bluuebunny/crossref_metadata_2025 huggingface dataset:
Lipid Modification during Epidermal Cell Differentiation
Authors: Thompson Guy A.
Published: April 2015

As keratinocytes differentiate into corneocytes of the stratum corneum or epidermal permeability barrier, their lipids are modified so as to fulfill totally different functions. Recent experimentation has clarified the molecular mechanisms by which lipids of membrane origin are targeted to specialized lamellar bodies, where metabolic retailoring makes them suitable for use in the water‐impermeable intercellular lamellae. In this latter structure the modified lipids are bound covalently to specialized proteins in a way that encourages the formation of lipid bilayers alternating with lipid monolayers. Only now are potential clues to the molecular regulation of this dramatic lipid transformation becoming apparent.
Historical Aspects of the Oral Use of Retinoids in Acne
Authors: Hartmann Diethelm , Bollag Werner
Published: April 2015

A number of investigations of the effects of vitamin A deficiency in animals and man and its treatment with natural products containing vitamin A were carried out in the twenties and thirties. In 1942, a clinical study in patients with acne treated with vitamin A yielded encouraging results. Further trials in the forties and fifties, trying to confirm the beneficial effect of oral vitamin A in acne, met with equivocal success. In the sixties, all‐trans retinoic acid (tretinoin) became clinically available, and its topical efficacy in acne could be demonstrated. In 1971, oral tretinoin also was shown to be active in patients with acne. Coincidentally, the efficacy of oral 13‐cis retinoic acid (isotretinoin) became evident in a series of unpublished studies in Europe. Then, in 1978, a trial carried out at the NIH, Bethesda, Maryland, yielded convincing evidence that isotretinoin is a potent new drug for the treatment of severe cystic acne.

In 1982, isotretinoin was registered in the United States and one year later in Europe for the treatment of severe, recalcitrant, cystic acne. Since then, many thousands of patients suffering psychologically and physically from the severity of their disease have been treated successfully with this drug. However, the main concern of physicians prescribing isotretinoin has to focus on its potentially severe side effects, particularly its teratogenicity.
Dispersed Cell Culture of Human Sweat Duct Cells under Serum‐free Conditions
Authors: Uchida Naoyuki , Oura Hajimu , Nakanishi Hideki , Urano Yoshio , Arase Seiji
Published: April 2015

Human eccrine gland duct cells were successfully cultured using a serum‐free medium, K‐GM medium. Eccrine sweat ducts were isolated from dispase treated skin specimens from palms or soles. After treatment of the isolated ducts with trypsin and EDTA, dispersed cells were cultured in K‐GM medium. In primary cultures, small colonies were seen 3 to 4 days after inoculation. Then the cells rapidly proliferated and formed large colonies with a paving stone‐like cell arrangement. During the culture, small dome shaped areas were sometimes formed in the centers of colonies. Cultures multiplied for a maximum of 7 passages. The plating efficiencies of the 1st to 6th passage cells were about 20% to 30%. Immunocytochemically, cultured cells were positively stained with anti‐carcinoembryonic antigens, K8.37 and K8.13, but not with anti‐S100 protein, anti‐HLA‐DR, 34βB4, or PKK3. An electron micrograph of the cultured cells showed a multilayer of flattened cells linked by desmosomes. These results indicate that the cultured cells possessed the staining properties compatible with those of the ductal portion of eccrine sweat glands. No contamination by other mesenchymal cells, such as fibroblasts, was seen during the culture.
Ultrastructural Observation of Epithelioid Sarcoma
Authors: Kanai Takako , Irisawa Ryokichi , Kusama Hiroshi , Oh‐i Tsunao
Published: April 2015

Epithelioid sarcoma located in the right hip‐to‐thigh region of a 58‐year‐old female was studied by light microscopy, immunohistochemistry, and electron microscopy. Light microscopy revealed both light and dark cells among the tumor cells. Round, homogeneous, eosinophilic bodies were noted extracellularly and intracellularly. Extracellular bodies were similar in size to tumor cells and were not stained by PAS or Congo red. In contrast, intercellular bodies were PAS positive and diastase resistant. Tumor cells were positive for vimentin, keratin, and, partially, for epithelial membrane antigen. Ultrastructurally, tumor cells had numerous microfilaments with tonofibril‐like arrangement, lipid droplets, and reticulogranular structure in their cytoplasm. The reticulogranular structure was similar to the tonofilaments recognized in degenerative tumor cells. Oval filamentous bodies were recognized in the stroma. They appeared to be very similar to colloid bodies derived from tonofilaments of keratinocytes. It was considered that the filamentous bodies corresponded to extracellular eosinophilic bodies and showed signs of fibrous necrosis of tumor cells. Intracellular eosinophilic bodies were considered to be lipid droplets.
Spontaneous Contraction of Leukodermic Patches in Waardenburg Syndrome
Authors: Chang Tsuling , Hashimoto Ken , Bawle Erawati V.
Published: April 2015

Waardenburg Syndrome is an autosomal dominantly inherited disorder with variable penetrance (1–5). It is a rare disorder with an estimated frequency of 1:20,000 in Kenya (East Africa) and 1:40,000, in the Netherlands presenting with or without deafness. The frequency with deafness is lower, estimated at 1:50,000 to 1:212,000 (1, 2). The major characteristic features are as follows, with reported incidences in parenthesis: 1) Dystopia canthorum (99%); 2) synophrys (17%–69%); 3) broad nasal root (78%); 4) depigmentation of hair, skin, or both (17%–58% with white forelock); 5) heterochromic or hypochromic irides (greater than 20%); 6) congenital deafness (9%–38%) (1–7). Genetic heterogeneity has led to classification of affected families as type I, with dystopia canthorum, or type II, without dystopia canthorum (2, 6). Piebaldism and Woolf's Syndrome can present with pigmentary changes which are similar to Waardenburg Syndrome (2, 3, 8). Woolf's Syndrome also includes deafness (9). However, the distinguishing structural ophthomologic abnormalities of dystopia canthorum, broad nasal root, and synophrys are not found in either piebaldism or Woolf's Syndrome (2, 3, 8, 9). The congenital patterns of leukoderma in both piebaldism and Waardenburg Syndrome has been believed to be stable throughout the lifetime of the affected individuals (2, 10). We report an otherwise typical family with Waardenburg Syndrome, type I, in which 2 members atypically demonstrate spontaneous pigmentation and contraction of congenital leukodermic patches. To our knowledge, this has not been previously reported in Waardenburg Syndrome (1, 2, 6, 10).
Folliculosebaceous Cystic Hamartoma Associated with Rosacea
Authors: Yamamoto Toshiyuki , Ohkubo Hiroko , Nishioka Kiyoshi
Published: April 2015

A case of folliculosebaceous cystic hamartoma associated with rosacea is presented. Clinically, a solid, 5‐mm‐sized nodule was observed on the nose which showed telangiectasia and a waxy appearance. Histologically, a large horn cyst was located in the dermis, and was continuous with the surface epidermis. It was associated with mature sebaceous glands and immature hair follicles. Folliculosebaceous cystic hamartoma and similar cases have recently been reported, but this is the first report accompanied by rosacea.
High‐dose Tocopherol Acetate Therapy in Epidermolysis Bullosa Siblings of the Cockayne‐Touraine Type
Authors: Shirakata Yuji , Shiraishi Satoshi , Sayama Koji , Shinmori Hideyo , Miki Yoshiharu
Published: April 2015

We have employed a successful therapy for epidermolysis bullosa with high‐dose oral tocopherol acetate. Two siblings with dominant dystrophic epidermolysis bullosa of the Cockayne‐Touraine type were reported. Both siblings suffered from tense blisters and erosions healing with scars and transient milia on the extremities. Electron microscopic study of the blisters revealed a cleavage beneath the lamina densa in both siblings. High‐dose oral tocopherol acetate therapy was administered to them with satisfactory clinical reduction of the blister formation.
Keratoses Following Topical Steroid for Psoriasis
Authors: Tsuji Takuo
Published: April 2015

A 42‐year‐old man with generalized psoriasis developed multiple benign keratoses on psoriatic lesions following topical steroid treatment.
Serum Levels of Interleukin 6 in Patients with Pustulosis Palmaris et Plantaris
Authors: Nakamura Takehiko , Oishi Munashi , Johno Masayoshi , Ono Tomomichi , Honda Mitsuo
Published: April 2015

Serum interleukin 6 (IL‐6) was measured in patients with pustulosis palmaris et plantaris by a fluorescent sandwich enzyme‐linked immunosorbent assay (ELISA) method. Increased production of IL‐6 was observed in 8 cases out of 10 showing numerous pustules in their active stage. Six cases were measured before and after tonsillectomy, and statistically significant reduction in the levels of IL‐6 paralleled an improvement in the disease activity. It is suggested that IL‐6 may be one of the mediators which link tonsillectomy to the activity of pustulosis palmaris et plantaris.
Clinical Criteria for Differentiating between Recessive and Dominant Forms of Dystrophic Epidermolysis Bullosa, Elaborated from an Analysis of 119 Cases
Authors: Nomura Kazuo , Imaizumi Takashi , Sato Takashi , Hashimoto Isao
Published: April 2015

We attempted to establish clinical criteria which differentiated between recessive dystrophic epidermolysis bullosa (RDEB) and dominant DEB (DDEB), since these two groups show prominent differences in prognosis, genetic recurrence risk and response to some types of treatment. The total of 119 cases examined consisted of our own 9 cases (2 of RDEB and 7 of DDEB) and 110 cases (26 of RDEB and 84 of DDEB) collected from the medical literature. They were analyzed by calculating the sensitivity and specificity of ten clinical features. We concluded that, syndactyly, presence of complications, dental lesions, remission‐less course, and oral lesions are strongly indicative of RDEB (more than 70% specific). Intractable skin ulcer is suggestive of RDEB (more than 55% specific). Nail lesions, scar and atrophy, milia and pigmentation are not helpful in the differentiation because of their commonality. The proposed criteria are simple, reliable, and practical, providing us with a useful tool for differentiation of RDEB and DDEB in daily practice.
An Analysis of 24 Patients with IgA Deposition at the BMZ
Authors: Meng‐Wu Weng , Bing‐Sen Qiu , Ke‐Fei Kang
Published: April 2015

A study of 24 patients with IgA deposition at the BMZ of the skin showed that five conditions could be recognized: 1) linear IgA bullous dermatosis in adults (LAD, 7 cases); 2) linear IgA and IgG bullous dermatosis in adults (LAGD, 10 cases); 3) chronic bullous disease of childhood (CBDC, 3 cases); 4) dermatitis herpetiformis (DH, 1 case), and 5) systemic lupus erythematosus (SLE, 3 cases). Histopathologically, 5 of 7 patients with LAD were similar to the DH group, but 7 of 10 patients with LAGD were similar to the BP group. Half the patients with LAD and LAGD had oral lesions, and most of them had excellent responses to dapsone and Tripterygium Wilfordii, but the patients with CBDC did not respond to these treatments. In the patients with LAD and LAGD, the positivity rates of IgA anti‐BMZ antibodies examined by indirect immunofluorescence (IIF) on intact skin and NaCl split skin were 41% and 64%, respectively. The heterogeneity of the histopathologic pictures of LAD and LAGD, the incidence of DH, and the value of using NaCl split skin for IIF are discussed.
A Correlation between Carotenemia and Biliary Dyskinesia
Authors: Nishimura Toshio
Published: April 2015

The interrelationship between carotenemia and biliary dyskinesia was studied in eighty‐two biliary dyskinesia patients and twenty‐seven normal subjects. Incidence of serum carotene levels of more than 300 µg/dl was more frequent in biliary dyskinesia patients without liver damage or hyperlipemia. Among the carotenemia patients, no dietary cases were found, but metabolic and hyperlipemic ones were observed. Significant relationships were found between gall bladder contraction rate and the levels of serum carotene, vitamin A, and lipids in metabolic carotenemia. A close relationship between metabolic carotenemia and biliary dyskinesia was strongly suggested.
Association of Generalized Granuloma Annulare with Autoantibodies
Authors: Tada Joji , Seno Akemi , Ueda Masumi , Arata Jirô , Nagao Yo
Published: April 2015

Granuloma annulare is a degenerative disease of the skin histopathologically characterized by focal degeneration of collagen with a surrounding infiltrate of lymphoid cells, histiocytic cells, and multinucleated giant cells. Immunological abnormalities such as delayed‐type hypersensitivity and vasculitic origin are suspected in the pathogenesis. We describe three patients with generalized granuloma annulare, in whom autoantibodies, including antinuclear antibody, antithyroid stimulating hormone receptor antibody, and immune complex, were detected.
A Case of Cutaneous B‐cell Lymphoma with a Storiform Stromal Reaction
Authors: Nagatani Tetsuo , Miyazawa Megumi , Matsuzaki Toshiko , Iemoto Gaijiro , Kim Shu‐Taku , Baba Naoko , Miyamoto Hideaki , Nakajima Hiroshi
Published: April 2015

A case of cutaneous B‐cell lymphoma is described. The patient was treated only by surgical excision of the skin tumors five times during a period of about two years from February of 1984 to October of 1986. After the last surgical excision, a continuous disease‐free period was achieved. Biopsy samples showed dense lymphocytic infiltrations with discrete masses in the dermis and subcutis; one of them showed a storiform pattern. At the time, the infiltrating cells were composed of medium and large lymphoid cells and spindle‐shaped cells. The medium and large lymphoid cells were positive for CD20, CD22 and HLA‐DR and negative for CD3, CD4, CD5, CD8, CD43, and kappa and lambda light chain. The spindle‐shaped cells were negative for CD20, CD43, kappa and lambda light chain, lysozyme, and S‐100 protein.
Granulomatous Tissue Reaction and Calcification of Heterologous Elastin Implanted in Hairless Mouse Skin: Light and Electron Microscopic Studies Compared with Reaction of Heterologous Collagen
Authors: Tsuji Takuo , Sawabe Motokazu
Published: April 2015

Heterologous elastin particles were injected into the deep dermis or below the panniculus carnosus of hairless mice. A granulomatous tissue reaction with concomitant giant cell formation occurred around the implanted elastin in the early stages and, subsequently, calcium deposition with disappearance of the histiocytes and giant cells occurred in the later stages. Ultrastructural study revealed that some elastin particles were engulfed by the giant cells; others underwent calcification but remained intact.

The heterologous collagen used as a control also induced a granulomatous tissue reaction, but did not undergo calcification and gradually disappeared.

These results suggest that the heterologous elastin and collagen particles exhibit different susceptibilities to digestion. However, it is not clear why the heterologous elastin underwent calcification.
Properties of γ‐Glutamyl Transpeptidase in Squamous Cell Carcinoma
Authors: Takami Yoshihiro , Chiba Masahito , Takahashi Makoto
Published: April 2015

γ‐Glutamyl transpeptidase (GGT) was extracted from squamous cell carcinoma tissues of human skin (SCC) by Triton X‐100 and bromelain treatment, and some of its biochemical properties were compared with those of GGT extracted from eccrine gland‐rich tissue and normal kidney. GGT activity significantly increased in SCC, but there was no definitive differences in enzymological properties between GGT of SCC and normal tissue enzyme. However, GGT of SCC was distinguishable from those of normal tissues by isoelectric point, electrophoretic mobility, and sensitivity to neuraminidase treatment. These results indicate that GGT of SCC has some variant properties which may be related to skin carcinogenesis.
A Study of the Efficacy of Antimicrobial Detergents for Hand Washing: Using the Full‐hand Touch Plates Method
Authors: Namura Shoko , Nishijima Setsuko , McGinley Kenneth J. , Leyden James J.
Published: April 2015

We studied the effects of four kinds of antimicrobial detergents, 4% chlorhexidine gluconate (CHG), chlorbenzarconium (CBC), 10% povidone‐iodine (PVI), 0.3% triclosan (TRI), and one non‐medicated detergent (NMD) using the full‐hand touch plates method.

Before and after 3 minutes of hand scrubbing with a brush, bacterial colonies on the hand surface and subungual bacteria were counted. CHG, CBC, and PVI were excellent antimicrobial detergents against hand surface bacteria, but most of the subungual bacteria remained. The subungual space was the most difficult region from which to eradicate bacteria. TRI was much less effective than hand soap against hand surface bacteria.
Self Limited Dermal Invasion of Keratinocytes in Maculopapular Eruptions after Systemic Chemotherapy
Authors: Hann Seung Kyung , Rhoe Byung Seon , Kang Won Hyoung , Park Yoon‐Kee
Published: April 2015

Benign, multifocal, and transient (spontaneously disappearing within one month) stromal invasions of atypical basal keratinocytes were found in light and electron microscopic examination of maculopapular eruptions which developed after receiving an 8 day cycle of doxorubicin, 5‐fluorouracil (5‐FU), and cyclophosphamide (Cy) in a 63‐year‐old woman. She had had a modified radical mastectomy to remove a carcinoma of her right breast.
Concomitant Occurrence of Circulating IgA Anti‐intercellular and Anti‐basement Membrane Zone Antibodies in Autoimmune Blistering Diseases: Immunofluorescence and Immunoblot Studies
Authors: Dmochowski Marian , Hashimoto Takashi , Bhogal Balbir S. , Black Martin M. , Miyakawa Kaori , Miyamoto Ryoko , Nishikawa Takeji
Published: April 2015

Recently, cases with circulating IgA anti‐intercellular antibodies have been described. The objective of this study was to present immunofluorescence and immunoblot findings in three cases of bullous diseases with concomitant circulating IgA anti‐intercellular and anti‐basement membrane zone antibodies. Direct immunofluorescence, indirect immunofluorescence on intact and 1M NaCl‐split skin, immunoblotting of epidermal extracts from dispase‐ and EDTA‐separated (two different procedures) human skin, and immunoblotting of the bovine desmosome preparation were performed. All three cases had IgA anti‐intercellular and anti‐basement membrane zone antibodies. However, immunoblot results were divergent. Case 1 had antibodies against the 150 kD pemphigus foliaceus antigen (IgG), the 170 kD protein (IgG and IgA), and the 97 kD antigen (IgG and IgA). Case 2 had IgG antibodies reactive with the 230 kD and the 170 kD bullous pemphigoid antigens, while case 3 had IgA antibodies against the 97 kD antigen only. The results of immunofluorescence and immunoblot studies in our patients widen the spectrum of laboratory features in blistering skin diseases mediated, at least in part, by antibodies of the IgA class.
Epidermolysis Bullosa Acquisita (EBA) with Nonclassical Distribution of Eruptions
Authors: Matsumura Yasuhiro , Hamanaka Hiroshi , Horiguchi Yuji , Tanaka Toshihiro , Okuwa Takashi , Imamura Sadao
Published: April 2015

The skin lesions in epidermolysis bullosa acquisita (EBA), a mechanobullous disease, often show acral distribution. Recently, we experienced a case of EBA in which most of the skin lesions were located on the trunk. We reviewed the distribution of the skin eruptions in 58 reported cases of EBA. Although the extensor surfaces of the extremities are the most common site, there were some cases with non‐acral distribution. These “nonclassical” cases should also be considered in the clinical diagnosis of EBA and other bullous diseases.
Sexually Transmitted Diseases in a HIV Infected Patient
Authors: Ishii Norihisa , Ichiyama Shin‐ichi , Nakajima Hiroshi , Ito Akira
Published: April 2015

We report a case of HIV infection with herpes simplex, syphilis, and condyloma acuminatum in a 66‐year‐old heterosexual man. The patient was an asymptomatic carrier (group II) of HIV infection. Herpes simplex on his penis was controlled by aciclovir. Secondary syphilis was treated with penicillin G, after which skin lesions disappeared. These four diseases were all sexually transmitted diseases (STD).

One should consider the possible existence of other STD in similar cases.
Incidental Epidermolytic Hyperkeratosis in Progressive Systemic Sclerosis
Authors: Sasaki Tetsuo , Nakajima Hiroshi
Published: April 2015

Incidental epidermolytic hyperkeratosis (EH) has been reported in a variety of lesions. We describe here incidental EH in a patient with progressive systemic sclerosis (PSS). We reviewed 108 skin biopsies from our cases of PSS and localized scleroderma, but this finding was seen only in the present case. Focal acantholytic dyskeratosis is analogous to EH, but we believe that this case is most consonant with EH. Since there has been no other report of EH in PSS, this association may be coincidental.
Prominent Telangiectasia Associated with Marked Bleeding in CREST Syndrome
Authors: Ueda Masumi , Abe Yoshiko , Fujiwara Hideki , Fujimoto Wataru , Arakawa Kenzo , Arata Jirô , Yoshioka Toshifumi , Tomoda Jun , Katayama Haruko
Published: April 2015

A 64‐year‐old woman with CREST syndrome developed prominent telangiectases mimicking hereditary hemorrhagic telangiectasia (HHT) of Osler‐Rendu‐Weber. We have been following her since she first came to us with discrete telangiectatic mats and Raynaud's phenomenon 11 years ago. Telangiectatic lesions have been seen on her larynx and esophagus in addition to commonly affected sites. She has experienced spontaneous epistaxis and marked bleeding from the lesions on her lips, oral mucous membrane, and soles.

This case illuminates new aspects of telangiectasia in CREST syndrome.
Eosinophilic Panniculitis
Authors: Kato Naoko
Published: April 2015

A 39‐year‐old obese female patient with borderline diabetes mellitus who developed multiple, tender, and hard nodules on the lower abdominal wall is described. The histological features were characterized by mixed panniculitis, showing massive eosinophilic infiltration and fibrosis in the septae and many foam cells in the parenchymal area of subcutaneous tissues. The eruption regressed gradually during the course of diet therapy for diabetes mellitus and obesity. Although the etiology is diverse and nonspecific, eosinophilic panniculitis seems to be a unique histopathological reaction pattern characterized by massive eosinophilic infiltration into subcutaneous tissues.
Furuncle‐like Lesions in Mouse Experimental Skin Infections with Staphylococcus aureus
Authors: Abe Yoshiko , Akiyama Hisanori , Arata Jirô
Published: April 2015

The pathomechanism of furuncle has not been fully elucidated and should be investigated using an appropriate animal model. We observed the invasion of Staphylococcus aureus cells into hair follicles in mice, using a strain of S. aureus isolated from human furunculosis. Light microscopical examination revealed that S. aureus cells attached to corneocytes at 6 h after inoculation, proliferated around the ostium of the hair follicle and invaded the hair follicle at 12 h after inoculation. Electron microscopically, S. aureus cells attached to the horny layer of hair follicle with long, thick, string‐like structures. At 12 h after inoculation, S. aureus cells invaded in a file between the inner root sheath and outer root sheath. We could not induce direct invasion from the follicle ostium. Our findings suggest that there are some regions of the hair follicle through which S. aureus cells can relatively easily invade deeper into the follicle. The most important question is what confines the invasion and inflammation of S. aureus to the hair follicle. We suggest that there is some locus minoris for invasion into hair follicles by S. aureus, such as an interface between the two sheaths.
Light Microscopic Autoradiographical Analysis of [125I]Epidermal Growth Factor Binding in Basal Cell Epithelioma and Squamous Cell Carcinoma of the Skin
Authors: Ikeuchi Tsuneo , Urano Yoshio , Fukuhara Kosaku , Nakanishi Hideki , Arase Seiji
Published: April 2015

Levels of epidermal growth factor (EGF) receptor expression were investigated in five basal cell epitheliomas (BCEs) and 10 primary lesions from squamous cell carcinoma (SCC) of the skin, using light microscopic autoradiography with [125I]EGF. All of the BCEs were clinically the pigmented type and histologically the solid type. All of them showed an EGF binding level similar to that of the basal and suprabasal layers of the normal epidermis. The SCCs included one case of Bowen's disease (SCC in situ), five of the well differentiated type, three of the moderately differentiated type and one of the poorly differentiated type. Eight of the 10 SCCs showed an EGF binding level similar to that of the normal epidermal basal and suprabasal cell layers. One of the two remaining SCCs, a moderately differentiated type, showed highly increased EGF binding. The other one, a poorly differentiated type, showed very little EGF binding in a large region consisting of poorly differentiated cells, although a small area composed of more differentiated, nest‐forming cells had an EGF binding level similar to that of the basal and suprabasal cells. Metastasis was found in three of these 10 SCCs after surgery. Two of the three SCCs with metastasis showed increased or decreased EGF binding levels in primary lesions as described above; in contrast, primary lesions of the seven SCCs without metastasis had EGF binding levels similar to those of the normal epidermal basal and suprabasal cells. Abnormally increased or decreased EGF binding level in SCC of the skin may be indicative of a poor prognosis, although it is necessary to examine more SCCs to confirm this assumption.
Giant Mucocele of Oral Cavity as a Mucocutaneous Manifestation of Sjögren Syndrome
Authors: Katayama Ichiro , Yamazaki Sayuri , Nishioka Kiyoshi
Published: April 2015

Two cases of Sjögren syndrome who developed a giant mucocele on the floor of the oral cavity are reported. Histological analysis revealed the dense infiltration of lymph‐plasmacytic infiltration around the dilated salivary duct. Similar findings were observed in the biopsied specimens of the labial salivary gland which were consistent with the grade 4 score proposed by Chisholm and Mason's criteria. Mucocele is a common mucocutaneous disease of unknown etiology except for traumatic origin and Sjögren syndrome might be one of the important underlying disease which causes giant mucocele, especially in elderly female patients.
Effects of Krestin (PSK) on Tumorigenesis Induced by Two‐stage and Complete Chemical Carcinogenesis
Authors: Nakayama Juichiro , Urabe Atsumichi , Terao Hiroshi , Moon Doo Chan , Hori Yoshiaki , Kinoshita Nadao
Published: April 2015

The effects of PSK on tumorigenesis in mouse skin were investigated either when mouse skins were initiated by benzo(a)pyrene and promoted by 12‐O‐tetradecanoyl‐phorbol‐13‐acetate (Group I, two‐stage carcinogenesis) or when both initiated and promoted by benzo(a)pyrene (Group II, complete carcinogenesis). Twelve mice in each group were fed chow with or without 0.4% PSK. This concentration of PSK was determined by calculation to give mice enough PSK to exert antitumorigenic activity without cytotoxicity. By the end of the experimental periods (26 weeks), two carcinoma‐burdened mice in Group I without PSK were dead, but no carcinomas at all were identified in the mice fed with PSK, although considerable numbers of papillomas developed in both groups. In Group II, carcinomas started to evolve at the 15th week of the experiment regardless of PSK feeding. The number of carcinomas observed in the mice fed with PSK in Group II was statistically significantly lower than that in the mice fed without PSK. Histologically, mild inflammatory infiltrations were seen around the papillomas, and moderate to dense infiltrations, mainly composed of neutrophils, T lymphocytes, and macrophages, were observed in squamous cell carcinomas. There were apparently no significant differences in the number of the infiltrating cells around carcinomas in PSK (+) and PSK (−) groups in both early and fully developed lesions. However, considerable numbers of cells infiltrating into the nests were observed in the early lesions of elicited carcinomas in the mice fed with PSK, while such cells were rarely seen in carcinoma nests in the group without PSK at that stage. The multi‐stage carcinogenesis regimen which evokes both benign and malignant epidermal tumors in mouse skin should provide insights into the function of the specific infiltration of immuno‐competent cells and should also be a valid system for the quantitative and qualitative analysis of the anti‐tumor effects of immunopotentiators such as PSK.
Immunohistochemical Study of Graft‐versus‐Host Reaction (GVHR)‐Type Drug Eruptions
Authors: Osawa Junko , Kitamura Kazuko , Saito Sumi , Ikezawa Zenro , Nakajima Hiroshi
Published: April 2015

Skin biopsies of graft‐versus‐host reaction (GVHR)‐type drug eruptions in the acute phase were compared immunohistochemically with those in the chronic phase and also with non‐GVHR type drug eruptions in the acute phase. Predominance of CD8+ T cells in the epidermal infiltrates, reduction in the number of epidermal OKT6+ dendritic cells (Langerhans cells), and increased expression of HLA‐DR and ICAM‐1 on keratinocytes were observed in the acute phase of GVHR‐type, but not in either the chronic phase of GVHR‐type or the acute non‐GVHR type. These findings were similar to those of previous reports on skin lesions of acute GVH disease (GVHD) seen after bone marrow transplantation.

Therefore, immunohistochemistry is not useful for differential diagnosis between acute GVHR‐type drug eruptions and acute cutaneous GVHD. These findings also indicate that similar immunomechanisms may be involved in the pathogenesis of both GVHR‐type drug eruptions and cutaneous GVHD.
Scrofuloderma of the Scalp, Psoas Abscess, and Caries Spine: An Unusual Association
Authors: Sehgal Virendra N. , Chander Ram , Garg Vijay K. , Karmakar Sanchita
Published: April 2015

An unusual association of scrofuloderma of the scalp, psoas abscess, and caries spine was seen in a 4‐year‐old girl. The diagnosis was confirmed by relative and absolute criteria. The peripheral T‐lymphocytes and their subsets were within normal limits, although her immunohistopathological changes indicated an intermediary response across the spectrum depicting an unstable immunity. This may have been responsible for the silent spread of Mycobacterium tuberculosis and the current association.
Rudimentary Polydactyly
Authors: Chung Joon , Nam In Whan , Ahn Sung Ku , Lee Seung Hun , Kim Joong Gie , Sung Yeol Oh
Published: April 2015

A case of rudimentary polydactyly on the radial aspect of the thumb of a 4‐year‐old male was examined. Histologic examination revealed hyperkeratosis and acanthosis in the epidermis and large numbers of nerve bundles in the dermis. With immunoperoxidase staining for S‐100 protein, the nerve corpuscles were positively stained. We think that rudimentary polydactyly is a kind of congenital traumatic neuroma and that the possible cause may be intrauterine amputation.
Pemphigus Vulgaris Associated with Autoimmune Hemolytic Anemia and Elevated TNFα
Authors: Ujihara Mayumi , Hamanaka Sumiko , Matsuda Sachie , Numa Fumitaka , Kato Hiroshi
Published: April 2015

A 76‐year‐old female was admitted with many bullae and erythema on her trunk and extremities. A biopsy specimen showed significant intercellular edema in the lower epidermis and eosinophilic infiltration into the dermis and the epidermis. Immunofluorescent staining revealed the deposition of IgG in the intercellular area of her prickle cells. From these histologic findings and the typical clinical features, we diagnosed her as having pemphigus vulgaris. Examination of her blood revealed that she also suffered from autoimmune hemolytic anemia. Despite intensive treatment with prednisolone, she finally died. This case is of interest because of its rarity and the TNFα detected significantly in the blister fluid of this patient.
Biochemical Analyses of Macromolecular Matrix Components in Patients with Pseudoxanthoma Elasticum
Authors: Sakuraoka Koichi , Tajima Shingo , Nishikawa Takeji , Seyama Yoshiyuki
Published: April 2015

Two cases of pseudoxanthoma elasticum (PXE) were reported. Biochemical studies of collagen, glycosaminoglycan, and elastin content were performed using skin specimens from affected lesions. Hydroxyproline content was reduced approximately 46% and 24% in cases 1 and 2, respectively. The reduction in collagen content resulted from the reduction in the lower dermis, not from that in the upper dermis. Glycosaminoglycan content in PXE was also decreased, with a slight increase in the ratio of hyaluronic acid to dermatan sulfate. Isodesmosine content in PXE was increased 3.2‐ and 2.2‐fold in cases 1 and 2, respectively. These results suggest that the major and primary biochemical changes in PXE are an increase in elastin content.
Mucinous Carcinoma of the Skin: Report of a Case with DNA Cytofluorometric Study
Authors: Katoh Norito , Hirano Shinya , Hosokawa Youhei , Miyashita Aya , Kishimoto Saburo , Yasuno Hirokazu
Published: April 2015

A 62‐year‐old man with a mucinous carcinoma of the skin on the left cheek is described. The excised specimen showed a characteristic histopathologic picture. The findings from histochemical, immuno‐histochemical, and electron microscopic examinations suggested an eccrine differentiation of the tumor cells. The removed tumor was examined using DNA cytofluorometry in order to analyze the cell kinetics and to estimate its biological behavior and prognosis. The tumor cells showed a diploid mode with a small number of polyploid cells. Only a small number of cells in the S and G2/M phase ranges were detected. After four years, there has been no evidence of tumor recurrence nor metastasis. The results of DNA ploidy analysis were thus compatible with the nature of slow growth with a good prognosis in this case.
Black Dot Ringworm: The First Report of a Patient from the San'in District
Authors: Dekio Satoshi , Jidoi Joji , Yamada Yoshitaka
Published: April 2015

A 77‐year‐old Japanese woman, a resident of Shimane Prefecture, with black dot ringworm caused by a Trichophyton glabrum infection on the scalp is described. To the best of our knowledge, she is the first case of BDR reported from the San'in District.
Mycosis Fungoides with Leser‐Trélat Sign: The First Report of a Patient from Japan
Authors: Miyako Fukami , Dekio Satoshi , Tamura Haruko , Yamada Yoshitaka , Miyata Nobuko , Jidoi Joji , Tohgi Kimiko
Published: April 2015

We describe here a 35‐year‐old Japanese woman with mycosis fungoides (MF) who developed numerous, rapidly‐growing, seborrheic keratoses on the front of her neck and chest. To the best of our knowledge, this is the first reported case of MF with Leser‐Trélat sign from Japan.
Langerhans Cell Histiocytosis Presenting as a Varicelliform Eruption over the Entire Skin
Authors: Johno Masayoshi , Oishi Munashi , Kohmaru Masahiro , Yoshimura Kohji , Ono Tomomichi
Published: April 2015

A boy with skin eruptions resembling varicella and specific for Langerhans cell histiocytosis (LCH) is reported. At his initial visit when he was four months old, vesiculopustular lesions were present over the entire body; these had first appeared on the third day post partus. Histopathological, immunohistochemical, and electron microscopical examination confirmed the Langerhans cell phenotype and Birbeck granules in the responsible cells. He also had hydronephrosis, recurrent fever, and cutaneous bacterial infections. His parents refused further medical treatment and he died of diarrhea with cachexia about two years later. LCH may present diagnostic difficulties by manifesting as a skin eruption which resembles varicella.
Production of Overmodified Type I Procollagen in a Case of Osteogenesis Imperfecta
Authors: Tajima Shingo , Takehana Makoto , Azuma Noriyuki
Published: April 2015

Collagen synthesis in cultured skin fibroblasts from a patient with osteogenesis imperfecta was studied. Approximately 2 fold accumulation of collagen in the cell layer was found. The slower mobility of proα1 (I) and proα2 (I) as well as α1 and α2 (I) polypeptide on sodium dodecylsulfate‐polyacrylamide gel electrophoresis was detected, indicating that abnormal posttranslational modification could be present in type I procollagen in patient fibroblasts. The degrees of hydroxylation and subsequent glycosylation of lysine residues in the affected collagen were elevated 1.5 and 1.4 fold, respectively. There were no significant changes in the relative content of type III to type I collagen nor the incorporation of mannose into the carboxyterminal propeptide of proα1 (I) and proα2 (I). These results indicate that the patient produces an over‐modified type I procollagen which is responsible for the clinical features and has a collagen abnormality already reported in type II osteogenesis imperfecta.
Immunohistochemical Studies of Infiltrating Cells in Early and Chronic Lesions of Psoriasis
Authors: Onuma Sumi
Published: April 2015

The expression of surface antigens on infiltrating cells, epidermal keratinocytes, and dendritic cells in biopsy specimens from 31 patients with psoriasis was examined immunohistochemically. The specimens were divided into early‐phase and chronic‐phase groups and then examined in a double blind manner.

Among the infiltrating cells in the epidermis, CD4‐positive cells were dominant in the early phase; CD8‐positive cells were dominant in the chronic phase, resulting in a markedly decreased CD4/CD8 ratio in the latter. On the other hand, among the infiltrating cells in the dermal papillae, CD4‐positive cells were dominant in both the early and chronic phases; both CD4‐positive and CD8‐positive cells were more dominant in the chronic phase than in the early one. However, the CD4/CD8 ratios were decreased in both the dermal papillae and the epidermis in the chronic phase. CD1‐positive dendritic cells (probably Langerhans cells) were more numerous in the chronic phase than in the early phase. There were no significant differences between the early and chronic phases with regard to the expression of HLA‐DR and HLA‐DQ antigens on the infiltrating cells. However, the HLA‐DR antigens and ICAM‐1 (intercellular adhesion molecule‐1) were more strongly expressed on epidermal keratinocytes in the chronic phase than in the early phase. LFA‐1α (lymphocyte function‐associated antigen‐1α)‐positive cells were also significantly more numerous in the chronic phase than in the early one, consistent with the expression of HLA‐DR antigens and ICAM‐1 on keratinocytes mentioned above. On the other hand, VLA‐4 (integrin α4β1) positive cells were expressed more abundantly in the epidermis in the early phase than in the chronic phase.

These results suggest, first, that the chronic phase of psoriasis is as immunologically active as or more active than the early phase. Second, CD4‐positive T cells are more important than CD8‐positive T cells in the early phase of psoriasis; CD8‐positive rather than CD4‐positive T cells are more important in the chronic phase. Third, the LFA‐1/ICAM‐1 pathway may play an important role with regard to cell adhesion of the infiltrating cells in the psoriatic lesions in disease exacerbation or prolongation, whereas the VLA‐4/VCAM‐1 (vascular cell adhesion molecule‐1) pathway may be more important in disease onset.
Ultraviolet Irradiation Downregulates the IL‐1 Receptor in Pam 212 Keratinocytes
Authors: Nozaki Shigeyuki , Sauder Daniel N.
Published: April 2015

There is increasing evidence that keratinocytes, by virture of production of cytokines, may participate in inflammatory and immune responses in the skin. The expression of keratinocyte cytokines can be modulated by various exogenous and endogenous agents, including ultraviolet light (UV) and cytokines themselves. We have recently shown that augmentation of GM‐CSF expression by UVB irradiation is mediated by UV‐induced IL‐1 in Pam 212 keratinocytes. This may suggest that an autocrine mechanism exists in this murine keratinocyte cell line. In order to further clarify the mechanism by which UV irradiation augments GM‐CSF, this study was undertaken to assess the effect of UV on the expression of IL‐1 receptor (IL‐1R) in Pam 212 keratinocytes. UVB irradiation (35 or 70 J/m2) significantly downregulates the expression of IL‐1R mRNA. IL‐1R mRNA remains downregulated for 12h after UV, then slowly returns to the steady state level by 24h to 32h after UV. On the other hand, UV augments IL‐1 mRNA in a biphasic pattern with an initial phase (by 6h after UV) and a late phase (24h and 48h after UV). The results of these studies indicate that modulation of IL‐1R and IL‐1 itself by UVB irradiation are important in mediating autocrine cytokine networks in keratinocytes.
Molecular Genetic Analysis of the von Recklinghausen Neurofibromatosis (NF1) Gene Using Polymerase Chain Reaction‐Single Strand Conformation Polymorphism (PCR‐SSCP) Method
Authors: Sawada Shun'ichi , Honda Mariko , Niimura Michihito
Published: April 2015

Von Recklinghausen neurofibromatosis (NF1) is a common autosomal dominant disorder characterized by abnormalities in multiple tissues derived from the embryonic neural crest. The NF1 gene has been mapped to the pericentromeric region of the long arm of chromosome 17. Chromosome walking and sequencing of the NF1 gene have extended it's open reading frame; to date 49 exons have been identified. To investigate the mutation of the NF1 gene, the polymerase chain reaction‐single strand conformation polymorphism (PCR‐SSCP) method was applied to 4 exons of NF1 genes. We examined the DNAs from 49 samples, including those of 23 Japanese patients with NF1 (4 of these patients developed malignant schwannoma), a patient with segmental neurofibromatosis, and 14 clinically normal controls. A mutational band was detected in an exon of a tumor DNA extracted from a malignant schwannoma of a female NF1 patient. However, the mutation was not found in the germ line DNA of this patient. No mutations were detected in the other samples.
Tinea Corporis Due to Trichophyton verrucosum: Report of a Patient from the San'in District
Authors: Dekio Satoshi , Jidoi Joji
Published: April 2015

A 70‐year‐old Japanese housewife, a resident of Shimane Prefecture, developed an erythematous, annular skin lesion on her right forearm. Mycological examinations revealed that it was tinea corporis caused by Trichophyton verrucosum (T. verrucosum). This fungus was then shown to have been transmitted to her from young dairy cattle introduced from the Hokkaido District to the ranch of her son. To the best of our knowledge, she is the first reported patient with tinea due to T. verrucosum who was infected in the San'in District.
A Case of Giant Sebaceoma on the Head
Authors: Nakamura Shin‐ichi , Toyoda Kaoru
Published: April 2015

A 43‐year‐old Japanese woman had a giant dome‐shaped tumor on her head without any other involvement. Clinically, we considered several diseases; however, the histological features matched those of sebaceoma.
Stoichiometry of the Reaction Catalyzed by Skin Sulfhydryl Oxidase
Authors: Yamada Hiromichi , Suga Yasushi , Takamori Kenji , Ogawa Hideoki
Published: April 2015

The stoichiometry of the reaction catalyzed by skin sulfhydryl oxidase was investigated. Dithiothreitol (DTT) was used as the substrate for skin sulfhydryl oxidase. The consumption of DTT, consumption of oxygen, and production of hydrogen peroxide were measured during the enzyme reaction. The molar ratio of DTT:O2:H2O2 in the enzyme reaction was 1:1.02:0.89. Correspondingly, the stoichiometry of the enzyme reaction was calculated to be R(SH)2 + O2 → + H2O2.
Interleukin 8 in Behçet's Disease
Authors: Itoh Rie , Takenaka Teruyoshi , Okitsu‐Negishi Shoko , Matsushima Kouji , Mizoguchi Masako
Published: April 2015

Activated peripheral polymorphonuclear leukocytes (PMNs) and infiltration of PMNs into the lesions are characteristic findings of Behçet's disease (BD). A variety of cytokines, including interleukin 8 (IL‐8), have been shown to activate PMNs. To investigate the role of IL‐8 in the development of BD lesions, IL‐8 production in vivo and in vitro was examined in 25 BD patients. IL‐8 levels measured by ELISA in the non stimulated culture supernatants of peripheral mononuclear cells (MNCs) were higher in patients with active BD than in those with inactive BD or normal controls. Without LPS stimulation, IL‐8 mRNA expression in incubated MNCs detected by Northern blot analysis was higher in active BD patients than in controls. Polarization assay confirmed the accelerated activity of PMN isolated from patients with active BD. However, these PMNs did not respond to IL‐8 as strongly as to FMLP (an exogenous stimulator); a possible reason is that the PMNs of these patients are constantly exposed to IL‐8 in vivo. Immunohistochemically, MNCs, endothelial cells and fibroblasts in BD lesions were positively stained by anti‐IL‐8 antibody.

These data indicate that the production of IL‐8 may be accelerated in inactive BD and that IL‐8 may play an important role in the pathogenesis of BD.
Study of the Efficacy of Antiseptic Handrub Lotions with Hand Washing Machines
Authors: Namura Shoko , Nishijima Setsuko , Mitsuya Kaoru , Asada Yasuo
Published: April 2015

The effectiveness of quick handwashing in regards to four alcohol‐based handrub lotions, including two products already on the market and our original lotions 1, 2, with two different kinds of hand washing machines was studiedin vivo. We also tried to evaluate the efficacy of the four lotionsin vitro.

Thein vivotesting of each lotion, including ethanol, was evaluated using two hand washing methods, first with and then without a previous soap wash. Computerized image analysis was used to calculate the bacterial count on the hand surface.

The results showed that a 3 second application of the original lotion 2 (0.5% chlorhexidine in a 77% ethyl alcohol solution) preceded by a soap wash eradicated 89.3% of the bacteria on the hands; this was the highest reduction rate of all four detergents. AROKULIN‐E (67.9% ethyl alcohol solution) without a prior handwashing produced the lowest reduction, 49.1% against hand surface bacteria. These results were compatible with thosein vitro. It seems that an alcohol‐based solution containing an effective antimicrobial detergent preceded by a soap wash is neccessary to acceptably reduce hand surface bacteria.
Cowden's Disease: Report of the First Case in a Chinese
Authors: Yang Jen‐Hung , Cheng Huey‐Mann , Wang Long‐Rule , Chu Kan‐C
Published: April 2015

A 19‐year‐old Chinese female presenting mucocutaneous manifestations including facial trichilemmomas, oral papillomatosis, and acral keratosis was diagnosed, according to the criteria proposed by Salem and Steck, as a definite case of Cowden's disease, although no members of her family were affected. The cutaneous reticulohistiocytic granuloma and congenital nystagmus of eyes that occurred in this case were new combinations in the syndrome. To the best of our knowledge, this is the first documented case of Cowden's disease in a Chinese.
Cutaneous Mesenchymal Hamartoma
Authors: Chang Sung Nam , Lee Seung Hun , Ahn Sung Ku
Published: April 2015

A case of a cutaneous mesenchymal hamartoma occurring on the thigh of a newborn infant is reported. Microscopically, the solitary tumorous lesion consisted of an intimate mixture of fibrocollagenous bundles, islands of mature fat cells, distorted blood vessels, and eccrine sweat glands. Many mast cells were scattered throughout the fibrocollagenous bundles. Ultrastructurally, most tumor cells were suggestive of undifferentiated mesenchymal cells.