bluuebunny/crossref_metadata_2025 huggingface dataset:
Environmental and Occupational Skin Diseases in Taiwan
Authors: Yu Hsin‐Su , Lee Chih‐Hung , Jee Shiou‐Hwa , Ho Chei‐Kong , Guo Yue‐Liong
Published: July 2014

This presentation focuses on the four most important skin diseases in Taiwan thought to be of environmental and/or occupational origin. The majority of work‐related dermatoses are contact dermatitis patients. Among occupational contact dermatitis patients, 58.5% involved irritant and 41.5%, allergic dermatitis. Electronics, hairdressing, medical practice, and construction were the most important occupations causing contact dermatitis. An endemic occurrence of chronic arsenism causing hyperpigmentation, keratosis, and cancer has been reported in Taiwan. Arsenical skin cancers present as multiple lesions at different disease stages. The skin cancers are usually found in non‐sun‐exposed areas. UVB exerts an inhibitory effect on the proliferation of arsenical cancers; this may explain its non‐sun‐exposed nature. An outbreak of premalignant and malignant skin lesions was reported among paraquat manufacturers in 1985. The skin lesions were mainly distributed over the sun‐exposed areas. Photodamage and photocarcinogenesis revealed a strong association with exposure to bipyridines among paraquat manufacturers. In 1979, a mass poisoning occurred in Taiwan from cooking oil contaminated by polychlorinated biphenyls (PCBs). Over 60% of patients were in grades O‐II by the Japanese classification. The blood PCB levels of the Taiwanese patients were found to be higher than those of the Yusho subjects.
Recent Advances in Dendritic Cell Vaccines for Cancer Treatment
Authors: Kumamoto Tadashi , Morita Akimichi , Takashima Akira
Published: July 2014

Dendritic cells (DC) are special subsets of antigen presenting cells characterized by their unique abilities to efficiently take up, process, and present various forms of antigens to immunologically naive T cells. Recent advances in the understanding of molecular mechanisms regulating the functions of DC have allowed the investigators to “design” innovative DC‐based vaccine formats for the treatment of cancer patients. In this article, we will review the most advanced DC vaccine strategies, focusing on three major areas: a) new ex vivo protocols for DC loading with tumor‐associated antigens (TAA), b) genetic approaches to load skin‐resident Langerhans cells (LC) with TAA, and c) chemokine‐mediated LC entrapment and in situ loading of LC with TAA at the entrapment sites. We believe that these new classes of DC vaccine strategies will soon become applicable to the treatment of patients with malignant tumors.
Clinico‐Mycological Profile of Tinea Capitis in North India and Response to Griseofulvin
Authors: Singal Archana , Rawat Sudha , Bhattacharya Sambit Nath , Mohanty Sandip , Baruah Manik Chand
Published: July 2014

There is a paucity of literature on tinea capitis from North India. The response to griseofulvin has not been studied as well. We studied 153 consecutive patients of tinea capitis for clinical patterns, causative dermatophytic species, clinico‐etiological correlation, and response to griseofulvin. Culture and sensitivity were done on all patients. All patients were treated with griseofulvin for 6‐8 weeks; non‐responders were further treated with fluconazole. Ninety percent of the patients were less than 15 years of age, 75% belonged to poor socioeconomic groups and 19% had a family history of tinea capitis. The seborrheic variant was the commonest clinical pattern seen in 47.8% of patients, followed by grey patch, black dot, kerion, and alopecia‐areata‐like tinea capitis in 35.9%, 8.5%, 6.5% and 1.3% of patients, respectively. Only 66% of patients had a positive culture. T. violaceum was the commonest dermatophytic species isolated in 38% patients. M. audouinii, T. schoenleinii, T. tonsurans, M. gypseum, T. verrucosum and T. mentagrophytes were isolated in 34%, 10%, 9%, 3%, 3% and 3% of patients, respectively. Of the isolates 94% were susceptible to griseofulvin, and 100% were susceptible to fluconazole. By using griseofulvin for 6–8 weeks 97.4% of the patients were cured; nonresponders required therapy with fluconazole for cure. To conclude, tinea capitis is still a disease of younger people of poor socioeconomic status. T. violaceum and M. audouinii are the most common responsible dermatophytes. The response to griseofulvin was excellent, and it should be used as a first line therapy.
Disseminated Superficial Actinic Porokeratosis with Both Typical and Prurigo Nodularis‐like Lesions
Authors: Kang Byung Duk , Kye Young Chul , Kim Soo Nam
Published: July 2014

We report a 50‐year‐old Korean patient who developed a disseminated superficial actinic porokeratosis (DSAP) with two types of lesions. One was a typical DSAP lesion clinically and histopathologically. The other was clinically similar to prurigo nodularis, but histologic examination showed the findings of porokeratosis such as cornoid lamellae and loss of the granular layer in addition to those of chronic lichenified dermatitis, so it could be described as prurigo nodularis‐like porokeratosis. The nodular lesions seemed to develop on preexisting typical lesions of DSAP mainly during the summer by the aggravation of pruritic symptoms and scratching associated with sun exposure. Although we could not find any published reports describing lesions like those of our case, we think that such prurigo nodularis‐like porokeratosis can develop in patients with DSAP in some situations involving pruritus and scratching.
Sarcoidosis Associated with Psoriasis Vulgaris
Authors: Usuki Kazunari , Hamada Hiroshi , Terasaki Yutaro , Hiwatashi Shuko , Hisadome Hirofumi , Setoyama Mitsuru , Kanzaki Tamotsu , Mera Syuji
Published: July 2014

We report a 70‐year‐old patient with sarcoidosis associated with psoriasis vulgaris. He had a nodule on the medial lower lid of his right eye. Oral corticosteroid for the sarcoid lesions and oral PUVA for psoriasis were employed. The cutaneous lesion disappeared within two months after starting the therapy. No relapse of sarcoidosis has been seen for eight years. The association of sarcoidosis with psoriasis has been previously reported; however, it is still unclear whether this association coincidental or meaningful.
The Role of the Antioxidative Defense System in Papulopustular Acne
Authors: Basak Pinar Y. , Gultekin Fatih , Kilinc Ibrahim
Published: July 2014

Acne vulgaris frequently occurs in the second decade of life. The pathogenesis of the disease is multifactorial. In this study, we aimed to investigate the role of reactive oxygen species in inflammation of acne by determining the activity of antioxidant defense enzymes in leukocytes. Fifty‐two patients with papulopustular type acne vulgaris and 36 healthy controls were enrolled. The severity of the disease was examined by the Global Acne Grading System, and the activities of superoxide dismutase (SOD), glutathione peroxidase (GSH‐Px) and catalase (CAT) enzymes as well as the level of thiobarbituric acid reactive substance (TBARS) were detected in leukocytes. The activities of SOD and GSH‐Px were significantly decreased in the acne group. CAT activity and TBARS level were higher in patients than controls. Only a poor correlation was detected between GSH‐Px activity and severity of the disease. Antioxidative defense enzymes are impaired in papulopustular acne, and drugs with antioxidative effects might be valuable in treatment.
Long‐term Follow‐up Study of Onychomycosis: Cure Rate and Dropout Rate with Oral Antifungal Treatments
Authors: Iozumi Ken , Hattori Naoko , Adachi Makoto , Kaneko Takehiko , Shimozuma Michiro , Tamaki Kunihiko
Published: July 2014

The “complete cure” of onychomycosis requires long‐term treatment with a systemic antifungal agent. Therefore, to properly assess the effects of an antifungal agent on onychomycosis requires a long follow‐up. We have conducted a retrospective analysis of the patients treated with griseofulvin (GRF) from 1962 to 1992 and a clinical study to compare the long‐term effect of GRF with that of a new oral antifungal agent, itraconazole (ITCZ), for patients who received treatment from 1992 to 1995. For the retrospective study, 281 patients who were microscopically diagnosed as having onychomycosis at the Department of Dermatology, Faculty of Medicine, University of Tokyo, and received GRF administration in 1962, 1972, 1982, and 1992, were evaluated for cure rate and dropout rate. The total cure rate was 29.2%, but the cure rate was 68.8% for the patients who continued their medication for more than one year. For the comparative study, 139 patients who received the treatment at the same institution between 1992 and 1995 were evaluated. The cure rate and the dropout rate for GRF were found to be 23.8% (23/97) and 52.6% (51/97) respectively. The cure rate and the dropout rate for ITCZ were found to be 50.0% (21/42) and 38.1% (15/42). When the two treatment protocols were compared for their long‐term effects, we found that most of the patients treated with ITCZ were cured within 3 years, and about 30% of the patients treated with GRF remained uncured even after long‐term administration of the agent. Furthermore, from a multiple regression analysis, the GRF/ITCZ administration required to cure onychomycosis was estimated to be 3.92 + 0.161 [Age (years)] + 0.635 [Number of infected toenails] months. The results of this study suggest that the biggest problem associated with the treatment of onychomycosis with an oral antifungal agent is compliance in long‐term therapy. Notably, the final cure rate of ITCZ therapy went over 90%, suggesting that the low dose continuous therapy, the standard treatment protocol in Japan, was a key contributing factor for the higher cure rate for ITCZ.
Recessive Epidermolysis Bullosa Dystrophicans (Hallopeau‐Siemens)—Improvement of Wound Healing by Autologous Epidermal Grafts on an Esterified Hyaluronic Acid Membrane
Authors: Wollina Uwe , Konrad Helga , Fischer Tobias
Published: July 2014

Epidermolysis bullosa dystropicans of the Hallopeau‐Siemens type (HS‐EBD) is an autosomal‐recessive blistering disease. Skin fragility due to mutations in structural proteins is responsible for further development of chronic and painful wounds, skin infections and sepsis. There is no causative treatment available. We present a case report with HS‐EBD and longstanding painful wounds treated with autologous keratinocytes on an esterified hyaluronic acid membrane. Two out of three wounds treated showed a complete take of the graft. They improved markedly with a stable result over 12 months until now. Even autologous keratinocyte grafting may have a beneficial effect on chronic wounds in HS‐EBD despite the fact that the genetic defects are unchanged.
Plantar Verrucous Carcinoma: Report of a Case Treated with Boyd Amputation Followed by Reconstruction with a Free Forearm Flap
Authors: Yoshitatsu Sumiko , Takagi Tadashi , Ohata Chika , Kozuka Takehito
Published: July 2014

Verrucous carcinoma is a relatively rare, well‐differentiated, squamous cell carcinoma. Although it is slow‐growing and mimics benign skin leasions, it can cause extensive local destruction that necessitates amputation. It is often underdiagnosed as a benign tumor in its early course. We report a case of extensive verrucous carcinoma on a recalcitrant ulcer and a severe long‐standing scar around it on the sole of the right forefoot, which had been treated as a benign tumor for more than two years. We treated it successfully with amputation of the foot and were able to spare the heel by using a free innervated forearm flap to cover the defect at the stump. The present case should remind clinicians that a verrucous lesion developing on a refractory ulcer may be a complex malignant neoplasm; an accurate diagnosis is difficult without a combination of clinical features and pathological findings from an adequately deep specimen.
Reduction of Serum Interleukin‐5 Levels Reflect Clinical Improvement in Patients with Atopic Dermatitis
Authors: Kondo Seiji , Yazawa Hitoshi , Jimbow Kowichi
Published: July 2014

Cytokines, in particular IL‐4 and IL‐5, regulate IgE synthesis and eosinophil activation in atopic dermatitis (AD). To elucidate whether the serum levels of IL‐4 and IL‐5 are related to the serum IgE level, eosinophilia, or clinical severity of the disease, 25 cases with AD were studied. Blood samples were isolated from two groups of donors: 1) patients with AD (n=25); 2) non‐allergic individuals (NA, n=20) with serum IgE levels below 100 IU/ml and with blood eosinophil counts below 250/μl. Each parameter was evaluated at least twice in AD patients at the beginning of the study and after 4, 8 or 12 weeks of treatment. IL‐4 was hardly detected in AD and NA, but IL‐5 was increased (>10 pg/ml) in most cases (22/25) of AD group with 513.6 pg/ml as the mean. AD with normal serum IgE levels exhibited increased levels of IL‐5, whereas AD with high serum IgE levels did not necessarily have elevated IL‐5 levels. The IL‐5 level tended to change in parallel with the clinical severity in each AD case, although the level itself was not correlated with the clinical severity per se. A significant decrease of IL‐5 was observed in AD when the clinical severity decreased. Eosinophils also decreased along with the improvement of AD, whereas the serum level of IgE did not change during the observation period. Our results suggest that IL‐5 is involved in the regulation of clinical courses of AD and that its kinetics at the serum level reflects the clinical activity of AD.
Acute Urticaria with Elevated Circulating Interleukin‐6 Is Resistant to Anti‐Histamine Treatment
Authors: Fujii Kimio , Konishi Kenji , Kanno Yuko , Ohgou Noriko
Published: July 2014

Histamine released from dermal mast cells plays a central role in the increased vascular permeability in acute urticaria, and administration of anti‐histamines usually suppresses development of wheals. Acute idiopathic urticaria, particularly a severe case, occasionally presents with acute inflammatory reactions such as low‐grade fever and leukocytosis and is resistant to anti‐histamines. Considering the wide spectrum of proinflammatory cytokines and chemokines that can be released from activated mast cells, some of them might be involved in the pathogenesis of urticaria. We measured plasma levels of interleukin‐6 (IL‐6), interleukin‐8 (IL‐8), and tumor necrosis factor‐α (TNF‐α) in 16 cases of severe acute urticaria. None of them showed elevated plasma levels of IL‐8 or TNF‐α. Nine out of 16 acute urticaria patients showed elevated circulating IL‐6 with concomitant increases in serum CRP levels. All such patients were resistant to conventional anti‐histamine treatment and required systemic steroids for complete suppression of wheal development. After subsidence of the urticaria, their elevated IL‐6 and CRP levels dropped to their normal ranges. In contrast, all but one patient without elevated circulating IL‐6 was successfully treated with a H1 receptor antagonist, cetirizine. The data suggest involvement of IL‐6 in the pathogenesis of severe acute urticaria that is resistant to anti‐histamines.
Generalized Hyperpigmentation of the Skin due to Vitamin B12 Deficiency
Authors: Mori Katsunori , Ando Iwao , Kukita Atsushi
Published: July 2014

A 49‐year‐old man presented with neurosis, hyperpigmentation of the skin, and depigmentation of the hair. On examination, hyperpigmentation was observed on the oral mucosa and the skin of the forearms, elbows, palmar creases and periunguinal area, knees, and feet. He had megaloblastic anemia with a low serum level of vitamin B12 due to malabsorption resulting from a gastrectomy 10 years previously. His hyperpigmentation was resolved with vitamin B12 supplementation. Histology showed an increase of melanin in the basal layer. In electron microscopic study, many melanosomes were observed in melanocytes and surrounding keratinocytes. We consider that the dominant mechanism of hyperpigmentation due to vitamin B12 deficiency is not a defect in melanin transport but is rather an increase in melanin synthesis.
The Significance of Mast Cells Associated with Basal Cell Carcinoma
Authors: Erkiliç Suna , Erbağci Zülal
Published: July 2014

In the stroma of basal cell carcinoma (BCC), the numbers of mast cells are increased, but their significance remains unknown. In a retrospective histological study of 74 cases, we investigated the significance of mast cells related to BCC and the possible relationship between increased numbers of mast cells and clinical and histological parameters including the patients' age, sex, subtype of BCC, and severity of peritumoral inflammation. We found a significant increase in peritumoral mast cell numbers over those in uninvolved skin (p<0.0001). Morpheaform BCCs had significantly more mast cells than did the other variants (p=0.047). No significant relationship was found between mast cell number and the degree of peritumoral inflammation, patient age, or gender. Our results support previous reports indicating that mast cell numbers are increased in BCC, particularly in its morphoeic variant, implying a contributory role for mast cells in the aggressiveness of BCC.
Lipodystrophia Centrifugalis Abdominalis Infantilis: Two Cases from China
Authors: Kam‐har Mak , Hing‐fung Ho , Lio‐yuen Chan , Lai‐yin Chong
Published: July 2014

We report the first two Chinese patients with lipodystrophia centrifugalis abdominalis infantilis in China. The first patient was a 3‐year‐old girl who developed an area of hyperpigmented skin depression on the right groin which spread centrifugally to the abdomen and right lower chest. Later, another lesion developed on the neck. The second patient was a 4‐year‐old girl who developed multiple areas of skin depression on her bilateral groin, periumbilical region, right axilla, and chest. The lesions also extended centrifugally. Erythematous margins and lymphadenopathy were present in both cases. Inflammatory changes were found in the subcutaneous fat. The clinical pictures and histologic features supported the diagnosis of LCAI in both cases.
Hair Follicle Nevus Occurring in Frontonasal Dysplasia: An Electron Microscopic Observation
Authors: Kuwahara Hiroaki , Lao Li‐Min , Kiyohara Takahiro , Kumakiri Masanobu , Igawa Hiroharu
Published: July 2014

We report a rare hair follicle nevus that occurred in a three‐month‐old Japanese boy with mild frontonasal dysplasia. It had been present since birth. Histologically, numerous tiny vellus hair follicles were found within the dermis. The constituent cells of these follicles showed the features of follicular germ cells under the electron microscope. The fibroblasts around the follicles were active and merged with the colloid substance. Many myofibroblasts were found in a collagenous stroma in the atrophic lesion of the frontonasal dysplasia.
A Case of Folliculitis Decalvans Involving the Beard, Face and Nape
Authors: Karakuzu Ali , Erdem Teoman , Aktas Akin , Atasoy Mustafa , Gulec A. Ihsan
Published: July 2014

Folliculitis decalvans is a rare and chronic progressive hair disorder leading to scarring alopecia and atrophy. Its etiology is still unclear. It starts with areas of perifollicular erythema, and follicular papules and pustules spread peripherally, leaving central scarred patches of alopecia. We report a 27‐year‐old man who presented with folliculitis decalvans involving the scalp, face, nape, and beard. There were pustules, crusts, and scarring alopecia on the scalp and beard.
Therapeutic Effects of Antibacterial Treatment for Intractable Skin Diseases in Helicobacter pylori‐Positive Japanese Patients
Authors: Sakurane Mikihisa , Shiotani Akiko , Furukawa Fukumi
Published: July 2014

In order to understand the pathogenic relationship between Helicobacter pylori (H. pylori) and skin diseases, we examined the serum levels of IgG antibody against H. pylori and then performed gastroscopic examinations in Japanese patients with chronic skin diseases. These H. pylori‐positive patients were treated with antibacterial eradication therapy, and therapeutic efficacy was evaluated. A total of 198 patients who were resistant to conventional therapies were randomly selected. They included 50 cases with chronic urticaria, 32 with pruritus cutaneous, 74 with atopic dermatitis, 15 with nummular dermatitis, 17 with prurigo chronica multiformis, 6 with psoriasis vulgaris, and 4 with erythroderma. Positive anti‐H. pylori antibody was detected in 102 out of these 198 patients; more than half of the ones with chronic urticaria, pruritus cutaneous, nummular dermatitis, and prurigo chronica multiformis had positive antibodies. Gastroscopy was then performed in 48 cases with positive antibodies. Eradication therapy was effective in 60% of the patients with chronic urticaria, in 58% with pruritus cutaneous, in 54% with nummular dermatitis, and in 50% with prurigo chronica multiformis. In chronic skin diseases, persistent infection with H. pylori may be an eruption trigger and may cause deterioration of the disease into an intractable and chronic form.
Cutaneous Manifestations in Childhood Staphylococcal Sepsis
Authors: Çaksen Hüseyin , Üzüm Kazim , Yüksel Şaban , Üstünbaş Hasan Basri
Published: July 2014

In this article, the clinical and laboratory findings of six (15%) cases of cutaneous manifestations of 39 patients with sepsis caused by Staphylococcus aureus (S. aureus) were reviewed retrospectively. Our purpose was to determine the cutaneous manifestations in patients with sepsis caused by S. aureus. In our study, four patients had maculopapular and/or petechial/purpuric rashes, and two had erythematous lesions (one of them also had pustular lesions, and the other had furuncles). Aside from these, all patients had one or more systemic involvement such as bronchopneumonia, arthritis, osteomyelitis, or cardiac involvement. In conclusion, our findings suggest that there are no skin findings specific to staphylococcal sepsis and that pulmonary infections appear to have a high correlation with cutaneous findings, because all of our patients had evidence of bronchopneumonia. The mortality of staphylococcal sepsis associated with cutaneous findings appears to be high.
Clinicopathologic Analysis of 66 Cases of Erythema Annulare Centrifugum
Authors: Kim Kyoung Jin , Chang Sung Eun , Choi Jee Ho , Sung Kyung Jeh , Moon Kee Chan , Koh Jai Kyoung
Published: July 2014

Erythema annulare centrifugum (EAC) denotes a group of eruptions characterized by slowly migrating annular or configurate erythematous lesions. It can be classified histopathologically as the deep or superficial type. Although there are many case reports of EAC associated with various underlying conditions, no recent clinicopathologic studies exist. The purpose of this study was aimed at analyzing the clinical and histopathologic features of EAC. Sixty‐six patients who have been diagnosed as EAC by clinical and histopathological examination were collected. The medical records and skin biopsy specimens of these patients were reviewed retrospectively. There were 24 male patients and 42 female ones. The mean age was 39.7 years, and the mean durtion of the disease was 2.8 years. The lower extremities, particularly the thigh, were the most frequently involved locations. The most common clinical manifestation was large (>1 cm), scaly, erythematous, indurated plaques. Forty‐eight patients (72%) had combined diseases including cutaneous fungal infection (48%), such as tinea pedis, other skin diseases (18%), internal malignancies (13%), and other systemic diseases (21%). By histopathologic examination, 33 of 42 patients (78%) were identified as superficial type, and 9 patients (22%) were deep type. Therapeutic trials with systemic or topical corticosteroid and oral antihistamine did not affect the chronic and recurrent course of these patients. EAC is a chronic and recurrent disease despite treatment. EAC is thought to be highly associated with internal disease as well as with superificial fungal infection. However, it was difficult to prove a causal association. The recognition and exact diagnosis of EAC is important, because it may be a quite stressful condition and lead to unnecessary over‐treatments.
One Confirmed and Six Suspected Cases of Cutaneous Larva Migrans Caused by Overseas Infection with Dog Hookworm Larvae
Authors: Nakamura‐Uchiyama Fukumi , Yamasaki Emi , Nawa Yukifumi
Published: July 2014

Cutaneous larva migrans (CLM) is characterized as creeping eruption/serpiginous erythema and/or mobile erythematous induration on the skin. In Japan, Gnathostoma spp. are the most well known pathogens causing CLM, especially the creeping eruption type. Recently, Spirurina type X larvae have been added to the list of causative agents for creeping eruption in Japan. Here we report one confirmed and 6 suspected cases of creeping eruption caused by infection with dog hookworm larvae. The patients were assumed to have been infected overseas. Dog hookworms such as Ancylostoma caninum and A. brasiliense should be considered as possible causative agents for creeping eruption, especially when the patients have a history of travelling overseas.
A Case of Angiosarcoma of the Nose
Authors: Nishiwaki Yoko , Tada Yurie , Nakatani Chie , Yamashina Yukio , Shirai Toshihiko , Miyagawa Sachiko
Published: July 2014

A case of angiosarcoma arising from the nose of a 69‐year‐old man is presented in this report. The patient was treated with a combination of recombinant interleukin‐2 (rIL‐2, Celeuk®), electron beam irradiation, and surgery. He died 27 months after diagnosis, but there was no apparent remote metastasis.
Amyloid Deposition Is Frequently Observed in Skin Lesions of Hypertrophic Lupus Erythematosus
Authors: Khan Mohammed Abul Kasem , Maruno Motoyoshi , Khaskhely Noor Mohammad , Uezato Hiroshi , Nonaka Shigeo
Published: July 2014

Four cases of Hypertrophic Lupus Erythematosus (HLE) were reported. The lesions of HLE were observed on the forearms, face and hands in all four cases. Clinically, the lesions were erythematous, hyperkeratotic plaques. The clinical course was marked by chronicity and progression of the lesion. Histologically, marked hyperkeratosis, parakeratosis, acanthosis, degenerative changes of basal cells in H/E stain, and thickened, multilayered basement membrane in PAS stain, were observed. The observations of Dylon stain revealed that localized amyloid deposition was observed in all four cases of HLE lesions, as fluorescent‐orange colored amyloid deposits in the papillary dermis and subepidermal areas at near or just below the dermo‐epidermal junction appeared under fluorescent microscope. On the basis of clinical and histological observations, we suggest that chronic irritation, such as sunlight exposure over a long‐duration, might have caused the characteristic abnormalities at the dermo‐epidermal junction and also initiated the frequency of amyloid deposits locally secondary to the diseases. We compared our HLE cases to other types of lupus erythematosus (LE) skin lesions, as to whether deposition of amyloid materials were frequently observed or not. Amyloid deposition was observed in one case of DLE and none of the SLE cases. Localized amyloid deposition was more frequently observed in skin lesions, secondary to HLE disease, as compared to other types of LE.
TCR Gene‐rearranged, Extranodal NK/T‐Cell Lymphoma, Nasal Type, Presenting as Gyrate Patches
Authors: Hwang Dong‐Kyu , Kwon Hyeok‐Man , Park Jin‐Woo , Yu Hee‐Joon , Park Yong Wook
Published: July 2014

In the CD56+ cutaneous nasal‐type NK/T‐cell lymphoma strongly associated with latent EBV infection, subcutaneous or dermal nodules are the most common skin findings, but great morphologic heterogeneity has been noted including papules, infiltrated plaques, and ulcerated tumors, and TCR genes are mostly germline. We describe a case of nasal and nasal‐type NK/T‐cell lymphoma featuring multiple erythematous polycyclic patches on the trunk, which is similar to patch stage mycosis fungoides or other cutaneous T cell lymphoma. Immunohistochemical study of a skin biopsy specimen revealed CD2+, CD3ε+, CD56+, and CD45RO+ expression in the neoplastic cells. In situ hybridization using an anti‐sense Epstein Barr virus early regions probe showed a positive reaction. However, clonal TCR β gene rearrangement was found.
The Japanese Version of Skindex‐16: A Brief Quality‐of‐Life Measure for Patients with Skin Diseases
Authors: Higaki Yuko , Kawamoto Kyoko , Kamo Toshiko , Horikawa Naoshi , Kawashima Makoto , Chren Mary‐Margaret
Published: July 2014

A practical quality‐of‐life measure applicable to patients with skin diseases is necessary. Recently developed dermatological quality‐of‐life measures must be translated and adapted for use in cultures other than the ones in which they were created. In this study, we translated and adapted culturally into Japanese a skin‐disease‐specific, brief quality‐of‐life measure, Skindex‐16, and studied its reliability and validity. Forward‐and back‐translations of Skindex‐16 were carried out. Six doubtful items as well as the term “skin condition” required a second forward‐ and back‐translation to reach satisfactory agreement with the original instrument. Cross‐cultural adaptation and cross‐sectional questionnaire studies were then performed to evaluate the reliability and validity of the instrument. One hundred patients and 30 healthy adults responded to the Japanese version. The internal‐consistency reliability of the final Japanese version of Skindex‐16 was high (range of Cronbach's alpha for each scale, symptoms, emotions, and functioning, was 0.83–0.92). The Japanese version showed construct and content validity. As hypothesized, scores for dermatological patients were higher than those for healthy persons (mean global scores 36 ± 23 vs 1 ± 2, p < 0.001) and scores for patients with inflammatory diseases were higher than those for patients with isolated skin lesions (mean global scores 48 ± 21 vs 22 ± 17, p < 0.001), indicating a poorer quality of life. Most patients' responses to an open‐ended question about their skin disease were similar to those of the American responders and were addressed according to the items. In conclusion, we have developed a semantically equivalent translation of Skindex‐16 into Japanese. It is a reliable and valid measure of the effects of skin disease on the quality of life in Japanese patients.
Rapid Effects of Olopatadine Hydrochloride on the Histamine‐Induced Skin Responses
Authors: Morita Keisuke , Koga Tetsuya , Moroi Yoichi , Urabe Kazunori , Furue Masutaka
Published: July 2014

Olopatadine hydrochloride is one of the second‐generation nonsedating antihistamines that are used for treating allergic disorders such as urticaria, rhinitis, and atopic dermatitis. We examined the inhibitory effects of this drug on the flare and wheal responses induced by histamine iontophoresis at 30, 60, and 90 min after oral administration in a double‐blind, cross‐over, and placebo‐controlled study. Olopatadine hydrochloride significantly inhibited the histamine‐induced flare and wheal responses as early as 60 min after oral administration when compared with placebo. Significant inihibitory effects of olopatadine hydrochloride on the itch responses were seen at 90 min after administration. Thus, olopatadine hydrochloride exhibited a very rapid and potent antihistamine effect on the histamine‐induced skin responses.
PDGF‐BB Induces MAP Kinase Phosphorylation and VEGF Expression in Neurofibroma‐Derived Cultured Cells from Patients with Neurofibromatosis 1
Authors: Kotsuji‐Maruyama Tomoe , Imakado Sumihisa , Kawachi Yasuhiro , Otsuka Fujio
Published: July 2014

Neurofibromas of neurofibromatosis 1 (NF1) are highly vascular. Because the number of PDGF β receptors in neurofibroma‐derived cultured cells (NF‐derived cells) has been reported to be increased, we tested whether platelet‐derived growth factor BB (PDGF‐BB) could induce expression of vascular endothelial growth factor (VEGF) in NF‐derived cells. When analysed by reverse transcription‐polymerase chain reaction, VEGF mRNA expression was found to be stimulated by PDGF‐BB and TGF‐β1. Those growth factors stimulated the secretion of VEGF from NF‐derived cells. PDGF‐BB furthermore induced the mitogen‐activated protein kinase phosphorylation in NF‐derived cells from patients with NF1. In conclusion, PDGF‐BB stimulated VEGF secretion in NF‐derived cells, and this stimulation is probably important in neurofibroma hypervascularization.
Immunohistochemical Analysis of the Infiltrated Cells in Tinea Capitis Patients
Authors: Koçak Mukadder , Deveci M. Salih , Ekşioğlu Meral , Günhan Ömer , Yağli Salime
Published: July 2014

Tinea capitis is a fungal infection of the skin and the hair with involvement of the hair shaft and the pilosebaceous unit. It may be the most common of all cutaneous mycoses in children. Tinea capitis can be inflammatory or noninflammatory. It is thought that humoral and cell‐mediated immunities play a role in the formation of the clinical types of the disease. We studied twelve patients with acute inflammatory disease, four patients with chronic non‐inflammatory disease, and one patient with a black‐dot variant of tinea capitis. The composition of inflammatory infiltrates present in lesional skin was analyzed by antibodies to T cells (CD3) and B cells (CD20). Anti‐CD3 revealed large numbers of T cells in twelve patients with acute, inflammatory dermatophytosis, whereas anti‐CD20 revealed marked infiltrates of both B and T cells in all patients with chronic, non‐inflammatory dermatophytosis. As a result, we thought that cell‐mediated immunity might play a role in the acute, inflammatory type of tinea capitis and that humoral immunity might do so in the chronic, non‐inflammatory type of tinea capitis.
Clinical and Histologic Features of 64 Cases of Steatocystoma Multiplex
Authors: Cho Soyun , Chang Sung‐Eun , Choi Jee‐Ho , Sung Kyung‐Jeh , Moon Kee‐Chan , Koh Jai‐Kyoung
Published: July 2014

Steatocystoma multiplex (SM) shares many clinical features and may show overlapping histopathological features with eruptive vellus hair cyst (EVHC). Clinical data and pathologic features of 64 patients with SM were evaluated in detail. Most of the cases were sporadic, with an average onset age of 26 years and distribution on the arms, chest, axillae, and neck. All cases exhibited eosinophilic cuticle and lack of granular layer, and 17–42% displayed vellus hair, hair follicles, keratin, and smooth muscle components within the cavity, in the wall, or adjacent to it. The results of this study add further evidence to the hypothesis that SM is a hamartomatous condition and that SM and EVHC are variants of one disorder which originates in the pilosebaceous duct.
Mechanisms of UV‐Induced Signal Transduction
Authors: Kulms Dagmar , Schwarz Thomas
Published: July 2014

Ultraviolet radiation (UV) causes a variety of biological effects that can be either beneficial or harmful for human health. To exert these effects on a cellular basis, UV uses a variety of signaling pathways. DNA is the major chromophore for UVB. Thus, nuclear DNA damage has been detected to be a major mediator of numerous UVB effects, and experimental reduction of DNA damage is associated with a loss of these effects. On the other hand, UV has been found to utilize molecular components within the cytoplasm or at the cell membrane for signaling. UV can directly activate cell surface receptors, kinases, and transcription factors. The nuclear and extranuclear signaling pathways are generated independently and have been recently recognized to be not mutually exclusive but to contribute to various UV effects in an independent and additive way. Further knowledge of how these signaling pathways relate to each other will certainly increase our understanding of how UV acts as a pathogen. The following review will briefly discuss current aspects of the mechanisms involved in UV‐induced signal transduction.
Ultrastructural Study of Acquired Pili Torti‐like Hair Defects Accompanying Pseudopelade
Authors: Sakamoto Fumiko , Ito Masaaki , Saito Ryuzo
Published: July 2014

Acquired structural hair defects are caused by various physical and chemical manipulations. Plucked hairs and hair follicle biopsy specimens of pili torti‐like hairs that arose from pseudopelade scalp were studied. In scanning electron microscopy, the hair shafts had a segmental pili torti‐like appearance, accompanied by oblique or longitudinal grooves and ridges. In light microscopy, the hair follicles showed an asymmetric hair bulb and inner root sheath, and a shortened keratogenous zone within sclerosing fibrous connective tissue. In transmission electron microscopy, the numbers and thickness of the hair cuticle cells were different on the opposite sides of the hair shaft. The hair cuticle was irregularly shaped and formed asymmetric waves. The tonofilaments in the hair cortex ran almost parallel to the hair axis. From these findings, it was clear that the grooves and ridges were produced by the deformed hair cuticle and cortex, whose shapes were modulated by the asymmetric inner root sheath. This asymmetry most likely resulted from a dysfunctional dermal papilla, which was affected by fibrosis. The pili torti‐like appearance appeared to be caused by the grooves and ridges that ran obliquely on the hair shaft surface.
Proliferating Trichilemmal Cyst: Report of Two Cases, One Benign and the Other Malignant
Authors: Sethi Seema , Singh Usha Rani
Published: July 2014

Proliferating trichilemmal cyst (PTC) is a rare but morphologically distinct tumor that usually arises on the scalp of elderly women. We report two cases of PTC, one benign and the other malignant. PTCs are well circumscribed, subepidermal lesions and demonstrate a uniform histologic pattern with varying degrees of cytological atypia. Malignant proliferating trichilemmal cyst (MPTC) has features in common with benign proliferating trichilemmal cyst (BPTC), including a central area of abrupt keratinization and hyperplastic squamous epithelium forming solid areas. The diagnosis of MPTC is essentially based on histological features. The presence of a high mitotic rate, atypical mitosis, severe nuclear pleomorphism, and tumor invasion of the adjacent tissues are the essential histological features of malignancy in these unusual tumors. The therapeutic approach in malignant cases is the same as that in the treatment of BPTC: surgical removal with a wide clear margin. However, even with adequate resection, both tumors tend to recur locally.
A Japanese Case of Tinea Corporis Caused by Arthroderma benhamiae
Authors: Mochizuki Takashi , Watanabe Seiji , Kawasaki Masako , Tanabe Hiroshi , Ishizaki Hiroshi
Published: July 2014

We report a case of tinea corporis in Japan caused by Arthroderma benhamiae. A 53‐year‐old female scientist, who had been working on dermatophytes in a laboratory, noticed pruritic erythema on the outer corner of her left lower eyelid. She used a steroid ointment for three days, but the lesion continued to expand. When she visited our clinic, the erythema was 15 mm in diameter and clearly demarcated with a slightly depressed center. A scale from the periphery of the erythema was positive with direct KOH examination, and T. mentagrophytes was isolated from the lesion. The erythema was successfully treated with topical application of butenafine hydrochloride. The isolate was mated with a (+) strain of the Americano‐European race of A. benhamiae. Using the most sensitive molecular typing method, restriction exzyme analysis of the non‐transcribed spacer region of the ribosomal DNA, the restriction profile of the isolate was the same as that of strains used in her laboratory but different from those of any Japanese isolates associated with pet animals. The results suggest that the patient became infected during her experiment.
Dapsone in Behçet's Disease: A Double‐Blind, Placebo‐Controlled, Cross‐Over Study
Authors: Sharquie Khalifa E. , Najim Rafid A. , Abu‐Raghif Ahmed R.
Published: July 2014

The study was designed to investigate the effects of dapsone in the treatment of mucocutaneous manifestations of Behçet's disease and the possible prophylactic role of dapsone in a double blind/placebo controlled clinical trial. Twenty patients diagnosed according to the International Study Group criteria as Behçet's disease were included in the study. Patients were randomly allocated to receive either dapsone 100 mg daily or placebo for three months in a double‐blind manner. After three months, patients were crossed over and followed for a further three months. Patients were followed up in each visit by assessing the number, size, duration and frequency of oral and genital ulcers, other cutaneous manifestations, and systemic manifestations of the disease. A pathergy test was done on each visit. Laboratory investigations included hemoglobin concentration, white blood cell count, ESR, and C‐reactive protein. In dapsone‐treated patients, there were significant reductions in the oral and genital ulcer parameters as well as the incidence of other cutanous and systemic manifestations. In the placebo‐treated group, there were no significant changes in these parameters. The pathergy test result as well as those of other laboratory tests were all decreased in the dapsone‐treated group. Although this study was a small scale study, it shows that dapsone was effective in treatment of mucocutaneous manifestations of Behçet's disease and possibly in prophylaxis against systemic manifestations of the disease. This result should lead to a larger scale study with a longer duration of follow‐up.
Activation of Mast Cells within a Tumor of Angiosarcoma: Ultrastructural Study of Five Cases
Authors: Demitsu Toshio , Inoue Tae , Kakurai Maki , Kiyosawa Tomoharu , Yoneda Kozo , Manabe Motomu
Published: July 2014

The accumulation of mast cells around tumors is a well‐recognized phenomenon in a number of malignancies, including basal cell carcinoma, melanoma, and breast cancer. However, little information exists regarding mast cells within tumor nests. To clarify the role of mast cells infiltrating in skin cancers, we examined the morphological features of mast cells within tumors of five cases of angiosarcoma, including two patients with Stewart‐Treves syndrome, by electron microscopy. In light microscopy, mast cells were observed within tumor nests at various densities and exhibited weak staining intensity with toluidine blue. By electron microscopy, most of the tumor‐infiltrating mast cells exhibited anaphylactic or piecemeal degranulation, indicating that the mast cells had been activated in situ. Some mast cells were noted in close apposition to tumor cells, suggesting the existence of direct cell‐to‐cell interactions. Tumor cells adjacent to mast cells showed no degenerative changes. In conclusion, these results suggest that careful histologic examination in combination with electron microscopy should enable us to identify more mast cells within cancer lesions with greater sensitivity than in a number of prior reports. Furthermore, the close proximity of mast cells and surrounding tumor cells suggests some biologically significant role of mast cells in the development of angiosarcoma, including tumor growth as well as host immunity and stromal reaction.
Onion Juice (Allium cepa L.), A New Topical Treatment for Alopecia Areata
Authors: Sharquie Khalifa E. , Al‐Obaidi Hala K.
Published: July 2014

Alopecia areata is a patchy, non‐scarring hair loss condition. Any hair‐bearing surface may be involved, and different modalities of treatment have been used to induce hair re‐growth. This study was designed to test the effectiveness of topical crude onion juice in the treatment of patchy alopecia areata in comparison with tap water. The patients were divided into two groups. The first group [onion‐juice treated] consisted of 23 patients, 16 males (69.5%) and 7 females (30.5%). Their ages ranged between 5–42 years with a mean of 22.7 years. The second group [control; tap‐water‐treated] consisted of 15 patients, 8 males (53.3%) and 7 females (46.6%). Their ages ranged between 3–35 years with a mean of 18.3 years. The two groups were advised to apply the treatment twice daily for two months. Re‐growth of terminal coarse hairs started after two weeks of treatment with crude onion juice. At four weeks, hair re‐growth was seen in 17 patients (73.9%), and, at six weeks, the hair re‐growth was observed in 20 patients (86.9%) and was significantly higher among males (93.7%) compared to females (71.4%) P<0.0001. In the tap‐water treated‐control group, hair re‐growth was apparent in only 2 patients (13%) at 8 weeks of treatment with no sex difference. The present study showed that the use of crude onion juice gave significantly higher results with regard to hair re‐growth than did tap water (P<0.0001), and that it can be an effective topical therapy for patchy alopecia areata.
Our Experience with Aplasia Cutis Congenita
Authors: Çaksen Hüseyin , Kurtoğlu Selim
Published: July 2014

Aplasia cutis congenita is a rare disorder characterized by developmental absence of skin on the scalp as multiple or solitary, noninflammatory, well demarcated, oval or circular 1‐ to 2‐cm ulcers. The disease may be isolated or associated with anomalies of the skin, eyes, ear‐nose‐neck and limbs, developmental defects of the cardiovascular, gastrointestinal, genitourinary and central nervous systems, and malformation syndromes such as chromosomal abnormalities, Adams‐Oliver syndrome, Bart's syndrome, and Johanson‐Bilzzard syndrome. In this article, five newborn infants with aplasia cutis congenita (one associated with Adams‐Oliver syndrome and another concomitant with Bart's syndrome) are reported because of their rare presentation in the literature.
Blood Thiols and Malondialdehyde Levels in Psoriasis
Authors: Relhan Vineet , Gupta Sunil K. , Dayal Surabhi , Pandey Rajesh , Lal Harbans
Published: July 2014

Forty patients with psoriasis and forty healthy controls were enrolled to study the levels of total blood thiols (an important part of the body's antioxidant defence system) and plasma malondialdehyde (a lipid peroxidation product). The levels of total blood thiols in psoriatic patients in the acute phase were significantly lower than those in controls, but total blood thiol levels in psoriatic patients in the remission phase were not significantly different from those in controls. There was a significant difference between levels of total blood thiols of patients in the acute phase and in remission. The levels of plasma MDA were significantly raised in psoriatic patients in the acute phase as compared to those in controls and in patients in remission. The differences in levels of plasma MDA were not significant between control subjects and patients in remission. These findings suggest a role of oxidative stress in the etiopathogenesis of psoriasis.
Familial Amyloidosis Cutis Dyschromica: Six Cases from Three Families
Authors: Choonhakarn Charoen , Wittayachanyapong iporn
Published: July 2014

Amyloidosis cutis dyschromica, a rare form of primary cutaneous amyloidosis requiring histopathological confirmation, is characterized by generalized, asymptomatic hyperpigmentation intermingled with several hypopigmented spots without papulation, atrophy, and telangiectasia. Its onset usually begins before puberty. We describe six patients from three families, four male and two female. The mean age at onset was 10.2 years. Although the skin eruptions had developed extensively since childhood, systemic involvement was not evident even after long‐term follow‐up. Due to its unique and characteristic features, this condition should be considered as a separate entity and differentiated from other variants of primary cutaneous amyloidosis. The familial occurrence in our report suggests a genetic causal factor in this disease.