bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical and Immunohistochemical Responses of Plantar Warts to Topical Immunotherapy with Diphenylcyclopropenone
Authors: van der Steen Pieter , van de Kerkhof Peter , der Kinderen Daan , van Vlijmen Ivonne , Happle Rudolf
Published: April 2015

A 30‐year‐old man with bilateral plantar warts of the mosaic type which had been resistant to standard treatment modalities was treated with diphenylcyclopropenone. After 10 weeks, the treated warts had disappeared; the untreated warts, although showing some involution, still persisted. The untreated warts, serving as a control to prove the effectiveness of topical immunotherapy, responded likewise to subsequent treatment with diphenylcyclopropenone. Wart regression was reflected histopathologically by decreases in acanthosis, papillomatosis, granular vacuolation, and hyperkeratosis. Immunohistochemically, Ki‐67 expression was markedly reduced, and a reversal of the CD4/CD8 ratio was seen. These findings suggest a major role of a cell‐mediated immune response in the spontaneous resolution of warts.
Recurrent Malignant Fibrous Histiocytoma with Expression of Cytokeratin
Authors: Murakami Isamu , Itami Satoshi , Fujiwara Sakuhei , Terashi Hiroto , Kurata Sotaro , Honda Tomohito , Shinkai Hiroshi , Takayasu Susumu
Published: April 2015

A case of locally recurrent malignant fibrous histiocytoma was documented in a 70‐year‐old man. He first noticed a subcutaneous nodule forty years previously. The tumor was surgically removed four times during the last four years with local recurrence on every occasion. In the recurrent tumors, the tumor cells almost completely replaced the whole dermis and invaded skeletal muscles. They were composed of pleomorphic spindle cells arranged in a storiform pattern and bizarre histiocytic cells, which were present principally in the deeper portions of the tumor. Both types of tumor cells showed marked nuclear atypicality. In the primary tumor, surrounding a large necrotic area, spindle‐shaped cells were arranged in a storiform pattern. These tumor cells exhibited only mild nuclear atypia. The recurrent tumor was strongly positive for vimentin and alpha‐1‐antichymotrypsin. Most tumor cells were also weakly positive for KL1, a monoclonal antibody for keratin. A Western‐blot analysis revealed the presence of two bands (62 and 69 Kd) reacting with KL1 in the fractions which were obtained from the tumor according to the method for keratin extraction.
An Electron Microscopic Study of Experimentally‐induced Comedo and Effects of Vitamin A Acid on Comedo Formation
Authors: Maeda Tetsuo
Published: April 2015

The mechanisms of comedogenesis and comedolysis were investigated at the ultrastructural level after applying oleic acid (OA) only, or oleic acid together with vitamin A acid (VAA), to rabbit ears daily for two weeks.

In the follicular epithelium of the experimentally‐induced comedo (EIC) by OA, several ultrastructural changes similar to those in human comedo were observed. EIC in rabbit ears appeared to be induced both by the hyperkeratinization of the follicular epithelium and by the delayed desquamation of horny cells due to the persistence of intercellular binding apparatus.

VAA strongly inhibited the formation of EIC. In the follicular epithelium, two different types of changes, non‐cohesive hyperkeratinization and inhibition of keratinization, were observed. These represent the cell injury and recovery stages, respectively. VAA induced the disturbance of follicular epithelial keratinization and reduction of intercellular bindings between horny cells. These effects might prevent the cohesion and accumulation of horny cells and inhibit EIC formation.

The number of Odland bodies (Ods) showed an inverse correlation with the cohesion of horny layer. These findings support the theory that Ods have a desquamating function as extracellular lysosomes. The change in Ods would also contribute to both EIC formation by OA and the inhibition by VAA. In addition, VAA caused a characteristic increase in Ods with lamellar structures. It is suggested that Ods with lamellar structures have a desquamating function.
An Immunohistochemical Study of Mixed Tumor of the Skin
Authors: Mohri Shinobu , Andoh Shin'ichiro
Published: April 2015

An asymptomatic tumor developed on the upper lip of a 63‐year‐old man. Histologically, the tumor contained glandular and cystic structures forming many branching lumina, and many scattered single cells in an abundant mucoid to chondroid stroma. The tumor was diagnosed as mixed tumor of the skin. Histochemically, the cells composing the tubular structures contained neutral mucopolysaccharides and the stroma, acid mucopolysaccharides. Immunohistochemically, the cells of the glandular and cystic structures showed epithelial and sweat gland differentiation (EMA‐, CEA‐, BRST‐1‐and BRST‐2‐positive), while the cells scattered in the stroma showed a tendency toward myoepithelial differentiation (S‐100 protein‐ and vimentin‐positive).
Modulation of Epidermal Terminal Differentiation in Patients after Long‐term Topical Corticosteroids
Authors: Sheu Hamm‐Ming , Tai Chang‐Long , Kuo Kou‐Wha , Yu Hsin‐Su , Chai Chee‐Yin
Published: April 2015

The expression of the various markers for terminal epidermal differentiation in atrophic skin of patients after long‐term topical corticosteroids (TCS) was studied by electron microscopy, immunofluorescence using antibody to profilaggrin/filaggrin (PF/FG), immunoperoxidase staining using antibody to involucrin, and oil red O stain for neutral lipids of the stratum corneum. Thirty‐nine patients were subdivided into two groups: (A) 19 patients suffering from rebound phenomenon after stopping TCS and (B) 20 patients without rebound phenomenon. Biopsy specimens were taken before ending the use of TCS in both groups. In group A, both the morphological markers (including the different epidermal strata, keratohyalin granules, lamellar granules, and cornified cell envelopes) and the molecular markers (including involucrin, PF/FG, and neutral lipids) of terminal epidermal differentiation were significantly suppressed. On the other hand, the differentiational markers in the atrophic skin of patients without rebound phenomena were only slightly altered. These results suggest that potent TCS not only has antiproliferative actions but also inhibits the differentiation of epidermis, resulting in structural defects in the epidermis, especially the stratum corneum.
A Pedunculated Follicular Hamartoma: A Case Showing a Central Trichofolliculoma‐like Tumor with Multiple Trichogenic Tumors
Authors: Kato Naoko , Ueno Hiroo
Published: April 2015

We report a rare case with a pedunculated nodule on the nasal septum, which seems a kind of follicular hamartoma with a pedunculated appearance. Our case was a 77‐year‐old Japanese male with an 11 times 11 times 10 mm sized, skin‐to‐pink colored, pedunculated nodule on the center of his nasal septum. Histopathological study revealed the nodule to be a well‐formed dilated hair follicle at the central pore of the tumor, where keratin debris and vellus hairs were present. In addition, epithelial cells forming long thin strands or immature follicle‐like structures had proliferated multifocally from the epidermis of the wall of the central follicle to the peripheral epidermis. One distinctive feature was the formation of a primary germinal bud with thick concentric collagen fibers and sparse elastic fibers. Although a combined tumor of trichofolliculoma with highly‐graded desmoplasia, multiple trichogenic trichoblastomas, and perifollicular fibromas was suggested, calling it a pedunculated follicular hamartoma seemed more useful because the pathological features were basically similar to reported follicular hamartomas and the clinical feature was so distinctive.
Sclerotic Fibromas of the Skin
Authors: Nogita Toshitatsu , Akiyoshi Emiko , Kawashima Makoto
Published: April 2015

We report a case of a 34‐year‐old Japanese woman with a fibrous tumor on the left palm that fulfilled the criteria of sclerotic fibroma of the skin. Immunohistochemically, the tumor cells were positive for vimentin, but negative for S‐100 protein and neuron‐specific enolase. Ultra‐structurally, the cross‐striations of collagen microfibrils were less prominent. Our case supports the concept that sclerotic fibroma of the skin is a distinctive lesion which may represent a hamartoma of the skin.
A Case of Atypical Inter‐muscular Lipoma (Evans)
Authors: Kashima Masato , Saito Kazuyoshi
Published: April 2015

A case of a 51‐year‐old woman with a lipoma‐like tumor on the right arm which showed rapid recurrence after the first simple excision is reported. On the second surgical operation, a lipoma‐like tumor with extensive growth between the biceps muscle and brachialis muscle of the right arm was noted. Histological examination revealed almost mature fat cells and scattered atypical lipoblast‐like cells. For the treatment of an atypical inter‐muscular lipoma, complete excision is necessary, although very extensive treatment is not recommended.
Eruptive Steatocystoma Multiplex on the Scalp
Authors: Kumakiri Masanobu , Yajima Chiho
Published: April 2015

We report a 71‐year‐old Japanese woman who noticed approximately 120 small yellowish cysts on the scalp from nine months before her first visit. An incision made into the cysts discharged oily yellow material. Biopsy of a lesion disclosed that the cysts had typical features of steatocystoma multiplex histologically. This case was a unique eruptive variety of steatocystoma multiplex on the scalp.
Squamous‐cell Carcinoma Arising in Solar Keratosis of a Leprosy Patient: Relationship with Positive Skin Smear Examination
Authors: Kikuchi Ichiro , Nogami Reiko
Published: April 2015

A 70‐year‐old Japanese female with lepromatous leprosy developed squamous‐cell carcinoma within a long standing area showing solar keratoses on her head. Alopecia had been present at least for the preceding 34 years on her forehead and frontal area of the head, and solar keratoses had existed at least for the previous 9 years. Skin smear examination for acid‐fast bacilli which had continually been negative for the previous 2 years (during which 8 examinations were done) became positive. We assume that there may be some relationship between the onset of the tumor and the positive skin smear examination, although the exact connection remains unclarified.
Large Bullous Eruption in Patients with Ulcerative Colitis
Authors: Ishibashi Akira , Yamaji Kazufumi , Hayashi Yoshitomo , Miyahara Tohru , Niwa Hirofumi
Published: April 2015

Oligocentric large bullous eruptions in two patients with ulcerative colitis were reported.

Such bullae were similar to those seen in drug‐induced coma, and those described as drug eruption due to high dose frusemide. However, neither narcotic drugs nor frusemide had been given in either case. The bullae were cured after the administration of corticosteroid and/or salazosulfapyridine with a course paralleling that of the ulcerative colitis. Thus the bullae seem to be a cutaneous manifestation of ulcerative colitis.
Differential Oxygen Sensitivities in G6PDH Activities of Cultured Keloid and Normal Skin Dermis Single Cells
Authors: Sit Kwok Hung , Lau Yeow Kok , Aw Swee Eng
Published: April 2015

Cell cultures of excised keloids and biopsied normal skin were established from patients of the Plastic Surgery Department of Singapore General Hospital and their single cells quantitated for glucose‐6‐phosphate dehydrogenase (G6PDH) activity using microspectrophometry. G6PDH has been cited as a transformation‐linked discriminant. Analysis of variance shows no difference in overall activity between skin and keloid cells, but under oxygen saturation conditions, keloid G6PDH activity was significantly higher than skin G6PDH activity, although they were almost identical under nitrogen saturation conditions. Differential oxygen sensitivity in G6PDH activities between malignant and non‐malignant cells have been reported, but its occurrence between keloid and normal skin cells is novel, especially as the keloid is regarded as a benign tumor with a zero carcinogenicity rate.
Clinical Evaluation of Cutaneous Malignant Melanoma with Histologically Involved Lymph Node Metastases
Authors: Sugihara Tsuneki , Yoshida Tetsunori , Ohura Takehiko , Ohkawara Akira , Kumakiri Masanobu
Published: April 2015

Thirty‐six cases of cutaneous malignant melanoma with histologically involved lymph nodes were studied during a 2–10 year study period, and the characteristics of the metastasized nodes and the associated prognosis were compared. The results were as follows: 1) the survival rate in cases with 3 or fewer (n=16) metastasized nodes was significantly higher than in cases with 4 or more positive nodes (n=20); 2) the survival rate in cases in which metastasized nodes were limited to one regional lymph node section (n=12) was significantly higher than in cases where metastasis extended to two or more intra‐regional sections of nodes (n=24); 3) cases which had nodes measuring 3.00 cm or less (n=25) had significantly higher survival rates than those with nodes of 3.01 cm or more (n=11). Therefore, the results indicate that the number of metastasized lymph nodes, the extension into regional lymph node sections, and the size of the metastasized lymph node(s) can be considered as important prognostic factors for melanoma patients.
Transepidermal Elimination of Thrombi in Three Cases of Thrombotic Angiokeratoma: An Incidental Histopathologic Finding of Angiokeratoma
Authors: Bang Dongsik , Choi Young‐sik , Song Min Seok
Published: April 2015

Transepidermal elimination (TEE) is a well known phenomenon by which foreign or altered constituents are removed from the dermis. A thrombosis in the dilated dermal blood vessels of angiokeratoma is not unusual, hence the term thrombotic angiokeratoma.

We recently reviewed the histopathologic findings of previously diagnosed cases of angiokeratoma and found that multiple histologic sections of surgical biopsy materials disclosed changes indicating TEE of thrombi in three cases. Special stains searching for an altered substance in those thrombi failed.

In this report of three cases, we suggest that this phenomenon could be an incidental and long missed histopathologic finding of angiokeratoma which might explain the fate of these thrombi.
A Case of Erythropoietic Protoporphyria with Severe Liver Dysfunction Suggesting a Close Relationship between Erythrocyte Protoporphyrin Levels and Those of γ‐GTP
Authors: Watanabe Masahisa , Ohgami Taro , Nonaka Shigeo , Yoshida Hikotaro , Tanaka Masakazu
Published: April 2015

A case of erythropoietic protoporphyria (EPP) with severe acute abdominal pain and jaundice was reported. Erythrocyte protoporphyrin (PP) levels were constantly high, and liver histology showed a slight fibrosis with inflammatory infiltation. During the investigation period of 18 months, erythrocyte PP levels closely paralleled those of serum γ‐GTP.
Characterization of the Lymphoproliferative Diseases in the Skin by DNA Analysis
Authors: Nakajima Naoko , Tanaka Toshihiro , Miyachi Yoshiki , Imamura Sadao , Kakizuka Akira
Published: April 2015

Various samples from lymphoproliferative diseases in the skin were analyzed by Southern blotting technique with probes from the T cell receptor gene, immunoglobulin genes, and human T cell leukemia virus‐I genome. Samples were taken from 10 mycosis fungoides (MF) patients, 1 parapsoriasis en plaque patient, 10 Adult T cell leukemia/lymphoma (ATL) patients, 1 cutaneous T cell lymphoma (CTCL) patient, 4 lymphomatoid papulosis (LP) patients, 4 B cell lymphoma patients, and 2 actinic reticuloid (AR) patients. In MF, the monoclonality of the T cells became detectable first in the skin when plaques develop to tumors then in lymph nodes, and finally in the blood lymphocytes, indicating this disease develops from local (skin) malignancy to systemic malignancy. In parapsoriasis en plaque, no monoclonality was detected in any sample. We could distinguish cutaneous ATL from the carrier state by detecting the T cell monoclonality and HTLV‐I integration with these probes. One patient with CTCL showed detectable T cell monoclonality; 1 out of 4 patients with LP did the same. Four samples from patients with B cell lymphoma revealed detectable monoclonal rearrangement of immunoglobulin heavy and light chain genes. In AR, no monoclonality was detected in any sample. From these data, we conclude that DNA analysis is useful in determining the monoclonality, cell origin, and distribution of monoclonal cells from skin samples.
Dinitrochlorobenzene Treatment of Verrucae Plana
Authors: Shah Kirtikant C. , Patel Raksha M. , Umrigar Dipak D.
Published: April 2015

In a purely clinical, unbiased study, 50 patients with verrucae plana were treated with dinitrochlorobenzene for 1–24 weeks, keeping half the lesions as controls. The results were statistically insignificant when the treated patients were compared to the control group.
Annular Elastolytic Giant Cell Granuloma: An Unusual Case with Papular Lesions
Authors: Kato Hideyuki , Kitajima Yasuo , Yaoita Hideo
Published: April 2015

A 63‐year‐old Japanese woman with multiple annular lesions on the bilateral abdomen developed numerous papules on the upper part of the back and forearms.

A skin biopsy specimen taken from a papule showed the findings of annular elastolytic giant cell granuloma.
Two Cases of Diaper Area Granuloma of the Adult
Authors: Fujita Mayumi , Ohno Sayoko , Danno Kiichiro , Miyachi Yoshiki
Published: April 2015

Two cases of diaper area granuloma are reported.

Patient 1, a 34‐year‐old man, had multiple reddish‐purple nodules over the diaper area of the right part of the genitocrural region. Candida albicans was not detected from the lesion. Histological examination of the nodule showed acanthosis and dense infiltrates. The granulomas became smaller and flatter after the control of urination.

Patient 2, a 28‐year‐old man, had two large decubitus lesions and multiple nodules over the diaper area of the gluteal region. The decubitus became smaller and the granulomas disappeared after the lesion was kept clean.

Because these granulomas resemble granuloma gluteale infantum, but occurred in adults rather than in the aged or infants, we propose to call this condition “granuloma gluteale adultorum.”

We suggest that these granulomas may represent an inflammatory reaction to the irritation of urine or feces. It is, therefore, of great importance to treat and prevent this condition by controling the flow of urine and keeping the region clean.
Confluent and Reticulated Papillomatosis: A Clinical, Histopathological, and Electron Microscopic Study
Authors: Lee Seung Hun , Choi Eung Ho , Lee Won Soo , Kang Won Hyoung , Bang Dongsik
Published: April 2015

The clinical, histopathological, and electron microscopic features often patients with confluent and reticulated papillomatosis (CRP) of Gougerot and Carteaud were studied. Histopathologically, hyperkeratosis, decreased granular layer, irregular papillomatosis, and hypermelanosis of the basal layer were present. In an electron microscopic study, we found transitional cells between the stratum granulosum and stratum corneum that were increased in CRP. This finding supported the suggestion that this is a defect of keratinization.
Cutaneous Reaction Induced by Retained Bee Stinger
Authors: Hur Won , Ahn Sung Ku , Lee Seung Hun , Kang Won Hyoung
Published: April 2015

The clinical features and histopathologic findings of a 54‐year‐old Korean male who had retained the sting apparatus of a bee for four months are described. The clinical features showed ulcerative, erythematous plaques with irregular borders which resembled cutaneous neoplasms such as squamous cell carcinoma. Histopathologic findings included epidermal necrosis and marked pseudoepitheliomatous hyperplasia. In the dermis, the stick‐shaped sting apparatus of the bee was demonstrated and intense lymphohistiocytic and eosinophilic infiltrations were noted.
Acute Dacryocystitis Resembling an Infected Subcutaneous Cystic Tumor
Authors: Sawada Yukimasa , Nomura Kazuo
Published: April 2015

Two cases of acute dacryocystitis are described. Both cases manifested as a painful cystic tumor which enlarged suddenly with swelling of the involved cheek. The condition was quite similar to an infected epidermal cyst. The location of the tumor and an episode of epiphora are the characteristic features of this disease.
Comparative Study of Ki‐67 Immunostaining and Nuclear DNA Content in Histiofibrous Tumors
Authors: Ooe Mariko , Nogita Toshitatsu , Kawashima Makoto
Published: April 2015

A comparative assessment was made of dermatofibroma, dermatofibrosarcoma protuberans, and malignant fibrous histiocytoma. The study was comprised of an immunohistochemical investigation using the Ki‐67 monoclonal antibody and a quantitative analysis of cell nuclear DNA using flow cytometry. It was found that the index of Ki‐67 monoclonal antibody labeling, the histogram pattern, and DNA index correlated with clinical malignancy, suggesting the usefulness of these indices for differential diagnosis and evaluation of prognosis.
Common Histopathological Processes of Phenytoin Drug Eruption
Authors: Tone Takeshi , Nishioka Kiyoshi , Kameyama Kouichirou , Asai Toshiya , Takezaki Shinichirou , Nishiyama Shigeo
Published: April 2015

Fifteen patients (6 males and 9 females) with phenytoin drug eruptions which ultimately resulted in various skin manifestations were analyzed histopathologically. The following types of skin manifestations were noted; 2 cases of toxic epidermal necrolysis, 2 cases of mucocutaneous occular syndrome, 6 cases of erythema exudative multiform, 3 cases of lichenoid, and 2 cases of the maculopapular type. All of the biopsied specimens from these different skin manifestations exhibited some of the more common histopathological findings: 1) adhesion of the infiltrated cells to the basal layer of the epidermis, 2) cell infiltration into the epidermis, 3) vacuolation of the basal cells, 4) dyskeratotic cells in the epidermis, and epidermal necrosis.

Immunohistopathological examinations in 5 typical cases with different skin manifestations revealed that epidermal cells and infiltrating cells were HLA‐DR antigen positive. The infiltrating cells in the dermis consisted of almost equal numbers of CD4+ and CD8+ cells; CD8+ cells were predominant in the cells infiltrating into the epidermis. These findings suggest a possibility that the various clinical features in phenytoin drug eruptions may share some common mechanisms.
Microcystic Adnexal Carcinoma: A Case Report with Immunohistochemical and Electron Microscopical Examinations
Authors: Kato Naoko , Yasuoka Atsushi , Ueno Hiroo
Published: April 2015

Microcystic adnexal carcinoma (MAC) is an unusual cutaneous neoplasm comprised of pilar and sweat duct structures. We report here a 66‐year‐old Japanese woman with MAC on her left nasolabial fold with more prominent calcified keratinous cysts than ductal differentiated structures which stained positively for carcinoembryonic antigen (CFA). The clinical appearance and statistical characteristics of MAC are reported to be different from those of other adnexal tumors. Desmoplastic trichoepithelioma (DTE) is the most difficult tumor to differentiate from MAC, unless positive reactivity for CFA in differentiated ductal structures in MAC can be demonstrated. We compare the differences between the clinical, histological, immunohistochemical, and electron microscopical features of DTE and MAC. It seems probable that these differences could be explained by biological differences in the characteristics of the cells from which these tumors originate, hair follicle cells and eccrine sweat cells, respectively.
Epidermal Keratinocytes of Bullous Pemphigoid Express Intercellular Adhesion Molecule‐1 (ICAM‐1)
Authors: Karashima Tadashi , Hachisuka Hiroshi , Okubo Keiji , Sasai Yoichiro
Published: April 2015

Intercellular adhesion molecule‐1 (ICAM‐1) is the ligand for lymphocyte function associated antigen‐1 (LFA‐1), mediating the adhesion of lymphocytes to vascular endothelium. Keratinocytes are known to express ICAM‐1 in some inflammatory dermatoses. Using an indirect immunofluorescence method, we examined the patterns of ICAM‐1 and LFA‐1 staining in bullous pemphigoid (BP) lesions and compared them to pemphigus vulgaris (PV) cases. ICAM‐1 was expressed on the cell surface and in the cytoplasm of epidermal keratinocytes at the sites of erythematous and bullous lesions of BP. LFA‐1 molecules were expressed on T cells at the basement membrane zone. In addition, HLA‐DR‐positive keratinocytes were observed in the basal layer. ICAM‐1 was not, however, expressed on epidermal keratinocytes in uninvolved skin from BP patients, PV or normal control skin. It is known that ICAM‐1 is expressed on keratinocytes at the site of lymphoid infiltration in cutaneous dermatoses and that LFA‐1‐positive T cells can bind to interferon gamma‐induced ICAM‐1‐positive keratinocytes. Our results suggest that cellular immunity involving ICAM‐1 and LFA‐1 may play a part in the pathogenesis of bullous pemphigoid.
Significance of Monocytosis in Varicella and Herpes Zoster
Authors: Tsukahara Tetsuya , Yaguchi Atsushi , Horiuchi Yasuhiro
Published: April 2015

Percent ratios and absolute numbers of peripheral blood monocytes in patients with varicella and herpes zoster were determined and compared with those in patients with herpes simplex virus infection, measles and rubella. Monocytosis during the acute stage (p<0.01) was statistically significant in varicella and generalized and localized herpes zoster, compared with the levels in herpes simplex virus infection, measles and rubella. Absolute monocyte counts in varicella and HZ were significantly increased (p<0.02) beyond those of measles and rubella. The high % ratios of monocytes in varicella and herpes zoster during the acute stage decreased to normal ranges with cure.
Molluscum Contagiosum Occurring in an Epidermal Cyst
Authors: Park Soo Keun , Lee Jun Young , Kim Young Hwan , Kim Si‐Yong , Cho Baik Kee , Houh Won
Published: April 2015

We present three unusual cases of molluscum contagiosum occurring in epidermal cysts. All of them are asymptomatic, elevated, oval nodules diagnosed clinically as epidermal inclusion cyst or prurigo nodularis. Histology showed true epidermal cysts containing molluscum bodies throughout the cyst wall and some type of laminated material within the cyst itself. The lesion, in all three cases developed in the pubic area of young adult men.
Expression of Human T‐cell Lymphotropic Virus Type‐1 Gene Products in the Short‐term Cultured Skin Tissues of an Adult T‐cell Leukemia/Lymphoma Patient with Cutaneous Manifestations
Authors: Setoyama Mitsuru , Katahira Yoshihiko , Hamada Tetsu , Tashiro Masaaki , Yashiki Shinji , Tanaka Yuetsu , Tozawa Hideki , Sonoda Shunro
Published: April 2015

Adult T‐cell leukemia/lymphoma (ATLL) is recognized as a disease etiologically associated with human T lymphotropic virus type‐1 (HTLV‐1) infection, but, neither viral replication nor specific virus antigen expression have been detected on ATLL cells distributed in organs, including skin. To examine the latent expression of HTLV‐1 in the cutaneous lesions of ATLL patients, we cultured the lesional skin tissues in vitro and applied immunofluorescence staining with mouse monoclonal antibodies Lt‐4, GIN‐14, and F10, which react with p40tax, p19 and gp21, respectively.

We recognized HTLV‐1 specific antigens on clustered ATLL cells only in the deeper dermis of the skin after 24 hrs cultivation of the lesional skin tissue from an ATLL patient in RPMI‐1640 medium supplemented with 20% fetal calf serum. In the electron microscope, we observed HTLV‐1 like particles, 80–140 nm in diameter with envelope and core structures, in the same tissue specimen. These findings suggest that HTLV‐1 gene products may be expressed in the skin lesions of ATLL patients and involved in the pathogenesis of skin eruptions in cutaneous type ATLLs.

To our knowledge, this is the first report that envisages the potency of intracutaneous HTLV‐1 expression in vivo.
A New Animal Model for Contact Dermatitis: The Hairless Guinea Pig
Authors: Miyauchi Hiroko , Horio Takeshi
Published: April 2015

Allergic and irritant contact reactions were evaluated in the recently identified hairless guinea pig, Crl:IAF(HA)BR, a mutant from the Hartley strain. The cutaneous changes were observed macro‐ and microscopically. The irritant contact dermatitis was induced by croton oil, 2,4‐dinitrochlorobenzene (DNCB), or anthralin. Both hairless and hairy guinea pigs developed similar reactions to these chemicals. The density of the epidermal Langerhans cells (LC) of hairless guinea pigs was significantly higher than that in the hairy strain. Allergic contact sensitization was easily induced with DNCB. Photoallergic contact sensitization was also induced with tetrachlorosalicylanilide (TCSA) but not with tribromosalicylanilide (TBS). However, by administration of cyclophosphamide before sensitization, positive photocontact responses were seen with TBS. These results indicate that hairless guinea pigs can be used as animal models for investigation of immunologic and nonimmunologic contact reactions.
Immunohistochemical Characterization of Cellular Infiltrates in Epidermal Tumors Induced by Two‐stage and Complete Chemical Carcinogenesis in Mouse Skin
Authors: Moon Doo Chan , Nakayama Juichiro , Urabe Atsumichi , Terao Hiroshi , Kinoshita Nadao , Hori Yoshiaki
Published: April 2015

We investigated the population and pattern of the infiltrated cells in both benign and malignant epidermal tumors which were induced chemically with benzo(a)pyrene (B(a)P) in murine skin. In benign papillomas, which were evolved by a two stage carcinogenesis regimen, a slight to mild inflammatory infiltration around the tumors was observed, and cells infiltrating into the tumor nests were rarely seen. In carcinomas, which were produced by a complete carcinogenesis regimen, a dense inflammatory infiltration was observed around the tumor nests. The infiltrated cells were characterized as T‐lymphocytes, macrophages, and neutrophils. Natural killer (NK) cells were found around and in the tumor nests, but their number was small. Both T‐lymphocytes and macrophages were found to invade the tumor nests in squamous cell carcinoma whose duration was more than four weeks. This experimental carcinogenesis animal model allows the detailed quantitative and functional analysis of the infiltration of immunocompetent cells into epidermal tumors.
Long‐standing Dermatological Manifestations in a Patient with Chronic Heavy Metal Intoxication
Authors: Abraham Zeev , Glück Zahava , Feuerman Eleasar J. , Kinarty Amalia , Lahat Nitza
Published: April 2015

A patient with chronic metal intoxication is described, presenting during four years after the cessation of her exposure to industrial substances, maculo‐papular eruptions with several ulcerated lesions and excoriations on her abdomen and buttocks. She also had pallor of her face, greyish‐dark discoloration of the hair, while the fingernails were brittle and sensitive. Scrupulous physical examination excluded further cutaneous involvement The immunological workup revealed both phenotypic and functional defects in cellular immunity.
Eosinophil Involvement in Atopic Dermatitis as Reflected by Elevated Serum Levels of Eosinophil Cationic Protein
Authors: Tsuda Shingo , Kato Keiko , Miyasato Minora , Sasai Yoichiro
Published: April 2015

Eosinophil cationic protein (ECP), one of the eosinophil granule proteins, is released during allergic reactions. We investigated the possibility of correlations among the serum levels of ECP, clinical activity, and eosinophil number in patients with atopic dermatitis (AD). Forty‐four patients with AD and 25 normal, non‐atopic subjects were studied. ECP was quantitated by a double antibody radioimmunoassay. The levels of serum ECP correlate with the grading of severity of clinical evaluations in AD. The patients with severe and moderate AD had significantly higher ECP concentrations than normal controls (p<0.001); mild AD had levels identical with those of control groups. A positive correlation was observed between the number of peripheral blood eosinophils and serum ECP levels in the severe cases (r=0.67, p<0.05). Furthermore, these ECP levels significantly decreased in response to either improvement of clinical severity of AD or decreased numbers of blood hypodense eosinophils in anti‐allergic drug‐treated patients. No coefficient of correlation was observed between serum ECP and IgE levels. These findings indicate that eosinophils may release their granular contents, including ECP, into the peripheral circulation and/or inflammatory skin lesions and subsequently provoke a clinical exacerbation by stimulating allergic reactions.
Cell Proliferative Activity of Epidermal Keratinocytes in Hair Discs
Authors: Suzuki Hiroyuki , Baba Shunichi , Murase Mami
Published: April 2015

To clarify the differences in epidermal keratinocyte proliferative activity and in postnatal developmental changes of this activity between the hair discs and the interfollicular epidermis, the incorporation of 3H‐thymidine into the nuclei of the basal cells was measured by autoradiography, and the percentages of basal cells thus labelled were calculated. This percentage was higher in hair discs than in interfollicular epidermis at all stages examined. The percentage of labelled basal cells in the hair discs was 10% up to 15 days after birth, decreasing to about 6% from 20 days postnatally. These results suggest that the degree of cell proliferation in the hair disc epidermis differs from that in the surrounding epidermis and that changes in proliferative activity during the postnatal developmental stages are well correlated with the morphogenesis of the hair discs.
Immunogenetic Study of Three Japanese Families with Neonatal Lupus Erythematosus
Authors: Nitta Yukiko , Ikeya Toshihiko , Santa Tetsuro , Ohashi Masaru , Usuda Toshikazu
Published: April 2015

We encountered three Japanese families with neonatal lupus erythematosus. None of the three fathers showed any signs of collagen disease. The three mothers were found to suffer from Sjögren's syndrome; they all tested positive for anti‐SSA and SSB antibodies and had lymphocyte infiltration into the small salivary gland. In two families, one child had neonatal lupus erythematosus while a sibling was normal; in the third family, both children had neonatal lupus erythematosus. Thus, a mother with positive anti‐SSA and SSB antibodies can give birth to one infant with and one infant without or have two infants with neonatal lupus erythematosus. We conducted HLA typing of all 12 members of the three families in order to clarify the immunologic factors involved. We found no increased frequency of any HLA phenotype in the three mothers and their four children with neonatal lupus erythematosus; however, HLA‐DR4 was present in three of the children with neonatal lupus erythematosus.
Eruptive Lichen Planus
Authors: Kanzaki Tamotsu , Otake Naoki , Nagai Morihito
Published: April 2015

We herein report a case of a rare variety of the acute eruptive form of lichen planus. The patient was a 51‐year‐old male who developed an intensely pruritic eruption on the lower legs which spread rapidly to all four extremities and trunk within a few months. The papulosquamous lesions were more than ten thousand in number. Topical steroid, cyclosporine, and systemic griseofulvin treatments were ineffective. However, there was a dramatic response to oral etretinate.
Blue‐gray Pigmentation in a Patient Receiving Doxorubicin
Authors: Konohana Akira
Published: April 2015

A 64‐year‐old Japanese female who was treated for hepatocellular carcinoma with doxorubicin developed diffuse blue‐gray pigmentation of the face, fading out on the upper trunk. Skin biopsy revealed many melanin granules in the upper dermis. It is believed that the pigmentation was induced by doxorubicin.
Mucha‐Habermann Disease in a Child: Possible Association with Measles Vaccination
Authors: Torinuki Wakio
Published: April 2015

A 2.5‐year‐old boy presented with skin lesions consistent with Mucha‐Habermann disease, which appeared about 5 days after an injection of freeze‐dried live attenuated measles vaccine. He responded to both oral and topical corticosteroid therapy. To my knowledge, this represents the first such association of Mucha‐Habermann disease with virus vaccination.
Oral Spironolactone Therapy in Male Patients with Rosacea
Authors: Aizawa Hiroshi , Niimura Michihito
Published: April 2015

Spironolactone at 50 mg/day was orally administered for four weeks to 13 male patients with rosacea in order to observe its clinical effectiveness. Serum estradiol (E2), 17OH‐progesterone (17OH‐P4), testosterone (T), androstenedione (Δ4A), dihydrotestosterone (DHT), dehydroepiandrosterone sulfate (DHEA‐S) were measured prior to and after treatment. Although there were no significant changes in T, Δ4A, DHT, or DHEA‐S, the serum levels of 17OH‐P4 increased significantly. E2 tended to increase, although the change was not significant Two of the 13 patients discontinued spironolactone treatment because of general malaise, but seven of the remaining eleven patients exhibited an improvement in their rosacea. These findings demonstrate that a low dose of spironolactone is effective in the treatment of rosacea in some male patients and suggest that it is possible that changes in the metabolism of sex steroid hormones such as cytochrome p‐450 isozymes have some bearing on the etiology of rosacea.
The Coexistence of Psoriasis Vulgaris, Sjögren's Syndrome, and Hashimoto's Thyroiditis
Authors: Nogita Toshitatsu , Aramoto Yoko , Terajima Satomi , Akimoto Kayoko , Kawashima Makoto , Hidano Akira , Matsugami Keiko , Mochizuki Takahiro
Published: April 2015

A 52‐year‐old woman presented with psoriasis vulgaris, Sjögren's syndrome, and Hashimoto's thyroiditis with a 5‐year history. She had a number of immunological abnormalities and typical psoriatic plaques over her entire body. The relationship between psoriasis, Sjögren's syndrome, and Hashimoto's thyroiditis is discussed from the viewpoint of immunology, and similar cases in the literature are reviewed. This is the first report of a coexistence of psoriasis vulgaris, Sjögren's syndrome, and Hashimoto's thyroiditis.
Diaper Area Granuloma of Incontinence
Authors: Mostafa Wedad Z. , Abahussein Abdulaziz A. , Alzayer Ahmed A.
Published: April 2015

Granulomas in the diaper area developed in four patients; two male infants following surgery for Hirschsprung's disease and two female children with urinary (and/or fecal) incontinence. The use of the term ‘Diaper area granuloma of incontinence’ is suggested to describe these lesions seen in the elderly, as well as in incontinent infants and children.
Genetic Polymorphisms in the Fourth Component of Complement (C4) and in Properdin Factor B (BF) in Japanese Patients with Palmoplantar Pustulosis
Authors: Torii Hideshi , Nakagawa Hidemi , Ishibashi Yasumasa , Tokunaga Katsushi , Juji Takeo
Published: April 2015

Genetic polymorphisms in the fourth component of complement (C4) and in properdin factor B (BF) were investigated in 49 and 32 Japanese patients with palmoplantar pustulosis (PPP), respectively. C4B2 was significantly increased in frequency, whereas no significant deviations were detected in BF compared with the controls. These results may indicate that complement polymorphisms are involved in the pathogenesis of PPP.
Effects of Butylated Hydroxyanisole on Ornithine Decarboxylase Activity Induced by Ultraviolet‐B and PUVA in Mouse Skin
Authors: Kono Takeshi , Taniguchi Shoji , Mizuno Nobuyuki , Fukuda Michio , Maekawa Naoki , Hisa Tomoyuki , Ishii Masamitsu , Otani Shuzo , Hamada Toshio
Published: April 2015

The effects of butylated hydroxyanisole (BHA), a representative phenolic antioxidant, on the activity of ornithine decarboxylase (ODC, an indicator of tumor promotion and epidermal hyperproliferation) induced by ultraviolet‐B (UVB) or PUVA in mouse skin were investigated. By topical application of BHA (55 μmol), PUVA‐induced ODC activity was suppressed by about 60% at both 12 h and 24 h after treatment. In contrast, BHA failed to suppress UVB‐induced ODC activity in mouse skin. These results suggest that the induction of ODC activity by UVB or PUVA is mediated by different pathways.
Ultrastructural Aspects of Infiltrated Eosinophils in Bullous Pemphigoid
Authors: Iryo Kayoko , Tsuda Shingo , Sasai Yoichiro
Published: April 2015

By scanning (SEM) and transmission electron microscopy (TEM), we evaluated the infiltrated eosinophils in lesions at various stages of clinical development from patients with bullous pemphigoid (BP) and eosinophilia. Visualized by SEM, numerous inflammatory cells migrated through the cutaneous basement membrane into the cavity of newly formed blisters 12 to 24 hrs after formation. Many migrating cells attached to the reverse side of the bullous cavity, and some basal cells shed into the cavity. As the bullae developed 24 to 48 hrs after formation, the reverse surface of the bullous cavity became predominantly composed of these migrating cells and the exposed squamous cells. The migrating cells had villi, ruffles and ridge‐like profiles on their surfaces, which were suggested eosinophils. By TEM in the same lesions, many morphologically activated eosinophils were seen to have passed through the basement membrane into the newly formed blisters; they exhibited spheroidal cytoplasmic granules with less dense crystalloid cores and intracellular channels. Eosinophils infiltrating in the developed bullous cavity directly adhered to basal cells and released their granule contents onto these target cells. These findings suggest that inflammatory cells, especially eosinophils, may amplify the formation of dermalepidermal separation in BP lesions.
A Case of Dermatomyositis Associated with Pseudomyxoma Peritonei Originating from Mucinous Adenocarcinoma of the Appendix
Authors: Maekawa Yoshihiro , Nakamura Kayoko , Nogami Reiko
Published: April 2015

A 69‐year‐old Japanese woman with erythema, severe edema on the face, Gottron's papules and poikiloderma was diagnosed as having dermatomyositis. She also noticed muscle weakness in her extremities, although her electromyogram showed neurogenic patterns. Her levels of CA19‐9 and CEA were elevated and a CT of her abdomen revealed a giant, multilobular, cystic lesion in the pelvis. This tumor was diagnosed as pseudomyxoma peritonei originating from a mucinous adenocarcinoma of the appendix.
Fasting Diet Therapy for Chronic Urticaria: Report of a Case
Authors: Okamoto Osamu , Murakami Isamu , Itami Satoshi , Takayasu Susumu
Published: April 2015

We used fasting diet therapy with a 28‐year‐old woman with chronic urticaria who responded only to systemic administration of glucocorticosteroids. The rashes began to decrease on the third therapeutic day and completely disappeared on the 11th day. Although the eruptions relapsed three days after the termination of the therapy, they were milder than previous ones. We also discussed the possible efficacy of fasting diet therapy for chronic urticaria as reported in the literature.
Giant Condyloma Acuminatum in a Baby Boy
Authors: Matsumura Noriko , Kumasaka Kumiko , Maki Hideo , Yoshie Osamu , Tagami Hachiro
Published: April 2015

A giant condyloma acuminatum developed on the penis of a one and a half‐year‐old Japanese boy in two months. The histological features of this tumor were compatible with those of ordinary condyloma acuminatum. Although we detected the presence of human papilloma virus (HPV) type 16 by using the polymerase chain reaction system, we could not rule out the possibility that this HPV was present concurrently with other HPV types that cause condyloma acuminatum. The lesion was successfully treated with cryotherapy and topical application of 5% fluorouracil ointment under occlusion
Clear Cell Hidradenoma: A Tumor with Basaliomatous Changes in the Overlying Epidermis and Follicular Infundibula of Surrounding Skin
Authors: Kato Naoko , Ueno Hiroo
Published: April 2015

We report a clear cell hidradenoma on the cheek of a Japanese man. We performed the primary operation on the flesh‐colored tumor, which had surface telangiectasia. The histopathologic features of the tumor, which indicated an intradermal nodular hidradenoma, consisted mainly of typical clear cells with small numbers of eosinophilic fusiform cells. Most clear cells reacted negatively for CEA, EMA, S‐100 protein and KL‐1 keratin, but those in and around the cystic and ductal structures reacted positively for CEA, EMA and KL‐1 keratin. Ultrastructurally, these clear cells had numerous microvillus processes, abundant intracytoplasmic glycogen granules, and numerous mitochondria. In addition, buds of hyperpigmented keratinocytes hung from the overlying epidermis and thin cords of hyperpigmented keratinocytes proliferated around the follicular infundibula beside the tumor. Within two months of the primary operation, growth of the tumor into the overlying epidermis recurred rapidly. We discuss the histological features of the combination of clear cell hidradenoma with basaliomatous changes of the overlying and surrounding skin and the highly aggressive recurrence of this type of tumor after primary treatment.
Juvenile Dermatomyositis: A Statistical Study of 114 Patients with Dermatomyositis
Authors: Hiketa Takeshi , Matsumoto Yoshinari , Ohashi Masaru , Sasaki Ryuichiro
Published: April 2015

We conducted a statistical review of 114 cases of dermatomyositis (DMS) treated primarily at the Department of Dermatology at Nagoya University Hospital over 27 years from 1965 to 1991 in order to determine the primary characteristics of juvenile DMS with the following results.

Juvenile DMS was found slightly more often in males than females; the male‐to‐female ratio was 1.4: 1. Therefore, unlike adult DMS with its preponderance of females, there was no clear gender predominance.

Muscular manifestations tended to follow the appearance of cutaneous manifestations, but the frequency of minor muscular manifestations was high over the entire course of the disease.

Laboratory findings showed increases in serum aldolase and serum creatine kinase with significant frequency when compared with adult patients (p<0.01 and p<0.05, respectively). Elevated serum aldolase most often occurred prior to or at the time of the appearance of muscular manifestations, suggesting its usefulness in early diagnosis. The positive rates for the antinuclear antibody on HEp‐2 cells and anti‐DNA antibody were significantly lower in children than in adults (p<0.001 and p<0.05, respectively).

There were no cases of juvenile DMS complicated by malignant tumors, interstitial pneumonia, or pulmonary fibrosis. There were also no deaths, and the rate of “remission or improvement” was significantly higher than in adult DMS cases (p<0.05). Adult cases which remained the same or worsened usually presented with intractable muscular manifestations. In children, however, the cutaneous manifestations were more difficult to treat.

The above conclusions from this statistical study suggest the possibility that juvenile DMS is an entity separate from adult DMS.
A Case of Adult T Cell Leukemia with Bullae in the Palmoplantar Regions Followed by a Crisis
Authors: Yoshimura Kazuko , Oishi Munashi , Johno Masayoshi , Ono Tomomichi
Published: April 2015

A 48‐year‐old Japanese female who had had chronic ATL for 4 years suddenly developed vesicles on the palms and soles. Histologically, these bullae were specific lesions of ATL. After a tendency to ward improvement, a crisis appeared with increases in the following: peripheral white blood cells, atypical lymphocytes, CD25 positive cells, serum LDH, and soluble IL‐2R. Palmoplantar bullae, a rather rare finding, may be indicative of a following crisis.
A Case of Trichoadenoma Arising in the Buttock
Authors: Yamaguchi Jun , Takino Chohei
Published: April 2015

A 41‐year‐old Japanese man with trichoadenoma on his buttock was described. Histological examination showed numerous horn cysts and some tumor islands consisting entirely of eosinophilic epithelial cells. A review of 24 reported cases of trichoadenoma revealed that most of them developed on the facial region (14 of 24 cases, 58%); the buttock (6 of 24, 25%) was the next most common site.