bluuebunny/crossref_metadata_2025 huggingface dataset:
Erythema Multiforme: Pathomechanism of Papular Erythema and Target Lesion
Authors: Imamura Sadao , Horio Takeshi , Yanase Keiko , Taniguchi Shinkichi , Miyachi Yoshiki , Tachibana Takao , Yoshioka Akira , Fujita Mayumi
Published: April 2015

Skin lesions of erythema multiforme show time‐dependent changes from early papular erythema to the late target lesion which consists of a peripheral elevated erythematous area and a central depressed area. We investigated the pathomechanism of erythema multiforme, by examining the papular erythema and target lesion separately. In the early papular erythema, a small number of polymorphonuclear leukocytes and nuclear debris were seen intermingled with mononuclear cells around the slightly swollen blood vessels, on which immunoglobulin and complement components were deposited. Circulating immune complex levels were occasionally elevated. Sera from the patients generated high levels of reactive oxygen species and nitroblue tetrazolium test revealed positive reaction on the infiltrating cells around the blood vessels. These findings suggest that the papular erythema develops via incomplete type III allergic reaction, followed by damage through reactive oxygen species. In the target lesion, the activity of histamine‐N‐methyltransferase, which is the major histamine‐degrading enzyme, was markedly decreased in the peripheral elevated erythematous area and it was recovering in the central clearing area. ICAM‐1 and HLA‐DR antigens were expressed on the surfaces of the keratinocytes. An increased number of epidermal Langerhans cells and CD4 cell infiltration were observed in the peripheral elevated erythematous area, while a decreased number of epidermal Langerhans cells and CD8 cell infiltration in the central depressed area were observed. These findings suggest that impaired histamine metabolism and cellular allergic reactions play important roles in the development of the target lesion.
Classic Kaposi's Sarcoma: A Review of 90 Cases
Authors: Zurrida Stefano , Bartoli Cesare , Nolé Franco , Agresti Roberto , Prato Ivan Del , Colleoni Marco , Bajetta Emilio
Published: April 2015

A series of 90 cases of classic Kaposi's sarcoma observed and treated over the last 25 years was examined retrospectively. Fifty‐one were the localized and 39 the disseminated form. Outpatient surgery for the localized and vinblastine chemotherapy for the disseminated form are probably the best treatments. Radiotherapy may be a valid alternative.
A Case of Cytophagic Histiocytic Panniculitis with Sicca Symptoms and Lupus Nephritis
Authors: Tsukahara Tetsuya , Fujioka Akira , Horiuchi Yasuhiro , Eto Hikaru , Nishiyama Shigeo , Akaboshi Tohoru , Kokubo Tohoru
Published: April 2015

A 48‐year‐old Japanese woman presented with many subcutaneous nodules. The skin was purplish in color and tender; the nodules were scattered over the entire surface. Histological findings of biopsy specimens from the nodules indicated septal panniculitis comprised of histiocyte and/or macrophage infiltrates, often with erythro‐ and/or leukophagocytosis. Phagocytic cells were OKM1 (CD11b), MT1 (CD43), LeuM3 (CD14), and histiocyte antigen positive, indicating the presence of histiocytes and/or macrophages. The patient had sicca symptoms, positive homogenous, speckled pattern ANA (×320), and diffuse proliferative lupus nephritis.
The Clinical Expression in Anticentromere Antibody‐positive Patients Is Not Specified by the Epitope Recognition of CENP‐B Antigen
Authors: Muro Yoshinao , Sugimoto Kenji , Himeno Michio , Ohashi Masaru
Published: April 2015

Centromere protein B (CENP‐B), which is an alphoid DNA binding protein, is the target antigen in autoimmune disease patients (often with scleroderma). From our previous analysis of the reactivity of anticentromere sera, four independent epitopes were identified on recombinant CENP‐B. The anticentromere sera displayed heterogeneity in their patterns of reactivity to the four epitopes. We have investigated to what extent this heterogeneity of the target autoepitope on CENP‐B accounts for the clinical diversity of anticentromere antibody (ACA)‐positive patients. A major autoepitope, epitope I, was recognized by all 40 ACA‐positive sera; however, the other three epitopes were recognized differently from case to case. We could not find any significant correlation between the reactivity to CENP‐B autoepitopes and the clinical presentation of ACA‐positive patients. There was considerable clinical diversity, even among the nine patients showing specificity for the single major autoepitope. In conclusion, we found that, although ACA‐positive patients were both clinically and immunologically heterogeneous, in most respects the clinical expression appeared to be independent of the reactivity to the CENP‐B autoepitope, a finding which suggests that identification of the target epitope of CENP‐B is unlikely to assist in the clinical classification of the disease in ACA‐positive patients. The identification of multiple B cell epitopes on CENP‐B is consistent with the concept that the self‐antigen drives the antibody response. However, factors other than CENP‐B autoepitope specificity must determine the clinical expression of ACA responses.
Growth and Collagen Synthesis of Cultured Neurofibroma Fibroblasts
Authors: Sasaki Tetsuo , Arai Katsuhiko , Nagai Yutaka
Published: April 2015

Cells from cutaneous neurofibromas of three patients with von Recklinghausen's disease and skin fibroblasts from four healthy adults were cultured. After two passages, DNA and collagen syntheses were determined by measuring incorporation of [3H] thymidine and [3H] proline respectively, and expressed as the values per unit DNA content. These values from neurofibroma cells were increased by 54% in DNA synthesis and 60% (p<0.05) in nondialyzable hydroxyproline synthesis, suggesting that neurofibroma cells in culture even after several passages still possess those characteristics corresponding to their pathological features in vivo. Collagen synthesized by neurofibroma cells appears to be normal as judged by intracellular degradation rates and SDS‐polyacrylamide gel electrophoresis.
Effects of Malnutrition on Development of Experimental Pressure Sores
Authors: Takeda Toshiaki , Koyama Tamotsu , Izawa Yoshihiro , Makita Tokutaro , Nakamura Nobuo
Published: April 2015

Using food‐deprived rabbits we investigated the effects of nutritional deficiency on the development of pressure sores. The body weight of these animals was decreased significantly from normal. Organ weights of liver, heart, spleen, kidney, and testis were significantly decreased from normal as well. Protein deficiency in these animals was indicated by serum tests, as well as by histologic features of liver and testis and ultrastructural findings on fibroblasts. We produced lesions in malnourished as well as normal rabbits by exposing their skin to a balloon‐produced compressive force of 120 ± 10 mmHg for 4 hours. Biopsies were taken 1, 2, and 3 days after the pressure application. Histologic findings at each time were as follows: At day one, the degree of ischemic skin destruction in the malnourished animals was more severe than that in the normal ones, and thrombi were occasionally seen in the malnourished cases. At day two, proliferation of fibroblasts and macrophage infiltration were evidenced in the normal animals, whereas signs of collagen fiber degeneration as well as microthrombi were seen in the malnourished ones. At three days, epidermal cells covered the lesions in the case of normal animals; however, massive necrosis of the epidermis was still recognized in the malnourished rabbits. Thus, the healing process of pressure sores was strongly suppressed in the malnourished animals. This suppression was attributed to the reduction in fibroblast proliferation, capillary formation, macrophage infiltration, and also to the low level of epidermal cell proliferation.
Subcorneal Pustular Dermatosis and IgA Multiple Myeloma
Authors: Bölcskei Lajos , Husz Sándor , Hunyadi János , Varga Gyula , Dobozy Attila
Published: April 2015

A case of subcorneal pustular dermatosis associated with IgA multiple myeloma is described. The significance of the combination of the two diseases is not yet known, but the association is certainly more than coincidence.
Tuberous Sclerosis and Spina Bifida Occulta
Authors: Sehgal Virendra N. , Thappa Devinder M. , Jain Sanjiv
Published: April 2015

An interesting occurrence of tuberous sclerosis and spina bifida occulta is described, highlighting their unique and previously undescribed association in a 5‐year‐old boy.
Growth Factors and Chronic Wounds: The Need to Understand the Microenvironment
Authors: Falanga Vincent
Published: April 2015

The care of chronic wounds has become a major health issue in developed countries because of their increasingly elderly populations. There is hope that progress made in understanding and producing growth factors will lead to their successful use to induce faster and better healing of chronic wounds. This report will discuss growth factors in the context of their use in chronic wounds, and will focus on the importance of the wound microenvironment in determining the interactions between growth factors and wounds. We believe that a greater understanding of the chronic wound microenvironment will be of benefit in the optimal use of growth factors. In published studies, we have found that wound fluid taken from acute wounds stimulates fibroblast and endothelial cell proliferation, whereas fluid obtained from chronic non‐healing wounds inhibits the growth of fibroblasts, endothelial cells, and keratinocytes. In this report, we describe the effect of these two types of wound fluid on the synthesis of extracellular matrix components. We hypothesize that the chronic wound microenvironment is generally non‐conducive to cell growth, and that this may prevent a truly successful use of topical growth factors in chronic wounds. Novel approaches in the delivery of growth factors to wounds may be necessary to overcome these obstacles.
The Role of Growth Factor in Wound Healing
Authors: Higashiyama Mari , Hashimoto Koji , Takada Akiyoshi , Fujita Kazuhiko , Kido Katsunobu , Yoshikawa Kunihiko
Published: April 2015

A pig wound healing model was developed to study the morphological processes involved in incisional and excisional wound healing, the immunohistochemical localization of TGF‐α in wound healing, and the latter's relevance. In incisional wounds, a few layers of epidermis were regenerated after only 32 hours. In contrast, several layers of epidermis were regenerated on day 7 in excisional wounds. In general, the incisional wound model is useful for evaluating tensile strength, while the excisional wound model is suitable for evaluating epidermal regeneration.

Immunohistochemical study showed that keratinocytes migrating from wound edges expressed TGF‐α very faintly, while TGF‐α was present prominently in the upper several layers of the epidermis adjacent to the wound, which resembled normal epidermis and showed no changes during the wound healing process.
Xeroderma Pigmentosum: Recent Clinical and Photobiological Aspects
Authors: Kondo Seiji , Fukuro Shuhei , Nishioka Kiyoshi , Satoh Yoshiaki
Published: April 2015

In Japan, more than 400 patients with xeroderma pigmentosum (XP) have been registered. The major groups are XP‐A and variant, while clinically mild types of XP with intermediate levels of unscheduled DNA synthesis (UDS) have recently been increasing. The classical type of XP‐A and some of the XP‐D patients exhibit neurologic abnormalities. XP individuals display a marked increase in the frequency of skin malignancy. Development of skin malignancies appears to be related to the level of DNA repair capacity; the lower the capacity, the earlier and more frequently the skin tumors develop. Furthermore, the incidence of internal malignancy in XP patients is at least ten times higher than that for the Japanese general population over the age of 40 years. Cultured fibroblasts from XP patients exhibit higher sensitivity not only to UVC but also to UVB. The cellular sensitivity to UVB may correlate to photosensitivity in vivo from a study on a group E patient who showed age‐related changes in photosensitivity and cellular sensitivity to UVB. We have also reviewed current status of molecular genetics in XP.
Proteins of the Cornified Envelope
Authors: Hosokawa Kayo , Hosokawa Hiroshi , Futamura Shozo , Baden Howard P.
Published: April 2015

The cornified envelope of keratinocytes is an insoluble structure formed beneath the plasma membrane at the base of the stratum corneum. It is made by cross‐linking precursor proteins by a membrane‐associated transglutaminase. Using the cornified envelope of cultured human keratinocytes as the immunogen, we obtained a number of monoclonal antibodies which stained epidermis in a variety of ways. The peripheral staining pattern has been associated with several envelope precursors and this has been confirmed by western blots. A mouse IgM monoclonal antibody directed against epidermal basal cell hemidesmosomes was also discovered. By immunofluorescence, the monoclonal antibody produced a strong linear staining of the basement membrane zone and a polar cap on trypsin‐dissociated epidermal basal cells. By immunoelectron microscopy, immunoreactants were present in the attachment plaques of hemidesmosomes on guinea pig esophagus. However, no protein reactive with the antibody was detected. This study suggests that an antigen associated with the basal cell hemidesmosomes may be incorporated in the cornified envelope.
The Cornified Cell Envelope: Loricrin and Transglutaminases
Authors: Yoneda Kozo , McBride O. Wesley , Korge Bernhard P. , Kim In‐Gyu , Steinert Peter M.
Published: April 2015

The cornified cell envelope (CE) of terminally differentiated human epidermis is a complex structure consisting of several defined protein constituents. The CE is the most insoluble component of the epidermis due to crosslinking by disulfide bonds as well as isodipeptide bonds that are formed by the action of transglutaminases (TGases). We have recently determined that loricrin is the major component of CE. We now have isolated and characterized its gene and showed that it has a simple structure with a single intron. We also show that the loricrin gene maps to position 1q21, which, coincidentally, is similar to the location of the profilaggrin and involucrin genes. Human loricrin in 26 kDa and consists of three long glycine‐serine‐cysteine rich sequence domains that contain quasi‐repeating peptides and which form the novel glycine loop motif. These are interspersed by lysine + glutamine rich domains involved in isodipeptide crosslinks. The glycine loops are thought to be involved in organization of epidermal proteins and maintenance of the flexibility of the epidermis. By use of PCR analyses, we have found that human loricrin consists of two allelic size variants, due to sequence variations in the second glycine loop domain only, and these variants segregate in the human population by normal Mendelian mechanisms. Futhermore, there are multiple sequence variants within these two size class alleles due to various deletions of 12 bp (4 amino acids) in the major loop of this glycine loop domain. In order to study the expression and role of TGases in the formation of CE, we have isolated and sequenced cDNA and genomic clones encoding the TGasel enzyme. The deduced complete sequence has 816 amino acid residues of 90 kDa. It shares 49–53% sequence homology with the other TGases of known sequence but has unique sequences in its amino‐ and carboxyltermini. The TGM1 gene has been isolated and characterized. It is 14.1 kbp long, contains 15 exons and is similar in structure to other TGase genes. It was located to chromosome position 14q11. It will now be possible to further study the regulation of the expression of the loricrin and TGase1 gene systems in normal and abnormally keratinizing epidermis.
Evidence of Differentiated Keratin Peptide (K1) in Cultured Human Squamous Cell Carcinomas: Demonstration of Generality by Three Different Approaches
Authors: Katagata Yohtaro
Published: April 2015

The largest keratin peptide (K1, 68KD) has not been detectable in cultured human squamous cell carcinomas. However, quite recently, the K1 peptide was clarified to be present in two kinds of cultured HSC by using a low salt aqueous solution, rather than the high salt and Triton X‐100 employed by many previous researchers (Biochem. Biophys. Res. Commun., 182, 1440–1445, 1992). To determine whether this phenomenon is common or not in cultured HSCs, I further demonstrated the K1 peptide by extracting it with two different buffers and by 2D‐PAGE, immunological techniques, and Northern blot analysis, using another kind of HSC.

Until now, keratin extraction has been done using high salt/Triton X‐100 solution, during which K1 peptide may be removed because it has developed an affinity with the buffer. Many investigators may have therefore overlooked it.
Inactivation of Keratin Genes by Gene Targeting: A Perspective
Authors: Oshima Robert G. , Baribault Hélène
Published: April 2015

Recent technological advances in experimental molecular genetics have provided an opportunity for determining the function of any gene including those which are important in different epithelia. This report summarizes some recent results of experiments utilizing gene targeting technology to determine the function of intermediate filaments and emphasizes both the problems and the potential of applying this technology to problems in dermatology.
Dysregulated Expression of Cellular Adhesion Molecules in Autoimmune‐prone Mice
Authors: Wang Weila , Kobayashi Seiichi , Uede Toshimitsu
Published: April 2015

The expression of various cell adhesion molecules on lymphocytes and endothelial cells was examined. The strong expression of CD44 antigen on abnormal double negative T cells of lymph nodes was characteristic in MRL‐lpr mice. The accumulation of abnormal double negative T cells in swelling lymph nodes was also predominant in MRL‐lpr mice; this may result from augmented binding of lymphocytes to endothelial cell surfaces of lymph nodes, possibly due to the failure of Mel‐14 antigen shedding from abnormal lymphocyte cell surface. The expression of VCAM‐1 antigen was detected in endothelial cell surface of lymph nodes in MRL‐lpr mice, which also explains the accumulation of lymphocytes in lymph nodes. However, the expression of VLA‐4 antigen on lymphocytes which interact with VCAM‐1 on endothelial cells was not significantly different between MRL‐lpr and MRL‐+ mice.
Actin Organization and Cell Migration of Melanoma Cells Relate to Differential Expression of Integrins and Actin‐associated Proteins
Authors: Byers Hugh Randolph , Etoh† Takafumi , Vink Jacqueline , Franklin Nancy , Gattoni‐Celli Sebastiano , Mihm Martin C.
Published: April 2015

We have recently described marked differences in cell migration rates and organization of actin in human melanoma cell lines isolated from various stages of tumor progression. Metastatic lines derived from lymph node metastases organized actin into stress fiber arrays and had high mean migration rates in vitro when compared to lines from other stages. Melanoma cells also reveal marked differences in localization of alpha‐actinin and β1 integrins at stress fiber termination sites (focal contacts). Disruption of this organization is induced by antibodies against β1 integrins. α‐actinin, recently postulated as having a role in linkage of actin to β1 integrins, is differentially expressed in melanoma cells by Northern blot analysis and a relatively high α‐actinin to actin ratio is associated with stress fiber formation and increased cell migration. Furthermore, actin‐binding protein, which cross‐links actin filaments, is also significantly increased in lines exhibiting high migration rates.

Control of migration and actin organization may be mediated by extracellular matrices and/or modulation of actin‐associated proteins including α‐actinin and actin binding protein. These findings provide evidence that an interaction of transmembrane adhesion molecules and elements of the cytoskeleton in melanoma cells may be responsible for differences in migration rates and capacity for metastatis
Aspects in Neurofibromatosis from the Viewpoint of Dermatology
Authors: Niimura Michihito
Published: April 2015

The neurofibromatoses are a heterogenous set of conditions having clinical manifestations such as skin, nervous system, bone and eye disorders. The clinical pictures of the patients will obviously differ, and there is considerable variation of manifestations even within a family. During the last twenty‐five years, one thousand and two hundred patients with neurofibromatosis were personally examined. Almost all our patients had classical von Recklinghausen disease. But in addition to these cases, there are 28 cases of NF‐2 and 10 patients which we call multiple neurilemmomatosis. Also, there are related groups of patients with conditions which were not neurofibromatosis, such as 40 cases of localized multiple neurofibromas and 61 cases of localized café‐au‐lait spots.

The features of neurofibromatosis in Japan are not different, compared with foreign countries, except increased pigmentation is more common. In addition to café‐au‐lait spots, some 20% of Japanese neurofibromatosis patients have pigmentary conditions which I termed hairy fuscoceruleus spots. These spots are blue‐brown in colour, and one can see coarse hairs in them.

Our recent study indicates that the patients with neurilemmomatosis have loss of heterozygosity of chromosome 22, the same position as the site of patients with NF‐2. Neurilemmomatosis may be classified as an NF‐2 without acoustic tumors.
Tuberous Sclerosis Complex: Genetic Aspects
Authors: Northrup Hope
Published: April 2015

Much has been learned about tuberous sclerosis complex (TSC) since it was described at the end of the nineteenth century. TSC was recognized to be a genetic disease with autosomal dominant inheritance in the early twentieth century. The prevalence in the general population is at least 1 in 10,000 with two‐thirds of cases occurring sporadically and one‐third of cases being familial. The disease exhibits variable expression which may cause mildly affected individuals to be undiagnosed. Because the aberrant or missing proteins which result in TSC have eluded investigators, a positional cloning approach has been pursued to find the mutated genes. Genetic linkages have been reported to chromosomes 9, 11, and 12. There is definite evidence for a TSC‐causing locus on chromosome 9 which is thought to account for between one‐third and one‐half of all familial cases. Investigators have narrowed the location on chromosome 9 to approximately two megabases of physical distance. There is some evidence for a locus on chromosome 11 which probably accounts only for a small percentage of familial cases. The locus proposed on chromosome 12 was reported by a single group and has not been confirmed by other research groups. Evidence for genetic heterogeneity is abundant. There is definitely a TSC‐causing locus on chromosome 9q (TSC‐1) and there is at least one additional locus, maybe more than one. As the molecular basis of TSC unfolds, new insight will be gained about the protean nature of the disorder and the genetic heterogeneity.
Significance of Antibodies to Phenolic Glycolipid‐I in Leprosy Diagnosis
Authors: Prakash Kunti , Aggarwal Ravindra , Sehgal Virendra N.
Published: April 2015

A gelatin particle agglutination assay for the detection of anti PGL‐I antibodies in 40 clinically diagnosed and variously classified groups of leprosy cases revealed elevated PGL‐I antibody titers in 85% of cases. In contrast, the slit‐skin smear examination was positive in only 30% of cases. It was further observed that, out of 28 cases with Bacteriological Index (B.I.) zero, 22 cases (78.5%) had significant levels of PGL‐I antibodies. There was no case in which the slit skin smear was positive and the PGL‐I antibody titer was not significant. The elevated titers of PGL‐I antibody better correlated (84%) with histopathological findings than did B.I. Thus it was concluded that estimation of PGL‐I antibody titer is a better supplement to clinical diagnosis than B.I.

Significant levels of PGL‐I antibody were seen in 85% of cases who had no earlier chemotherapy or were treated for less than 2 months. Similar findings were observed in 12 patients who were on MDT for more than 5 months but for less than 2 years. In order to determine the significance of anti PGL‐I antibodies in monitoring the response of patients to chemotherapy, a longer follow up with a greater number of cases should be contemplated.
Influence of Oral Metronidazole on the Endocrine Milieu and Sebum Excretion Rate
Authors: Aizawa Hiroshi , Niimura Michihito , Kon Yukiko
Published: April 2015

As part of a study of the mechanism of metronidazol's efficacy in the treatment of acne and rosacea, its effects on the endocrine milieu and sebum excretion rate were assessed. Thirteen healthy males received oral metronidazole treatment (500 mg/day) for 4 weeks.

Serum sex hormone levels were determined in all 13 subjects and the sebum excretion rate was determined in seven of them, before and after treatment. We measured serum levels of estrone (E1), estradiol (E2), total testosterone (T), free testosterone (FT), dihydrotestosterone (DHT), dehydroepiandrosterone sulfate (DHEA‐S), and sex hormone‐binding globulin (SHBG). There were no significant changes in E1, T, FT, DHT, or SHBG levels, but E2 and DHEA‐S levels decreased significantly after treatment. In all seven subjects in whom the sebum excretion rates were determined, the amount of facial skin surface lipids decreased significantly after treatment.

These results suggest that metronidazole exerts its clinical effects through suppressing the sebum excretion by a mechanism other than anti‐androgenic action.
Perforating Dermatoses: A Review and Report of Four Cases
Authors: Sehgal Virendra N. , Jain Sanjiv , Thappa Devinder M. , Bhattacharya Sambit N. , Logani Kulbhushan
Published: April 2015

Perforating dermatoses, an often overlooked entity comprised of Kyrle's disease, perforating folliculitis, reactive perforating collagenosis, elastosis perforans serpiginosa, and acquired perforating dermatosis, are succinctly described, focusing attention on their clinical features, histopathology, treatment, and pathogenesis. The literature on these facets has been extensively reviewed. In addition, three fresh cases of Kyrle's and one of perforating folliculitis have been incorporated to illustrate these conditions.
Significance of Elevated Serum Squamous Cell Carcinoma (SCC)‐Related Antigen and Lactate Dehydrogenase (LDH) Levels in Senile Erythroderma Following Eczema
Authors: Tsukahara Tetsuya , Otoyama Kazunobu , Horiuchi Yasuhiro
Published: April 2015

Clinical and laboratory tests were used to evaluate fourteen patients with senile erythroderma following eczema, and the results were compared with those from four patients with psoriatic erythroderma, two with Sézary syndrome, and twelve with prurigo chronica multiformis or nummular dermatitis. Characteristic laboratory findings included elevated serum squamous cell carcinoma‐related antigens (SCC‐RAg), high lactate dehydrogenase (LDH), peripheral‐blood eosinophilia, and a decreased peripheral blood lymphocyte percentage. Following treatment, titers of SCC‐RAg and LDH resumed normal levels with remission. In patients with senile erythroderma following eczema, serum IgE was quite high and varied but, in a few instances, was within the normal range. SCC‐RAg and LDH may thus be considered useful as markers for evaluating disease conditions of the skin of patients with senile erythroderma following eczema.
Double Cross Lip Flaps for Reconstruction of the Lower Lip
Authors: Yoshida Tetsunori , Sugihara Tsuneki , Ohura Takehiko , Minakawa Hidehiko , Igawa Hiroharu
Published: April 2015

Squamous cell carcinoma of the lower lip is a common tumor. Of the many methods available for reconstructing lower lip defects after radical excision, we found double cross lip flaps from each lateral side of the upper lip philtrum rotated into the defect of the lower lip to be an effective method, not only functionally but also cosmetically. The main reason why satisfactory results were obtained by this procedure is that the anatomical structure (skin‐orbicularis oris muscle‐mucosa, vermilion) of the upper lip is very similar to that of the lower lip. Our experience is with double cross lip operations in the management of lower lip cancers are described.
Congenital Giant Pigmented Nevus Associated with Angiolipoma
Authors: Won Jin Hyoung , Ahn Sung Ku , Lee Seung Hun , Kim Soo‐Chan , Choi Soo Im
Published: April 2015

We report a 20‐year‐old‐Korean woman with a congenital giant pigmented nevus and angiolipoma. She was admitted our department with a large, dark, pigmented lesion on the right flank and abdomen and a slowly growing mass on the right flank area since birth. On biopsy, the specimen taken from the giant pigmented patch showed typical findings of compound nevus. The right flank mass was surgically removed. The specimen was composed of mature fat cells with an increased vascular component. These findings are compatible with angiolipoma.
Localized Bullous Pemphigoid: Report of a Case with an Immunofluorescence and Electron Microscopical Studies on the Lesional Distribution of 180‐KD Bullous Pemphigoid Antigen, β4 Integrin, and Type VII Collagen
Authors: Kitajima Yasuo , Suzuki Masayuki , Johkura Yoji , Yaoita Hideo
Published: April 2015

A 67‐year‐old woman with a left‐sided hemiplegia had localized bullous pemphigoid demonstrating typical clinical lesions on the left pretibial skin and the radial‐side skin of the right forearm. The histology showed a subepidermal blister with extensive hyperkeratosis, hypergranulosis, and acanthosis. Direct immunofluorescence revealed distinct linear deposits of IgG and C3 at the dermo‐epidermal junction in the perilesional skin and in the roof of the blisters, but few deposits in nonlesional skin. Electron microscopy revealed separation in the lamina lucida. Indirect immunofluorescence of type VII collagen showed its localization in the blister floor. The distribution of the 180‐KD bullous pemphigoid antigen (BPA) and β4 integrin, hemidesmosomal transmembrane proteins, were studied in the lesional skin by indirect immunofluorescence. Both 180‐KD BPA and β4 integrin were localized in the blister roof. By immunoelectron microscopy, β4 integrin was detected in small groups on the cell surface facing the blister cavity. Since the epitope of the monoclonal antibody to 180‐KD BPA used here is known to be localized at a distance of 20 to 50 nm from the membrane surface and this epitope retained in the blister roof, it appears that the blister was produced in the deep lamina lucida. The lesions were cleared with topical 0.05% clobetasole propionate ointment.
Langerhans' Cells of Elderly Patients with Decubital Ulcers
Authors: Kohn David , Kohn Sarah
Published: April 2015

An ultrastructural and morphometric study compared Langerhans' cells in sacral epidermis, 8–10 cm from the lesion of patients (mean age 70) with decubital ulcers, with those in the patients' own normal epidermis from the upper leg and with those in the epidermis from the upper leg of normal age‐matched volunteers. The Langerhans' cell section area was significantly lower in patients' control leg epidermis (25.86 ± 2.29 μm2) than in that from normal controls (35.74 ± 3.76 μm2) or that from patients' sacral epidermis near the lesion (41.26 ± 3.45). The number of Langerhans' cell granules was higher in control leg epidermis of patients (10.22 ± 1.26) and was significantly higher in lesioned sacral epidermis (12.94 ± 1.90) than in normal controls (6.97 ± 1.47). In Langerhans' cells in patients' epidermis, formative stages of Langerhans' cell granules were observed. The findings may indicate that Langerhans' cells in patients' epidermis are in an active state.
Vitiligo, Rheumatoid Arthritis and Pernicious Anemia
Authors: Abraham Zeev , Rozenbaum Michael , Glück Zahava , Feuerman Eleasar J. , Lahat Nitza , Kinarty Amalia
Published: April 2015

A patient with a 46‐year history of vitiligo who also presented rheumatoid arthritis and pernicious anemia is described. Meticulous physical examination excluded further systemic or cutaneous involvement. The immunological workup revealed a low CD4 cell percentage with T cells mostly composed of CD8 cells, a discrepancy between the high percentage of cumulative CD4 + CD8 cells and the measured CD3 proportions, very low NK cytotoxicity toward K562 cells, and almost negligible responses to PHA, Con A and PWM mitogens. The results point to severe T and NK cell functional defects. The pathogenetic significance of these data is discussed.
Fournier's Gangrene: Report of a Case Associated with Paralytic and Mechanical Ileus throughout the Management of the Gangrene
Authors: Maekawa Yoshihiro , Nojiri Keiko , Nogami Reiko
Published: April 2015

A 65‐year‐old Japanese male, who was treated for Fournier's gangrene, developed an enlarged erythema over the right thigh and right lower quadrant. The area was surgically debrided, and he was given antibiotics. However, he complained of abdominal swelling with a metallic bowel sound, pain, and vomiting and was then treated for paralytic ileus. Although his symptoms initially improved, he complained again of the same symptoms and underwent surgery for mechanical ileus occurring at the site of a surgical scar from an appendectomy 43 years earlier.

This is a very rare case of Fournier's gangrene which caused mechanical ileus of the small intestine and adherence to a peritoneal scar after paralytic ileus due to inflammation of the abdominal fascia following scrotal gangrene.
Relapsing Syphilis
Authors: Yoon Juho , Haam Ik Byeung , Chung Kee‐Yang , Lee Min Geol , Lee Jung Bock
Published: April 2015

Although penicillin still remains highly effective for syphilis, concerns have been raised that current regimens may be inadequate for the treatment of early syphilis. We report the failure of benzathine penicillin in the treatment of secondary syphilis. Extensive tracing of sexual contact history failed to identify sources of possible reinfection; therefore, we believe that this case represents a treatment failure and an ensuing relapse of secondary syphilis.
Cytokine Production of Peripheral Blood Mononuclear Cells in a Dermatophytosis Patient in Response to Stimulation with Trichophytin
Authors: Koga Tetsuya , Ishizaki Hiroshi , Matsumoto Tadahiko , Hori Yoshiaki
Published: April 2015

Interferon‐γ (IFN‐γ), interleukin 2 (IL‐2) and granulocyte/macrophage colony‐stimulating factor (GM‐CSF) were detected in the culture supernatant after 72 hours incubation with trichophytin in the peripheral blood mononuclear cells (PBMC) obtained from a patient who had a dermatophyte infection. These findings indicate that this patient has peripheral T‐lymphocytes that produced IFN‐γ, IL‐2 and GM‐CSF, which may play roles in the development of delayed‐type hypersensitivity (DTH) reaction in the skin.
Blister Formation over a Soft Fibroma of the Nipple
Authors: Higaki Yuko , Yoshinaga Yoko , Kawashima Makoto
Published: April 2015

We report a case of soft fibroma on the nipple which was accompanied by a blister. Histologically, a subepidermal blister overlying the tumor and the degeneration of the lower part of the epidermis were observed. The causes of blister formation are briefly discussed.
Augmentation of In vitro Cytolytic Activity of LAK Cells with Heated ATL‐Derived Cell Lines
Authors: Nakayama Juichiro , Toshitani Akito , Hattori Toshio , Moroi Yoichi , Hori Yoshiaki
Published: April 2015

Three adult T‐cell leukemia/lymphoma‐derived cell lines, MT‐2, MJ, and HUT102, were investigated to determine how they responded to hyperthermia, lymphokine‐activated killer (LAK) cells, or a combination of both in vitro. All three cell lines showed a similar sensitivity to LAK cells, but revealed varying degrees of sensitivity to hyperthermia (MT‐2<MJ<HUT102) by 51Cr release assay. Hyperthermia did not cause immediate cell death as determined by the trypan blue exclusion test, but did cause substantial decreases in the numbers of heated cells within 2 days. The density of the cells began to increase thereafter, which was consistent with the results of the experiments labeling the cells with 3H‐TdR after hyperthermia. When the cells were heated at 39–43°C for 1–3 hr and then interacted with various LAK cell/ATL cell (E/T) ratios at 37°C for 4 hr, total cytolysis of the cells increased in a synergistic and/or additive manner over that of the cells without hyperthermia. Prolonged incubation of the cells at high temperature did not necessarily cause a large increase in the interaction of LAK cells after hyperthermia. This augmentation of cytolysis by LAK cells after hyperthermia was not seen in normal peripheral lymphocytes. These results suggest that the combination therapy of hyperthermia and LAK cells may be more specific, useful, and effective for treating malignant lymphoma.
Subungual Pigmented Nevus: Evaluation of DNA Ploidy in Six Cases
Authors: Asahina Akihiko , Chi Hyung‐In , Otsuka Fujio
Published: April 2015

The discrimination between subungual pigmented nevus and subungual melanoma in situ is still a clinical problem. We measured DNA ploidy in six cases of subungual melanotic lesions which exhibited the features of subungual pigmented nevus or lentigo simplex histologically. Five cases presented a diploid pattern with or without a slight increase of hyperdiploid cells. One case presented a polyploid pattern; it also exhibited histologically abnormal melanocytes with large nuclei and pigment‐filled elongated dendrites. The DNA ploidy pattern and histologic features suggest that the lesion of this latter case contains abnormal melanocytes which probably have the potential to undergo a malignant transformation into a subungual melanoma. DNA ploidy analysis, therefore, is likely to provide information for evaluating the biologic behavior of subungual melanotic lesions.
A Case of Verrucous Carcinoma Associated with Human Papillomavirus Type 16 DNA
Authors: Nishikawa Takeshi , Kobayashi Hitoshi , Shindoh Masanobu , Yamashita Toshiharu , Fujinaga Kei , Ohkawara Akira
Published: April 2015

We report here a case of verrucous carcinoma which occurred on the penis of a 75‐year‐old male. The nodule was first noted six months earlier and was whitish, cauliflower‐like, and 17 × 19 mm in size. The histopathological examination revealed hypertrophic epidermal proliferation with pale staining keratinocytes, extending into the deep dermis. Partial penectomy and inguinal lymph node dissection were done. No lymph node metastasis was recognized. DNA was isolated from the frozen tumor tissue and examined for the presence of human papillomavirus (HPV) 16, 18, and 33 DNA by the polymerase chain reaction (PCR), using common and specific primers. A 140 base pair (bp) band was amplified and finally determined to be the HPV16 sequence by dot‐blot hybridization.
Linear Porokeratosis
Authors: Taniguchi Yoshiki , Yuasa Tetsuya , Shimizu Masayuki
Published: April 2015

A case of linear porokeratosis in a 14‐year‐old girl was reported. The lesions started from the right forearm and extended to the right breast. Histological examinations showed cornoid lamella in the horny layer and dyskeratotic cells in the spinous layer beneath the cornoid lamella. Linear distributions of the lesions resembled the lines of Blaschko.
The Effect of Cimetidine on Verruca Plana Juvenilis: Clinical Trials in Six Patients
Authors: Choi Yong Seop , Hann Seung Kyung , Park Yoon‐Kee
Published: April 2015

Cimetidine is an H2‐receptor antagonist which is mainly used to treat gastrointestinal diseases. Recently, many authors have suggested that cimetidine has the ability to reverse acquired tolerance to dinitrochlorobenzene (DNCB).

We have used cimetidine in six patients with verruca plana who showed no therapeutic response to DNCB. Four of them responded and showed complete disappearance of the verruca plana. The mean duration of oral cimetidine administration (1.2 g/day) was 4 weeks until the disappearance. Therefore, we suggest that oral cimetidine can be used as an effective and safe adjunctive modality for the treatment of verruca plana.
The Relationship of Sun Protection Factor to Minimal Erythema Dose, Japanese Skin Type, and Skin Color
Authors: Kawada Akira , Noda Toshiaki , Hiruma Masataro , Ishibashi Akira , Arai Seiichi
Published: April 2015

The relationship of sun protection factor (SPF) to minimal erythema dose (MED), Japanese skin type, and skin color was investigated on the unexposed backs of 48 healthy subjects. SPF of a UVB‐sunscreen was determined using sun lamps as a light source. A significant correlation was found between SPF and MED; subjects with lower MED showed higher SPF. The average SPF decreased with increasing skin type. There was no significant correlation between SPF and skin color (L*a*b* color system).
The Relationship among Minimal Erythema Dose, Minimal Delayed Tanning Dose, and Skin Color
Authors: Noda Toshiaki , Kawada Akira , Hiruma Masataro , Ishibashi Akira , Arai Seiichi
Published: April 2015

The relationship among minimal erythema dose (MED), minimal delayed tanning dose (MDTD), and skin color was examined in 16 healthy volunteers using three different spectra. The subjects were exposed to UVB, UVA+B, and UV+Visible light (UV+Visible) with a xenon arc solar simulator as a light source. The MEDs for UVB and UVA+B were less than the MDTDs, whereas the MED for UV+Visible was higher than the MDTD. There was no significant correlation between the MED and the MDTD for UVB or UVA+B. The MED for UV+Visible was significantly correlated to the MDTD (p<0.01). Skin color significantly correlated with MEDs for UVB and UVA+B (p<0.01), but not for UV+Visible. There was no significant correlation between skin color and the MDTD for any spectra. From these results, it is suggested that the relationship between erythemal and melanogenic responses is dependent on spectral bands of the light source and that skin color is a predictor of UV‐induced erythema.
Experimental Murine Protoporphyria Induced by Griseofulvin (GF): The Relationship between Hepatic Porphyrin Levels and Liver Function Test Values in Mice Treated with GF
Authors: Tanaka Keiichi , Ohgami Taro , Nonaka Shigeo
Published: April 2015

To investigate the hepatic abnormalities accompanying experimental protoporphyria due to griseofulvin (GF), liver function test values and porphyrin levels in mice were assayed at days 2, 4, 8, and 16 after starting the administration of 0.5% GF feed. Furthermore, in an attempt to elucidate the harmful effects of GF on liver functions, the above mentioned assay was also performed after the feed was discontinued in mice given 0.5% GF feed for 16 days.

The hepatic protoporphyrin (PP) level had already risen by day 2, but the erythrocytic PP level was within normal limits at that time. Hepatic PP levels increased gradually, followed by an increase in erythrocytic PP levels. The variation in liver function test values roughly paralleled the porphyrin levels. Over the time span of the response to GF, the variations in the serum glutamate oxaloacetate transaminase (S‐GOT) levels, serum glutamate pyruvate transaminase (S‐GPT) levels, and leucine amino peptidase (LAP) levels resembled those in hepatic PP. On the other hand, the changes in alkaline phosphatase (ALP) levels paralleled those of the erythrocytic PP levels.

Erythrocytic and fecal protoporphyrin levels decreased to the normal level one month after the discontinuation of GF administration, but the hepatic protoporphyrin level still was 53.6 times higher than the normal level two months after switching to normal feed. The values of liver function tests had returned to within the normal range after one month.

By the fourth day after the administration of GF, a brown pigmented material could be observed around the hepatocytes and the Glisson sheath; the amount of this material increased day by day. Its amount gradually decreased after cessation of GF.

These results suggested that the hepatic abnormalities were not induced by the deposition of PP in the liver, but by the direct toxicity of GF. This means that GF‐induced protoporphyria mice are not suitable for investigating porphyric damage to the liver because of the strong hepatic intoxication by GF. However, they may be useful for studies of the removal of deposits of porphyrin granules from the liver.
A Case of Acrogeria
Authors: Matsumura Yasuhiro , Hamanaka Hiroshi , Okuwa Takashi
Published: April 2015

We report a 30‐year‐old Japanese male with acrogeria. He was in good health except for the prominent skin atrophy over the hands and feet. In the microscopic view of an atrophic skin biopsy specimen, elastic fibers were clumped and fragmented, especially in the upper dermis. Reviewing fourteen previously reported Japanese cases of acrogeria, the decrease and degeneration of elastic fibers were the prominent characteristic, as was the atrophy of subcutaneous fat.
Isolated Lichen Planus of the Nails Treated with Etretinate
Authors: Kato Naoko , Ueno Hiroo
Published: April 2015

A 46‐year‐old Japanese man with isolated lichen planus of the nails is reported. The affected nails were all of the fingernails and the third and fourth toenails of both feet. Histologically, the ventral part of the proximal nail folds showed mild band‐like cell infiltration below the epidermis, and the nail beds (ventral matrix) showed hypergranulosis and epidermal‐dermal interphase activity with liquefaction degeneration of basal cells and a band‐like cell infiltration consisting of lymphoid cells and histiocytes. Systemic use of etretinate in combination with application of steroid lotion was evaluated as very effective. Although the use of retinoids for lichen planus of the nails remains only a suggested method of treatment, a positive trial should be attempted, since this disorder sometimes results in severe nail damage.
1α,25‐Dihydroxy Vitamin D3 Modulation of HLA‐DR mRNA Induced by Gamma‐Interferon in Cultured Epithelial Tumor Cell Lines
Authors: Tone Takeshi , Eto Hikaru , Katou Takako , Otani Fumio , Nishiyama Shigeo
Published: April 2015

Using three cultured epithelial tumor cell lines, we investigated and analyzed the effects of gamma‐interferon (γ‐IFN) and 1α,25‐dihydroxy vitamin D3 (1,25‐(OH)2D3) on the levels of HLA‐DR (α) mRNA and HLA‐DR (β) mRNA by Northern blot analysis.

After treatment with γ‐IFN alone, the levels of the mRNA increased. Treatment with both γ‐IFN and 1,25‐(OH)2D3 at the same time resulted in a significant decrease in the levels of mRNA in K‐TL‐1, IK‐TL‐2, and M‐TL cells as compared to those induced by γ‐IFN alone.
Analysis of the Interleukin 6 Receptor on Normal Human Keratinocytes by Digital Imaging Fluorescence Microscopy
Authors: Kobayashi Teruaki , Hashimoto Koji , Matsumoto Kunio , Yoshizaki Kazuyuki , Yoshikawa Kunihiko
Published: April 2015

The interleukin 6 receptor (IL 6 receptor) on normal human keratinocytes was analyzed by digital imaging fluorescence microscopy (DIFM). Non‐fixed keratinocytes were incubated with monoclonal anti‐IL 6 receptor antibody (MT18). The fluorescence intensity was quantitatively determined by an interactive laser cytometer (ACAS 470). IL 6 receptor‐positive cells showed high density staining with the specific antibody in the center of the elevated cell surface. Therefore, DIFM appears to be an effective method for study of the distribution of IL 6 receptors at the single living cell level.