestrations, gaps, and a multilayered basal lamina.

In the ‘late phase’ (24–48 h), the endothelium still possesses many fenestrations and gaps. The density of endothelial cell nuclei is increased, and the relatively large nucleoli and high density of mitochondria are indicative of a hyperactive endothelium. The PMN in this phase show pycnotic nuclei and a vacuolated cytoplasm. Macrophages are observed phagocytosing these degenerating PMN. Monocytes and lymphocytes extravasate without any signs of endothelial or epidermal damage in their vicinity. The mast cells show no degranulation throughout the observation period.
Leukemia Cutis in Acute Myelomonocytic Leukemia: Infiltration to Minor Traumas and Scars
Authors: Koizumi Hiroko , Kumakiri Masanobu , Ishizuka Midori , Ohkawara Akira , Okabe Sanehiro
Published: April 2015

We describe a patient with acute myelomonocytic leukemia who demonstrated leukemic cell infiltration to scratched wounds and scars from trauma. A 65‐year‐old Japanese woman developed low grade fever, headache and exanthema. Hematology testing disclosed leukocytosis of 95,600/mm3 with 65% monocytes and 9% blast cells. Infiltrated erythema and nodules were disseminated over most of her body. Moreover, linear scratched wounds and traumatic scars were indurated. Skin biopsy showed dense atypical mononuclear cell infiltration with monocytic characteristics.

We discuss the possible reasons for the infiltration of leukemia cells into the wounds and scars from trauma.
Diffuse Neonatal Hemangiomatosis with a Giant Cutaneous Hemangioma on the Axilla
Authors: Sayama Koji , Higaki Takashi , Ohtsuka Hisashi , Kobayashi Yuko , Shirakata Yuji , Shiraishi Satoshi , Miki Yoshiharu
Published: April 2015

A case of diffuse neonatal hemangiomatosis is described. At birth, a giant tumor, 10 cm in diameter and 6 cm in height, was present on the left axilla and associated with thrombocytopenia. Numerous cherry‐red papules were present on the skin and buccal mucosa. On the second day of life, the giant tumor was excised. Histological examination of the tissue revealed masses of endothelial cells embedded in fibrous tissues. Plain and enhanced computed tomography of the brain revealed a hemorrhage and two hemangiomas. The associations of intravascular papillary endothelial hyperplasia were discussed.
Treatment of Vitiligo with Oral 5‐Methoxypsoralen
Authors: Hann Seung Kyung , Cho Moo Yon , Im Sungbin , Park Yoon‐Kee
Published: April 2015

Thirty‐six patients with vitiligo were treated with oral 5‐methoxypsoralen (5‐MOP) and subsequently exposed to UVA irradiation. The patients were treated once or twice weekly over a period of 2–10 months, taking 40–60 mg of 5‐MOP 2 hours before exposure to UVA light. The amount of exposure to UVA light was slowly increased according to the patient's tolerance.

Eleven (31%) patients showed remarkable repigmentation of the areas of vitiligo within six months. Overall, 78% of the patients showed effective repigmentation. Areas of vitiligo on the face and trunk were more responsive to treatment than those on the distal part of limbs. Adverse effects due to the drug included 2 patients with nausea and 1 patient with headache. It is suggested that treatment with systemic 5‐MOP is effective, safe, and useful in selected cases of vitiligo.