bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of Peplomycin or Camptothecin‐11 on X‐ray Skin Injuries of ICR Hairless Mice
Authors: Kawahara Kenichi , Kano Eiichi , Ueda Keiichi
Published: April 2015

In interdisciplinary oncotherapy by radiation and chemical substances, the injurious effects of radiation on the normal skin are occasionally modified by combined chemical substances. In the present experiment, the possible modifying effects of Peplomycin (PEP, 30 mg/kg body weight) and Camptothecin‐11, an inhibitor of DNA topoisomerase I (CPT‐11, 15 and 50 mg/kg body weight), on radiation skin injury were studied. Macroscopic changes on the thigh skin of male ICR hairless mice (at 8 weeks of age) induced by 10 Gy X‐ray irradiation alone and the combined treatment with the anticancer substances were estimated by a modified scoring first reported by Lowy and Baker. Intraperitoneal administration of PEP significantly enhanced radiation skin injury; while CPT‐11 (15 mg/kg), within the clinical dose range and in the similar molarities to that of PEP, did not show any appreciable modification effect. Treatment with CPT‐11 (50 mg/kg) showed a radiation enhancement without significant difference. The chemotherapeutic radioenhancement ratios of the combined treatments of X‐ray and PEP or CPT‐11 (15 or 50 mg/kg) were 1.49, 1.17 or 1.34, respectively. Treatment with PEP at the accepted dose showed a radiation enhancement, while CPT‐11 did not show any radiation enhancement within the clinical dose.
Primary Actinomycosis of the Breast: A Clinical Review and a Case Report
Authors: Jain Bhupendra Kumar , Sehgal Virendra Nath , Jagdish S. , Ratnakar Chiganti , Smile S. Robinson
Published: April 2015

An uncommon situation of primary actinomycosis of the breast is reported in a 40‐year‐old woman who presented with a lump, clinically simulating malignancy, in the right breast. Diagnosis of actinomycosis was established by incision biopsy. Resolution of infection, while conserving the breast, was achieved by timely diagnosis, limited surgery, and effective antibiotic therapy. Diagnostic failures leading to avoidable mastectomies have not been uncommon in cases previously reported in the literature. It is, therefore, imperative that this condition be considered in the differential diagnosis of intractable breast abscess and malignancy.
Lupus Erythematosus‐like Syndrome Induced by Thiamazole and Propylthiouracil
Authors: Sato‐Matsumura Kazuko C. , Koizumi Hiroko , Matsumura Tetsuri , Takahashi Tatsuro , Adachi Koichi , Ohkawara Akira
Published: April 2015

A 17‐year‐old Japanese woman developed a lupus erythematosus‐like syndrome during treatment for Graves' disease with thiamazole and propylthiouracil. Erythema, arthralgia, and low grade fever developed during therapy with thiamazole; purplish‐red erythema developed during therapy with propylthiouracil. Antinuclear antibodies, anti‐single‐stranded DNA antibodies, and anti‐double‐stranded DNA antibodies were positive throughout the administration of these two drugs. Eruptions and other symptoms improved after their discontinuation. The titers of autoantibodies also decreased two months after withdrawal. The patient had HLA DR4.
Granulocyte Colony‐Stimulating Factor (G‐CSF) and Granulocyte Macrophage Colony‐Stimulating Factor (GM‐CSF) in Behçet's Disease
Authors: Takahama Hideto , Itoh Rie , Inoue‐Komatsu Chiyuki , Furusawa Shuichi , Takahashi Hisashi , Mizoguchi Masako
Published: April 2015

Increases in the number and activity of peripheral polymorphonuclear neutrophils (PMNs) is often found in Behçet's disease (BD), indicating that PMN may play an important role in the pathogenesis of this disorder. It has recently been reported that G‐CSF and GM‐CSF, a family of hematopoietic growth factors, enhance PMN activity. To explore the role of these two CSFs in BD, we first examined the chemotactic response of PMNs to these CSFs by performing a polarization assay. PMN response to G‐CSF in BD patients was lower than that in controls, while PMN response to GM‐CSF was similar in patients and controls. However, PMNs from BD patients showed an enhanced chemotactic response to N‐formyl‐L‐methionyl‐leucyl‐phenylalanine. Thus, it is speculated that the PMNs of the patients might have already been activated in vivo by G‐CSF and thus could not respond further to this agent in vitro. We examined G‐CSF and GM‐CSF mRNA expressions in peripheral mononuclear cells stimulated with LPS, PMA, and Con A by Northern hybridization. G‐CSF mRNA expression levels in BD patients were higher than in the controls, while GM‐CSF mRNA expression levels were lower than in the controls. We also examined the serum levels of the two CSFs by ELISA and EIA. However, all levels of the two CSFs in both patients and controls were not detectable, except in the case of one BD patient in the active stage of the disease, who showed high levels of G‐CSF, but not of GM‐CSF. Based on the present findings, it is suggested that G‐CSF may be more intensively involved in BD than GM‐CSF.
An Immunohistochemical Study of Sebaceous Carcinoma with Anti‐Keratin Monoclonal Antibodies: Comparison with Other Skin Cancers
Authors: Ansai Shin‐ichi , Katagata Yohtaro , Yoshikawa Ken‐ichi , Hashimoto Hideki , Hozumi Yutaka , Kondo Shigeo , Aso Kazuo
Published: April 2015

Formalin‐fixed and paraffin‐embedded tissue specimens of six cases of extraocular sebaceous carcinoma were studied immunohistochemically with eight anti‐keratin monoclonal antibodies, 34βB4, 35βH11, Ks13.1, Ks19.1, PKK1, LP34, KL1 and AE1. The staining patterns of sebaceous carcinoma were compared with those of normal sebaceous glands and other skin cancers which should be distinguished from sebaceous carcinoma histopathologically. The other skin cancers compared were eccrine porocarcinoma, malignant clear cell hidradenoma, extramammary Paget's disease with underlying adenocarcinoma, malignant trichilemmoma, and squamous cell carcinoma. Most cases of sebaceous carcinoma were stained with 35βH11, Ks19.1, LP34, KL1 and AE1, while normal sebaceous glands were positive only with 35βH11, LP34, KL1 and AE1. By immunostaining, sebaceous carcinoma was distinguishable from extramammary Paget's disease with underlying adenocarcinoma, squamous cell carcinoma, malignant trichilemmoma, and eccrine porocarcinoma, but was not clearly distinguishable from malignant clear cell hidradenoma. These findings demonstrate that sebaceous carcinoma shows positive reactions with antibodies to simple epithelial keratin, probably as a result of neoplastic transformation, and that immunohistochemical examination using anti‐keratin monoclonal antibodies is useful in distinguishing sebaceous carcinoma from several other skin cancers.
Scanning and Transmission Electron Microscopic Studies of Lesional Epidermis in Herpes Zoster
Authors: Tanaka Katsumi , Tsuda Shingo , Sasai Yoichiro
Published: April 2015

The epidermal skin lesions of herpes zoster were studied by scanning (SEM) and transmission electron microscopy (TEM). When erythematous lesions were observed by TEM, many of the infected keratinocytes showed evidence of cell degeneration, being characterized by swollen nuclei, disappearance of desmosomes, and widening of intercellular spaces. Macrophages and/or lymphocytes migrated through the intercellular spaces between degenerated keratinocytes. In the vesicular lesions, SEM and TEM showed some infiltrating neutrophils, directly adhering to the virus‐infected keratinocytes, with swollen nuclei and irregularly clumped chromatin. In some specimens, balloon‐degenerated keratinocytes were observed in the cavity. In the pustular stage, ruptured keratinocytes and numerous neutrophils were observed in the reticular‐degenerated epidermal tissue. These results suggest that, in herpes zoster, the epidermal damage may be due, at least in part, to cell‐mediated host immunity as well as to the cytopathic effect of varicella‐zoster virus.
Multiple Trichoepitheliomas with Rare Features
Authors: D'Souza Mariette , Garg Bhagat Ram , Ratnakar Chiganti , Agrawal Karoon
Published: April 2015

A case of multiple trichoepitheliomas associated with epidermal cysts is reported. The trichoepithelioma lesions were florid and extensive with large nodulo‐cystic lesions on the face and a new variant simulating hidradenitis suppurativa near the gluteal cleft.
Coincidence of Vitiligo and Paget's Bone Disease in a Patient
Authors: Abraham Zeev , Glück Zahava , Kinarty Amalia , Lahat Nitza
Published: April 2015

Paget's bone disease developed in a patient with vitiligo. Scrupulous physical examination excluded further systemic or cutaneous involvement. The immunological workup revealed a reversed CD4/CD8 ratio due to a very low CD4 cell percentage and almost negligible responses to PHA as well as Con A, T cell mitogens. The pathogenic significance of these results, which point to phenotypic and functional T cell defects, is discussed.
A Case of Herpetiform Pemphigus Associated with Lung Cancer
Authors: Kubota Yasuo , Yoshino Yutaka , Mizoguchi Masako
Published: April 2015

We describe a case of herpetiform pemphigus associated with lung cancer. Only one other documented association between herpetiform pemphigus and malignancy could be found in the Japanese dermatologic literature. However, it is very difficult to determine whether such an association is coincidence or a true relationship.
Erythema Gyratum Repens Associated with Hypereosinophilic Syndrome
Authors: Morita Akimichi , Sakakibara Noriyuki , Tsuji Takuo
Published: April 2015

We report a case of typical erythema gyratum repens lesions observed as a manifestation of idiopathic hypereosinophilic syndrome in a 63‐year‐old man. While erythema gyratum repens is usually associated with malignancy, an intensive search over a 30‐month period failed to reveal any evidence of neoplasm. With administration of dapsone, the typical gyrate lesions disappeared as the subject's hypereosinophilia improved.
A Contribution to the Understanding of the Heredity of Skin Tumors
Authors: Schnyder Urs W.
Published: April 2015

At least 21 multiple tumors of the skin are inherited autosomal‐dominantly. Eighteen are benign and three are malignant. One‐third of these tumors have no associated lesions, another third is associated with benign visceral lesions, and a final third belongs to the group of cancer associated genodermatoses. The solitary variants of these tumors, however, are sporadic, not inherited.
Basal Cell Carcinoma: Seven Years' Experience at the Institute of Dermatology in Bangkok
Authors: Nakjang Yaovares , Kullavanijaya Preya
Published: April 2015

Sixty‐seven patients with basal cell carcinoma (BCC) were observed at the Institute of Dermatology, Bangkok, Thailand between 1982 and 1989. The male:female ratio was 1:2. The average age of the patients at first examination was 60.6 years. Lesions in sun‐exposed areas were three times more frequent than lesions in covered areas. The principal location was the face, including the cheek, nose, periorbital area, ears, and forehead. The remainder were on the scalp, breast, abdomen, back, thigh, and knee. Ulceration was the most frequent symptom, followed by a mass. Histopathologically, pigmented BCC was the most frequent, followed by solid BCC, superficial BCC, adenoid BCC, morphoeic BCC, cystic BCC, basosquamous BCC, mixed carcinoma, keratotic BCC, and fibroepitheliomatous BCC. In patients younger than 50 years of age, solid or pigmented tumors were frequent. The morphoeic type was present only on the face and scalp. In females, solid BCC or adenoid BCC predominated. Only 4 of our 67 patients had histories of ingestion of herbal medicine with arsenic as one of the ingredients. Sixty‐one patients were treated surgically. There was only one case of tumor recurrence after surgery. The remaining patients were treated by electric cautery, liquid nitrogen, or irradiation. No patients developed distant metastasis.
A Case of Double Cancer: A Squamous Cell Carcinoma Arising from a Long Pierced Site on the Left Earlobe and a Solid Tubular Carcinoma of the Left Breast
Authors: Hagiwara Keisuke , Shinzato Rimi , Higa Tadashi , Toyama Kensei , Miyazato Hajime , Nonaka Shigeo
Published: April 2015

A 43‐year‐old woman presented with a well differentiated squamous cell carcinoma of the left earlobe where a small hole for pierced type earrings had been made about 20 years earlier. A year after the removal of the tumor, a metastasis of a moderately differentiated squamous cell carcinoma to the left cervical lymph nodes was detected. A month later, a solid tubular carcinoma of the left breast was found. A modified radical neck dissection and a quadrantectomy with an axillary lymph node dissection were performed. A total of 5 courses of peplomycine‐mitomycine combinated therapy with 26 Gy of radiotherapy was administered for the cervical lesion. A month of postoperative chemotherapy with tegafur‐uracil and medroxyprogesterone acetate and a total of 56 Gy of radiotherapy to the mammary lesion were added. She has been well without recurrence for about a year after the operations. This case is not only a rare double cancer, a combination of a squamous cell carcinoma and a solid tubular carcinoma, but may also be the first case of a squamous cell carcinoma arising at a long pierced site on an earlobe for pierced type earrings.
Vogt‐Koyanagi‐Harada's Syndrome Associated with Hashimoto's Thyroiditis
Authors: Chi Hyung‐In , Furue Masutaka , Ishibashi Yasumasa
Published: April 2015

Vogt‐Koyanagi‐Harada's syndrome has been known as an autoimmune disease which affects the melanocyte‐containing tissues. We report a case of Vogt‐Koyanagi‐Harada's syndrome associated with Hashimoto's thyroiditis. IgM‐class antibodies against nevus cells were detected in the patient's serum by indirect immunofluorescence test. These clinical and laboratory findings support the autoimmune theory of this rare syndrome.
Dermatomyositis with Multiple Skin Ulcers Showing Vasculitis and Membrano‐cystic Lesion
Authors: Yamamoto Toshiyuki , Ohkubo Hiroko , Katayama Ichiro , Nishioka Kiyoshi
Published: April 2015

A 63‐year‐old woman with dermatomyositis (DM) developed multiple punched‐out ulcers of the skin. She had not only a past history of gastric cancer 10 years prior to the onset of DM, but also a familial history of cancer. A skin biopsy from one of the ulcers revealed both vasculitis and membrano‐cystic lesion in the same specimen. She died of interstitial pneumonitis one year after the onset of DM. Vasculitis and membrano‐cystic lesion may be an important marker of a poor prognosis in DM.
Pyoderma Gangrenosum on the Finger
Authors: Nihei Yasuko , Yamada Mina , Tsukimoto Atsumi , Kawashima Makoto
Published: April 2015

A case of pyoderma gangrenosum on the dorsal aspect of the right second and third fingers of a 50‐year‐old woman is reported. The patient had been wounded at the above‐mentioned site by a cutter. This wound developed into a painful ulcer which enlarged rapidly. No bacterial infections were detected. Histologically, an inflammatory infiltrate of lymphocytes mixed with neutrophils and nucleodusts was seen throughout the entire dermis, but there was no evidence of vasculitis. Based on this data, the case was diagnosed as pyoderma gangrenosum. The patient responded to treatment with systemic corticosteroids. Pyoderma gangrenosum at this site of the fingers seems to be rare.
Interferon‐γ‐induced HLA‐DR, but not ICAM‐1, Expression of Human Keratinocytes Is Down‐regulated by Calmodulin Antagonist
Authors: Saitoh Atsushi , Osada Atsushi , Kitajima Yasuo , Furue Masutaka , Tamaki Kunihiko
Published: April 2015

Interferon‐γ (IFN‐γ) has been shown to induce or enhance the expression of MHC class II and intercellular adhesion molecule‐1 (ICAM‐1) in a variety of human and murine cell types, including epidermal keratinocytes (KC). However, the expression of MHC class II and ICAM‐1 molecules induced by IFN‐γ is not necessarily coordinated. We investigated the inhibitory effects of the calmodulin antagonist, W‐7, and its chlorine deficient inactive analogue, W‐5, on the expression of MHC class II (HLA‐DR) and ICAM‐1 by human KC incubated with IFN‐γ. We found that the IFN‐γ‐induced expression of HLA‐DR was reproducibly and dose‐dependently inhibited by W‐7. However, the expression of ICAM‐1 was highly resistant to the inhibitory effects of W‐7. Neither HLA‐DR nor ICAM‐1 expression was affected by W‐5. These data suggest that the IFN‐γ‐induced HLA‐DR, but not ICAM‐1, expression is mediated, if not exclusively, by calmodulin in human KC.
Probable Mechanisms of Loss of Merkel Cells in Completely Depigmented Skin of Stable Vitiligo
Authors: Bose Sumit Kumar
Published: April 2015

Vitiligo is frequently associated with segmental involvement. It spares paralyzed limbs in transverse myelitis. There is spontaneous repigmentation of vitiligo lesional skin (VL) in diabetic neuropathy. Increased neuropeptide in VL and adjacent normal skin of vitiligo (ANS) along with thickened nerve fibers showing ultrastructural abnormalities all indicate a neural pathogenesis (1). Loss of Merkel cells has been observed in early vitiligo lesional skin (2). Recently, catecholamines have been found to play a major role in initiating the cascade of events leading to loss of melanocytes (1, 3, 4).

To investigate the presence of Merkel cells in the completely depigmented skin of stable vitiligo (SV), a study was undertaken using TROMA 1, a monoclonal antibody specific for adult Merkel cells. No TROMA 1‐positive cells were observed in SV, whereas normal numbers of these cells were seen in ANS. This new finding further supports the hypothesis of neural involvement in vitiligo.
Pre‐Existing Cutaneous Changes in Basal Cell Carcinomas of the Lower Extremities
Authors: Betti Roberto , Inselvini Elena , Perotta Elena , Crosti Carlo
Published: April 2015

Basal cell carcinomas (BCCs) of the lower extremities are not frequently reported. Some pre‐existing or predisposing conditions are thought to be implicated in their development. In this study, we investigated the possible relationships between pre‐existing cutaneous changes and the development of BCCs of the lower extremities, possible sex and age differences, and the histologic patterns involved. Among 1053 patients with BSSc, BCCs of the lower extremities were observed in 48 (4.5%): 25 men and 23 women. Lesions appeared on the thighs (16 cases), the lower legs (27 cases), or the feet (5 cases). Histologic patterns were nodular and micronodular (18 cases), superficial (27 cases), or infiltrative (3 cases). No differences were observed between sexes. The relative degree of elastosis was higher in the lower limbs of women than of men (2.25 vs 1.53).

Pre‐existing cutaneous changes were observed in 7 cases. The frequency of these BCCs of the lower limbs and the higher degree of elastosis observed in the women seem to be related to sun exposure. The histologic pattern seems not to be affected by environmental factors but rather characteristic of body site. Pre‐existent cutaneous changes are not thought to be possible etiologic factors.
The Rash of Measles Is Caused by a Viral Infection in the Cells of the Skin: A Case Report
Authors: Makino Sagae , Yamaguchi Fumio , Sata Tetsutaro , Urushibata Osamu , Kurata Takeshi , Nishiwaki Munekazu
Published: April 2015

Measles skin rash was immunohistochemically examined in an effort to detect virus antigen in skin samples taken from a 15‐year‐old girl with measles. A sectioned specimen obtained by punch biopsy from a 2nd‐day skin lesion showed localized parakeratosis and acanthosis with multinucleated giant cells in the epidermis, thickening and cellular edema of epithelia in the hair follicles, and vascular dilatation in the papillary plexus. Measles virus antigen was detected by ABC immunoperoxidase in the epidermis, follicular epithelia, and lympho‐histiocytic cell infiltrates in the upper part of the dermis. This rash was deemed to be caused in part by direct viral infection of the epidermal cells.
Interferon‐α (INF‐α) and Etretinate in the Treatment of Mycosis Fungoides
Authors: Torii Hideshi , Kaneko Takehiko , Matsuyama Tomohiko , Nakanishi Hiroshi , Harada Syotaro
Published: April 2015

A combination therapy of mycosis fungoides (MF) with interferon‐α (INF‐α) and etretinate was reported. A 53‐year‐old patient suffering from MF was treated with intramuscular administration of INF‐α at a dosage of 9 × 106 IU daily; skin lesions poorly responded to the treatment. After oral etretinate with a dosage of 50 mg daily was combined with INF‐α, marked clinical improvement was seen in skin lesions with minor side effects. INF‐α in combination with etretinate can have beneficial effects in the treatment of MF.
Three Cases of Organoid Nevus on the Trunk and Extremity
Authors: Kanekura Takuro , Kawahira Masakimi , Kanzaki Tamotsu
Published: April 2015

Organoid nevi are most commonly observed on the scalp. Although they are rarely found on the trunk and extremities, we were able to study 3 cases of organoid nevi involving distributions of this sort. These included a 39‐year‐old male with a 2 × 6 cm brown area on the left flank (case 1), an 8‐year‐old female with a 5 × 6 cm hypopigmented macule on the lower left leg (case 2), and a 45‐year‐old male with a 1.5 × 3 cm brown spot on the back (case 3). All these were histopathologically confirmed to be organoid nevi.

The lesion in case 1 revealed basal cell epithelioma, that in case 2 exhibited hypohidrosis caused by poorly developed sweat glands, and the lesion in case 3 was typical, as was an additional one on the same patient's scalp.
A Case of Giant Cell Tumor of the Tendon Sheath Developing on the Palm
Authors: Mizushima Junichi , Nogita Toshitatsu , Ooe Mariko , Kawashima Makoto
Published: April 2015

A 22‐year‐old Japanese woman with a giant cell tumor of the tendon sheath on the palm is described. The location of the tumor is rare. Light microscopically, the tumor consisted of round or polygonal cells, giant cells, and foam cells. Electron microscopically, histiocyte‐like cells and fibroblast‐like cells were mainly observed, suggesting that the tumor may have originated from the synovial membrane.
Prognostic Evaluation of Cutaneous Malignant Melanoma Based on the pTNM Classification
Authors: Sugihara Tsuneki , Yoshida Tetsunori , Kokubu Ichiro , Chiba Osamu , Ohura Takehiko , Ohkawara Akira
Published: April 2015

The prognoses of 100 consecutive melanoma patients were analyzed on the basis of Breslow's thickness and Clark's levels as well as according to stage employing the 1987 UICC pTNM classification. Among patients with lesions ≦1.50 mm thick, the 10‐year survival rate was 100% for both pT1 (n=13) and pT2 (n=6) disease, 73.4% for pT3a disease (n=26), 62.2% for pT3b disease (n=15), 69.3% for pT3 (n=41) disease, and 38.7% for pT4 disease (n=38). Significant differences in survival were found between the pT4 group and the pT1/pT3a or pT3 groups. The 10‐year survival rate was 100% for level II (n=13) and level III (n=13) disease, 58.3% for level IV (n=46) disease, and 34.5% for level V (n=26) disease. Significant differences were found between level V and other levels. The survival rate at 10 years was 100% for stage I (n=18), 63.3% for stage II (n=24), and 52.5% for stage III (n=55). In stage IV (n=3), there was only one patient who survived for 42 months. There were significant differences in survival among all stages except I and II. The 10‐year survival rate in 3 subgroups of stage III was 58.9% for pT4pN0M0 patients (n=14), 63.2% for pT,pN1M0 patients (n=31), and 20% for pT,pN2M0 patients (n=10). Significant differences were found between the pT,pN1M0 and pT,pN2M0 subgroups. These findings indicate that the survival of pT1, pT2 and stage I patients is extremely good. In contrast, the prognosis of patients with pT3, pT3b or pT4, and stage III or IV disease is significantly poor. Within stage III, the prognosis of the pT,pN2M0 subgroup is significantly poor, and the classification of pN2 patients may need to be reconsidered.
Minocycline Hydrochloride Hyperpigmentation Complicating Treatment of Pyoderma Gangrenosum
Authors: Miralles Enrique S. , Nuñez María , Pérez Bibiana , Ledo Antonio
Published: April 2015

Minocycline‐associated hyperpigmentation is an uncommon side effect We report the case of a patient with pyoderma gangrenosum successfully treated with oral minocycline but complicated by marked hyperpigmentation in his pyoderma gangrenosum and acne scars. One of the clinical forms of minocycline hyperpigmentation includes dark‐blue or black macules in depressed acne scars or other sites of skin inflammation; this pattern seems to be independent of the total cumulative dose and the skin process.
Conversion of Antinuclear Antibody Specificity as a Marker of Deterioration of Cutaneous Lupus Erythematosus into Lupus Nephritis
Authors: Kihira Chika , Mizutani Hitoshi , Shimizu Masayuki
Published: April 2015

A 34‐year‐old male systemic lupus erythematosus patient (SLE) with cutaneous vasculitis developed renal failure after switching anti‐nuclear antibody (ANA) specificity. He developed cutaneous lupus erythematosus with homogeneous and speckled type ANA and a high titer of anti‐DNA antibody without renal involvement at 21 years of age. After developing lupus nephritis at the age of 27, the original ANA disappeared gradually. Two years later, a discrete speckled type ANA titer elevated abruptly to as high as 1:640 with low complementemia and without DNA antibody. Within five years, he suffered renal failure. This case of SLE suggests a direct correlation with ANA pattern and organ involvement.
A Case of Cutaneous Infection by Exophiala jeanselmei
Authors: Hayashi Miki , Kiryu Hiroe , Suenaga Yoshinori , Asahi Masakazu
Published: April 2015

A case of cutaneous infection by Exophiala jeanselmei is reported.

The patient was a 45‐year‐old Japanese female. Her skin eruption consisted of a group of erythematous papules on her left cheek to which corticosteroid had been topically applied for nearly 10 years. Histopathologically, a granuloma formation was noted in the dermis within which were many brown spores. The isolated fungus was identified as Exophiala jeanselmei.
Healing of Chronic Atopic Dermatitis Lesions in Skin Areas of Paraplegia after Trauma
Authors: Amon Ulrich , Wolff Helmut H.
Published: April 2015

A case of atopic dermatitis in a 12‐year‐old boy with spontaneous clearing of skin lesions in areas of paraplegia after trauma is reported. This observation might confirm the important pathogenetic role of neuropeptides in the development of atopic dermatitis.
Coexistence of Pemphigus and Bullous Pemphigoid
Authors: Matsubara Kunihiko , Kanauchi Hideo , Tanaka Toshihiro , Imamura Sadao
Published: April 2015

Widespread tense blisters developed on a 60‐year‐old Japanese man who had been diagnosed with pemphigus 11 years earlier, because of a history of pruritic erythema and erosions on his face, chest, and back, mild supra‐basal layer blister formation found in a biopsy specimen, and a positive direct immunofluorescence test showing IgG deposition in the intercellular space. The histological findings showed subepidermal blister, and the immunoblot study detected 180kD bullous pemphigoid antigen. Direct immunofluorescence test revealed intercellular staining for IgG, and indirect immunofluorescence tests repeatedly demonstrated the presence of circulating antibodies to the intercellular space. From these observations, this case suggests the coexistence of pemphigus and bullous pemphigoid.
CD44 Expression in Normal Human Skin and Skin Tumors
Authors: Yasaka Nami , Furue Masutaka , Tamaki Kunihiko
Published: April 2015

CD44 is thought to be a principal cell surface receptor for hyaluronic acid. Although the distribution of hyalulonic acid has been studied, little is known about the distribution of the CD44 molecule in the human skin and skin tumors. This study was undertaken to investigate the distribution of the CD44 molecule in normal human skin as well as in benign and malignant skin tumors.

In normal skin, CD44 was expressed on 1) keratinocyte cell surfaces throughout the epidermis except for the granular and horny layers, 2) hair follicular cells, 3) eccrine sweat gland cells, and 4) cell surfaces of dendritic cells in the dermis. In skin tumors, although CD44 was expressed on the tumor cell surface of seborreic keratosis, Bowen's disease, and squamous cell carcinoma as in normal skin, we could not detect any CD44 expression on the cell surface of the tumor cells of basal cell carcinoma. However, CD44 positive dendritic cells were observed in the tumor islands of basal cell carcinoma. Phenotypic analysis suggested that these CD44 positive cells were melanocytes.
A Histological Study of Cutaneous Thermal Wounds Using a Clostridium perfringens‐Derived Wound Healing Substance with Wound Healing Stimulation Activity
Authors: Takahashi Makoto , Morimoto Yousuke , Kon Miyuki , Saga Kenji
Published: April 2015

We studied the effects of a Clostridium perfringens‐derived wound‐healing substance (WHS) on the healing of thermal burn wounds. Third‐degree burn injuries were inflicted on the back skin of rats. We histologically evaluated the effects of WHS ointments and compared them with those of lysozyme chloride ointment. We observed the formation of dermal collagen fibers and the increase of capillaries in the WHS ointment treated groups. From the results of hematoxylin and eosin staining and silver staining, an increase in capillaries was observed one week after the application of WHS ointment. Three weeks after the application, when the epithelization was in the final stage, capillary formation ceased. In the WHS ointment‐applied groups, electron microscopic observation showed that new collagen fibers were regularly formed in the dermis. On the other hand, in the lysozyme chloride ointment‐applied groups, new collagen fibers were present, but were irregularly formed. The main wound healing stimulative action of the WHS ointment could be due to its acceleration of new capillary formation.
A Case of Trichorrhexis Nodosa Developed in Winter
Authors: Bhutto Abdul Manan , Taira Kayo , Nagamine Yasushi , Maruno Motoyoshi , Takamiyagi Atsushi , Nonaka Shigeo
Published: April 2015

A young Japanese man developed localized trichorrhexis nodosa (LTN) of the scalp hair in the winter season. To investigate the roles of shampoo, severe sunlight exposure and/or mechanical injuries, we performed the following studies. Hair was collected from the patient and from a control. The study was performed in two steps. In the first step, hair was put into shampoo, rinsed with saline water, and then exposed to ultraviolet B (UVB) radiation once a day for one week. In the second step, the hair was similarly treated, but each shaft was bent gently with forceps before UVB exposure. Scanning electron microscopic studies revealed cuticular changes when the hair was treated only with shampoo and UVB. When it was treated with shampoo, UVB, and mechanical bending, the patient's hair developed longitudinal and transverse fractures of the hair shafts, while the control hair showed only partial damage to the hair shaft. On the basis on the above findings, we conclude that mechanical bending may damage the hair shaft.
Neutrophilic Eccrine Hidradenitis: Report of Two Cases
Authors: Kanzaki Hiroko , Oono Takashi , Makino Eiichi , Arata Jirô , Oda Megumi , Akazai Ayumi
Published: April 2015

Background

Neutrophilic eccrine hidradenitis (NEH) is an uncommon, self‐limited dermatosis usually attributed to anti‐cancer chemotherapy. It is characterized histologically by necrosis of the eccrine gland and neutrophilic infiltrate.

Observations

We saw NEH in a 5‐year‐old boy with acute lymphoblastic leukemia and a 4‐year‐old girl with acute monocytic leukemia. NEH developed after the anti‐leukemic chemotherapy including high dose cytarabine. The eruption was composed of vesicles, papules, and plaques.

Conclusions

Histological findings were compatible with those described in the literature. NEH in our two patients could be attributed to high doses of cytarabine.
Activity of Eight Fluoroquinolones against Both Methicillin‐Susceptible and ‐Resistant Staphylococcus aureus Isolated from Skin Infections
Authors: Nishijima Setsuko , Namura Shoko , Akamatsu Hirohiko , Kawai Shuzou , Asada Yasuo , Kawabata Shigekatsu , Fujita Maasa
Published: April 2015

The in vitro susceptibility of Staphylococcus aureus to eight fluoroquinolones, norfloxacin, ofloxacin, enoxacin, ciprofloxacin, lomefloxacin, tosufloxacin, sparfloxacin, and nadifloxacin was established by agar dilution tests, 71 isolates of methicillin‐susceptible (MSSA) and 74 isolates of ‐resistant S. aureus (MRSA) isolated from skin infections. Among all of the fluoroquinolones, nadifloxacin exhibited the lowest MIC for both MSSA and MRSA. In addition, there were no resistant S. aureus, neither MSSA and MRSA, to nadifloxacin. With the exception of nadifloxacin, the incidence of MRSA resistant to fluoroquinolones has gradually increased in recent years. Over half of the MRSA strains were resistant to norfloxacin, ofloxacin, enoxacin, ciprofloxacin, and lomefloxacin.
Further Immunocytochemical Characterization of Cultured Hair Apparatus Cells
Authors: Tanigaki‐Obana Noriko , Nakaoji Kouichi , Ito Masaaki
Published: April 2015

In immunocytochemical studies of cultured hair apparatus cells we employed anti‐hair keratin monoclonal antibodies (HKN‐2, HKN‐4, HKN‐5, HKN‐6 and HKN‐7) and compared the results with electron microscopic studies. On day 1, the cultured cells positively stained with HKN‐2 (52%), HKN‐4 (50%), HKN‐5 (43%), HKN‐6 (33%), or HKN‐7 (37%). On day 3, more than 88% of the cells showed no reaction to any antibody. On day 6, most of the cells stained with all of the antibodies: HKN‐2 (96%), HKN‐4 (92%), HKN‐5 (80%), HKN‐6 (72%) and HKN‐7 (74%). These reactivities were maintained until day 13. Electron microscopic studies revealed that, on day 1, half of the observed cells were immature and 47% of them were already differentiated. Most (88%) of the cells showed immature features and the percentage of differentiated cells had decreased by day 3. The differentiated cells (87%) reappeared by day 6, and degenerated cells (63%) increased by day 13. These immunocytochemical results were consistent with those of simultaneous electron microscopic studies, demonstrating that immature cells proliferated and differentiated into subpopulations of each hair apparatus layer type, including the outer root sheath cells, in this culture system.
So‐Called Mixed Tumor of the Skin on the Wrist: An Immunohistochemical Study
Authors: Torii Hideshi , Nakagawa Hidemi , Ishibashi Yasumasa
Published: April 2015

A case of so‐called mixed tumor of the skin arising on the wrist was reported. Immunohistochemical staining of keratins of several molecular weights (AE1/AE3, RCK102, NCL‐5D3 and 35βH11), carcinoembryonic antigen (CEA), S‐100 protein, and desmin was performed. AE1/AE3 and RCK102 were positive in all the tumor cells; CEA, NCL‐5D3 and 35βH11 were positive mainly in luminal cells of the tubuloalveolar structures. S‐100 protein was positive in peripheral cells of the tubular lumina and in scattered cells in the mucous stroma. Desmin was negative in all the tumor cells. Immunohistochemical findings lent further support to the hypothesis that so‐called mixed tumor of the skin differentiates into the secretory and ductal portions of the sweat gland.
Lymphoepithelioma‐like Carcinoma Originating on the Eyelid
Authors: Maruyama Misuzu , Miyauchi Shunji , Ohtsuka Hisashi , Miki Yoshiharu
Published: April 2015

An 89‐year‐old woman presented a rapidly growing red nodule of 5 years' duration on her left eyelid. Histologically, the entire dermis was occupied by multiple lobules of atypical tumor cell nests surrounded by inflammatory cells and fibrous stroma. The tumor cell nests were connected with the overlying epidermis and extended into the subcutaneous fat and muscles. There were no tendencies towards squamous or glandular differentiation of the tumor cells. Immunohistochemistry showed the tumor cells to be positive for keratin/cytokeratin and epithelial membrane antigen, but negative for neuron specific enolase and vasoactive intestinal polypeptide. S‐100 protein‐positive Langerhans cells were also found within the tumor nests. There was no apparent evidence of a primary lesion elsewhere.
Effects of Topically Applied Spironolactone on Androgen Stimulated Sebaceous Glands in the Hamster Pinna
Authors: Seki Taisuke , Toyomoto Takashi , Morohashi Masaaki
Published: April 2015

The effects of spironolactone (5% SYC‐201G, a preparation developed for clinical use in acne vulgaris by Searle Yakuhin K.K.), which is known to have antiandrogenic effects by competitively inhibiting dihydrotestosterone at androgen receptor sites, was topically applied to the androgen stimulated sebaceous glands of adult female golden hamsters.

Androgen stimulation, induced by intramuscular injection of testosterone propionate (TP) every other day over a two week period, resulted in a 2.5 to 2.7 time increase in the size of the sebaceous glands of the hamster pinna.

Once‐daily treatment with 5% SYC‐201G or matching placebo was applied to androgen‐stimulated hamsters on one pinna only during the same period as TP injection. Comparison between the treated and untreated sides revealed a significant suppression in the sebaceous gland size (p<0.05) by 5% SYC‐201G; no such effect was observed with placebo. The difference in the suppression rate of the sebaceous gland size between 5% SYC‐201G (23%) and matching placebo (–4.7%) was significant (p<0.01).
Cutaneous Eruption in a Patient with Cardiac Myxoma
Authors: Abraham Zeev , Rozenbaum Michael , Rosner Itzhak , Odeh Majed , Oliven Arie
Published: April 2015

Atrial myxoma was diagnosed in a young woman who had cutaneous and constitutional manifestations clinically suggestive of cutaneous vasculitis without cardiac signs or symptoms. Scrupulous physical and laboratory examinations excluded additional medical disorders. The patient was totally cured by surgical removal of the tumor. Various aspects of the association of cardiac myxoma with dermatological findings are discussed, emphasizing the importance of echocardiography in the diagnostic workup of various skin abnormalities, including unexplained vasculitis, even in the absence of cardiac findings.
Disseminated Eruptive Nevocellular Nevi
Authors: Bong Ha Wook , Lee Seok June , Lee Kwang Hoon , Chung Kee‐Yang
Published: April 2015

A 13‐year‐old boy suddenly developed about 2,000 dark brown to black colored papules on his face and neck and about 500 lesions on his trunk and upper extremities during a six month period. Histopathologic features were compatible with junctional nevus. The results of alpha melanocyte stimulating hormone (MSH), proliferating cell nuclear antigen (PCNA), and epidermal growth factor receptor (EGF/R) studies are presented. To the best of our knowledge, this report represents an outbreak of the highest number of nevocellular nevi in a short period without any malignant nature or evident triggering factor.
Production and Secretion of Platelet‐Derived Growth Factor AB by Cultured Human Keratinocytes: Regulatory Effects of Phorbol 12‐Myristate 13‐Acetate, Etretinate, 1,25‐Dihydroxyvitamin D3, and Several Cytokines
Authors: Zhang Jian‐Zhong , Maruyama Kohji , Ono Ichiro , Kaneko Fumio
Published: April 2015

Platelet‐derived growth factor (PDGF) is a potent mitogen for several mesenchymal cells and plays an important role in wound repair. Three PDGF isoforms, PDGF‐AA, PDGF‐BB, and PDGF‐AB, have been found to be generated in various tissues. PDGF‐AB production by normal human keratinocytes (NHKs), by human squamous cell carcinoma cell line (HSC‐1) cells, and by human dermal fibroblasts (HDFs) was studied in the presence of agents which influence cell growth. Both NHKs and HSC‐1 cells spontaneously produced and secreted PDGF‐AB. NHKs grown in keratinocyte growth medium produced more PDGF‐AB than did those grown in keratinocyte basic medium. Phorbol 12‐myristate 13‐acetate inhibited PDGF‐AB production in NHKs but promoted its production in HSC‐1 cells. 1,25‐dihydroxyvitamin D3 up‐regulated PDGF‐AB production, whereas etretinate did not. High levels of calcium in the culture medium induced little change in cellular PDGF‐AB levels. Prostaglandin E1 slightly inhibited PDGF‐AB production, transforming growth factor β1 promoted PDGF‐AB production and interferon‐γ, interleukin‐1α, and tumor necrosis factor‐α failed to exert any influence at all. Cultured HDFs did not produce any detectable PDGF‐AB. These results suggest that keratinocytes are a major source of cutaneous PDGF and that this factor may therefore play an important role in wound repair and in certain proliferative skin diseases.
Clinical and Histopathologic Analysis of the Relationship between Lichen Planus and Chronic Hepatitis C
Authors: Tanei Ryoji , Watanabe Kiyoharu , Nishiyama Shigeo
Published: April 2015

A prospective clinical investigation of 45 patients with lichen planus (LP) demonstrated a significant association between LP and chronic hepatitis C. Anti‐hepatitis C virus (HCV) antibodies were found in 17 (37.8%) of the 45 LP patients. This was significantly higher than in the controls. This higher prevalence of anti‐HCV antibodies was found equally in both male and female patients in the three types of LP; cutaneous only type, mucous only type, and both cutaneous and mucous type. Most of the patients with positive anti‐HCV antibodies had abnormal values of transaminase enzymes and/or a past history of chronic hepatitis. Histological and immunohistological investigations of three cases with LP and chronic hepatitis C demonstrated some morphologic similarities between these two diseases. Histopathologic findings of both LP and chronic hepatitis C were based on a T lymphocytic infiltrate with keratinocyte or hepatocyte damage. The degrees of infiltrating cells positive to UCHL‐1, MX‐panB, Leu‐7, and human leukocyte antigen (HLA)‐DR antibodies in the chronic hepatitis C lesions seemed to be similar to those in the LP lesions. These results may support a possible relationship between LP and chronic hepatitis C and the hypothesis that LP may be associated with chronic liver diseases as a result of a cytotoxic attack on the hepatocytes.
Skin Manifestations Associated with Rheumatoid Arthritis
Authors: Yamamoto Toshiyuki , Ohkubo Hiroko , Nishioka Kiyoshi
Published: April 2015

We examined cutaneous manifestations of rheumatoid arthritis (RA) of 142 Japanese patients who visited both the Departments of Dermatology and Rheumatology of our hospital. We classified cutaneous lesions into specific and/or characteristic or nonspecific ones. Nonspecific lesions predominated in our series. Among the specific skin manifestations, which comprised 10% of the total, rheumatoid nodules, rheumatoid papules, rheumatoid neutrophilic dermatitis, and severe vasculitic ulcers correlated with high titers of rheumatoid factors and progression of RA, while purpura and livedo did not. Nonspecific skin manifestations failed to correspond with the level of rheumatoid factors. Among the nonspecific lesions, asteatotic eczema, candida interdigitalis, and tinea unguium were commonly detected.
Extensive Aberrant Mongolian Spot
Authors: Park Kyung Deuk , Choi Gwang Seong , Lee Kwang Hoon
Published: April 2015

A 9‐month‐old male infant had generalized diffuse blue‐gray pigmentation over most of his body, sparing the scalp, face, neck, palms, soles, periumbilical area, genital area, and nipples. Within the lesion, there were several conspicuous macules of considerably darker hue. Histologic examination revealed numerous dermal melanocytes. By 16 months of age, the child's blue‐gray pigmentation had decreased substantially.
Destructive Encephalopathy in Incontinentia Pigmenti: A Case Report
Authors: Yang Jen‐Hang , Ma Shao‐Yin , Tsai Chang‐Hai
Published: April 2015

We report a 2‐day‐old neonate with incontinentia pigmenti combined with destructive encephalopathy. Generalized seizures developed soon after birth; characteristic papulovesicles and hyperpigmented linear streaks appeared several days later. The brain CT scan showed multiple low density areas with cortical atrophy and ventricular enlargement. Histopathological examination favored the diagnosis of incontinentia pigmenti. Although a series of microbiological examinations failed to identify any infectious agent, the patient was still treated vigorously with anticonvulsants, systemic antibiotics, and acyclovir from the beginning of hospitalization. However, the seizures persisted, and the patient died 26 days after birth. Our report suggests that incontinentia pigmenti with encephalopathy may have a fatal prognosis.
Nasal Myiasis in Leprosy Leading to Unusual Tissue Destruction
Authors: Thami Gurvinder Pal , Baruah Manik Chandra , Sharmce Subhash Chondee , Behera Niranjan Kumar
Published: April 2015

Nasal mucosal involvement is a constant feature in lepromatous leprosy (1). Granulomatous infiltration of nasal mucosa and consequent sensory loss may result in atrophic rhinitis and or painless ulceration, which is usually asymptomatic except for later complications of epistaxis, septal perforation, inflammation, and/or myiasis in long neglected patients. An unusual destruction of nasal architecture mimicking cancrum oris caused by myiasis in lepromatous leprosy is described for its rarity.
Topical 5‐Fluorouracil Ointment for Senile Comedones: A Case Report
Authors: Yoshinaga Keiichiro , Kanzaki Tamotsu
Published: April 2015

The usefulness of topical vitamin A acid for senile comedones was reported by Kligman et al. in 1971 (1). It is, however, not available in Japan. We treated senile comedones with topical 5‐fluorouracil ointment and found that it was very effective.
Immunoglobulin Gene Analysis of Cutaneous Pseudolymphoma by Polymerase Chain Reaction
Authors: Nakayama Fumiaki , Kurosu Katsushi , Yumoto Norio , Mikata Atsuo
Published: April 2015

Polymerase chain reaction (PCR) was used to amplify the V‐D‐J region of the immunoglobulin heavy chain gene from DNA extracted from the formalin fixed, paraffin embedded skin of 3 cases of pseudolymphoma. The products were electrophoresed and observed under ultraviolet light after ethidium bromide staining. Specimens of two cases showed smears of polyclonal amplified DNA. The specimen of one case (Case 3), however, showed a single band with a smear. The presence of monoclonality in B lymphocyte populations may suggest the possibility of low grade malignancy of pseudolymphoma or transformation to malignant lymphoma in the future.
Immunoglobulins Specific to Mosquito Salivary Gland Proteins in the Sera of Persons with Common or Hypersensitive Reactions to Mosquito Bites
Authors: Shan En‐zhi , Taniguchi Yoshiki , Shimizu Masayuki , Ando Katsuhiko , Chinzei Yasuo , Suto Chiharu , Ohtaki Tetsuya , Ohtaki Noriko
Published: April 2015

Using the immunoblot technique, we analyzed the quality and quantity of IgG, IgG4, and IgE specific to mosquito salivary gland (hereafter abbreviate as SG) components of Aedes albopictus in the sera of volunteers with common reactions and of 3 patients with severe reactions.

In the volunteers with delayed reactions only or with both delayed and immediate reactions, IgG against SG components of A. albopictus formed several faint or moderately stained bands. Those with immediate reactions showed several intense bands and many other weak bands. In volunteers, who had been bitten by Aedes sp. frequently but had no skin reaction, and in severe cases, many intense IgG bands were observed. IgG4 bound to SG components were found in the sera of the common reaction group at the levels of 24 and 48 kD, but, in one severe case, no bands were observed, although the total IgG was very high. IgE levels specific to SG components were much higher in severe cases than in the volunteers.

These results indicate that high titers of specific IgG and IgE and lack of IgG4 for particular components of SG may lead to severe allergic reactions in severe cases. Immunoblotting analysis of the antibodies also verified the possibility of developing in vitro tests to identify causative species of the mosquito for severe cases.