bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of an Inhibitor of Glucosylceramide Synthesis on Cultured Human Keratinocytes
Authors: Takami Yoshihiro , Abe Akira , Matsuda Takayoshi , Shayman James A. , Radin Norman S. , Walter Robert J.
Published: April 2015

Glucosylceramide (GlcCer) is a major glycosphingolipid component of epidermis, which is thought to be related to the barrier function of skin permeability. However, the role of glycosphingolipids in keratinocyte growth and differentiation has not been fully clarified. It has been reported that D‐threo‐1‐phenyl‐2‐decanoylamino‐3‐morpholino‐1‐propanol (PDMP), an inhibitor of GlcCer synthase (EC 2.4.1.80), depletes cells of glycosphingolipids. This inhibitor has been used as a tool for elucidating their functions. In the present study, the effect of PDMP on cultured normal human keratinocytes was investigated. The cells were treated with various concentrations of PDMP. Forty‐eight hours later cell growth, thymidine incorporation, and lipid content were studied. The cell growth and the incorporation of thymidine into cells were inhibited by PDMP in a dose dependent manner. The synthesis of GlcCer was strongly inhibited by PDMP treatment, whereas no significant changes in ceramide level were observed. We concluded that GlcCer in epidermis may play an important role in regulating epidermal growth and suggested that PDMP may be beneficial for treating proliferative skin disorders in the future.
The Expression of Endothelin‐1 and Its Binding Sites in Mouse Skin Increased after Ultraviolet B Irradiation or Local Injection of Tumor Necrosis Factor α
Authors: Ahn Gun Young , Butt Khalid Iqbal , Jindo Toshimasa , Yaguchi Hitoshi , Tsuboi Ryoji , Ogawa Hideoki
Published: April 2015

Endothelin (ET)‐1 is a 21‐amino acid peptide which has vasoconstrictor and growth regulatory activity. Recently, cultured keratinocytes have been reported to express ET‐1 and its receptor when irradiated by ultraviolet (UV) B. In order to further understand the role of ET‐1 in vivo during UVB‐induced inflammation, we examined the localization, intensity and time course of the expression levels of ET‐1 and its binding sites in UVB‐exposed BALB/c mouse skin. Frozen and paraffin sections prepared from mouse skin 48 h after treatment with UVB irradiation (0.36 or 0.72 J/cm2) or after injection with tumor necrosis factor (TNF)‐α (1.0 μg) or interleukin (IL)‐1α (0.05 μg) were incubated with monoclonal anti‐ET‐1 IgG and then visualized by peroxidase staining. In normal skin, faint ET‐1 immunoreactivity was observed in the epidermis, pilosebaceous structures and blood vessels. Upon exposure to UVB irradiation or administration of TNF‐α injection or IL‐1α injection, such immunoreactivity was found to be significantly enhanced. Subsequently, the frozen sections were incubated with 125I ET‐1 for 30 min, and visualized by autoradiographic technique. In normal skin, ET‐1 weakly bound to the skin, while UVB irradiation and TNF‐α injection significantly enhanced ET‐1 binding in the epidermis, pilosebaceous structures and blood vessels. Time course experiments (1, 2, 4 and 7 days) indicated that ET‐1 immunoreactivity and ET‐1 binding peaked 1 or 2 days after UVB irradiation or TNF‐α injection. These results suggest that the up‐regulated expression of ET‐1 and its binding sites in the epidermis and pilosebaceous structures may act as an autocrine/paracrine factor during UVB‐induced inflammation.
Spongiotic Annular Erythema in SS‐A/SS‐B Antibody Negative Sjögren's Syndrome
Authors: Higuchi Tetsuya , Taniguchi Hiroko , Katayama Ichiro , Nishioka Kiyoshi
Published: April 2015

We reported four cases of Sjögren's syndrome (SjS) who manifested a new type of annular erythema that differs from the previously described annular erythema seen in anti‐SS‐A/SS‐B antibody positive SjS in both clinical and histological findings. Characteristic histological features are the presence of spongiotic changes around the acrosyringium and perivascular lymphocytic infiltration without liquefaction degeneration or epidermal change, suggesting lupus erythematosus. No complement or immunoglobulin depositions are demonstrated along the basement membrane zone or around blood vessels. Clinically, this type of erythema usually appears on the trunk or extremities with itchy sensations, especially in summer, which contrasts with the preferential occurrence of the previously reported SjS related annular erythema on the facial skin in winter. Immunologically, all four cases lacked anti‐SS‐A and anti‐SS‐B antibodies, but possessed positive anti‐microsome antibodies or thyroid tests. In three cases, metal allergy was demonstrated by patch test, which might suggest that the sweat duct is the primary target of excreted metals in this condition and that underlying SjS might play some role in the higher prevalence of metal allergy or in induction of sweat duct injury, similar to the interstitial nephritis which is now thought to be an exocrine manifestation of SjS.
The Effectiveness of Modified Ingram Therapy Compared with Severity of Psoriasis
Authors: Youn Jai Il , Kim Byoung Kook , Suh Dae Hun
Published: April 2015

To treat cases of psoriasis, various modifications of the original Ingram method were tested for increased effectiveness and minimized side reactions. Our modified method consists of 0.1–0.5% anthralin ointment application and selective UVB phototherapy with adjunctive warm water bath and the application of emollients. The object of this study was to evaluate the effectiveness and duration of remission in response to our modified Ingram method and compare the data with the severity of psoriasis.

The clearing rate was higher and the failure rate was lower in the moderate group. The number of occasions on which therapy was used and the duration of this therapy were greater in the severe group, but there were no significant differences except for the number of occasions of therapy to the trunk. Fifty‐eight percent of the moderate group did not relapse in more than one year, but 63% of the severe group relapsed within six months.

The results of this study showed that the modified Ingram regimen is an effective therapeutic modality in psoriasis, especially in the moderate group.
A Case of Post‐kala‐azar Dermal Leishmaniasis
Authors: Ono Hiroko , Ghoreishi Meiran , Yokozeki Hiroo , Katayama Ichiro , Nishioka Kiyoshi
Published: April 2015

Only a few cases of Post‐kala‐azar dermal leishmaniasis have been reported in Japan, especially recently. We describe a case of a 32‐year‐old woman who developed rose‐colored nodules on her forearms two years after Kala‐azar. A skin biopsy specimen from a nodule revealed not only granulomatous changes but also many amastigotes of Leishmania donovani in macrophages. Rose‐colored nodules were also distributed on her face and neck. Treatment with antimony compound was very effective.
The Vascular Space‐like Structure in Melanocytic Nevus Is Not an Injection Artifact: Report of a Case and an Experimental Study
Authors: Demitsu Toshio , Kakurai Maki , Yamada Tomoko , Kiyosawa Tomoharu , Yaoita Hideo
Published: April 2015

Melanocytic nevi may microscopically associate with clefts or slits of the nests resembling lymphatic or vascular spaces. This unique histologic feature has been known as an artifact of injection or tissue‐processing. We present a case of melanocytic nevus with a prominent vascular space‐like structure. We also studied whether intralesional injection of local anesthetic could reproduce similar histologic findings.

A 45‐year‐old Japanese female visited us with a solitary, brownish papule on the chest. Histology revealed numerous nests composed of round to oval‐shaped nevus cells throughout the entire dermis. In the mid‐dermis, nevus cells were lined up in a layer anastomosing and forming a vascular space‐like structure. These nevus cells were uniformly stained with vimentin and S100 protein but not with factor VIII‐related antigen. They were also positively immunoreactive with anti‐type IV collagen and anti‐fibronectin. There were no significant differences in staining intensity in the nevus cells between the solid portion and the vascular space‐like structure.

In the experimental study, eight melanocytic nevi were removed under local anesthesia. The local anesthetic solution was then injected into the excised nevus. Intralesional injection of a considerable volume of local anesthetic was capable of causing slits or clefts of the nests and dermal edema; however, it failed to reproduce a vascular space‐like structure similar to that in the present case. These findings suggest that a vascular space‐like structure in melanocytic nevus is not caused by the injection alone. Some other factor(s) may play a major role in the development of such structures in melanocytic nevus.
A Large Number of Tandem Repeats in the Polymorphic Epithelial Mucin Gene Is Associated with Severe Acne
Authors: Ando Iwao , Kukita Atsushi , Soma Genichiro , Hino Haruko
Published: April 2015

Polymorphic epithelial mucin (PEM) or MUC1 is a glycoprotein secreted from various epithelial gland tissues. In skin, PEM is detected in sweat glands and sebaceous glands by the DF3 monoclonal antibody. The gene of PEM includes an allele exhibiting length polymorphism due to a variable number of tandem repeats (VNTR); this is expressed co‐dominantly, which may influence the microenvironment of the skin. The allelic size variation of the PEM gene was investigated in Japanese acne patients, atopic dermatitis patients, and healthy controls. The frequency of longer length alleles was significantly higher in severe acne patients.
HLA Antigens and Linkage Disequilibrium Patterns in Turkish Behçet's Patients
Authors: Alpsoy Erkan , Yilmaz Ertan , Coşkun Mesut , Savaş Ayşe , Yeğin Olcay
Published: April 2015

Behçet's disease (BD) is a multisystem disorder featuring mucocutaneous, ocular, articular, vascular, intestinal, pulmonary, and neurologic involvement. Although the pathogenesis of the disease is still unknown, most studies have proposed that immunologic factors may play a major role in its development in genetically predisposed individuals.

Seventy‐one Turkish patients with BD, diagnosed according to the International Study Group for Behçet's Disease criteria, were studied and compared with 600 healthy controls to determine not only frequencies of HLA‐A, B, and DR antigens but also whether BD shows any distinct linkage disequilibrium (LD) patterns. In addition, three‐point linkage disequilibrium and relative risk (RR) values were determined.

Of the HLA‐A, B, and DR antigens examined, only B5 (51) was significantly increased in the patient group (X2=55.4; p<0.05; RR=6.44). DR7 was significantly decreased in the patient group (X2=6.9; p>0.05; RR=0.31). HLA haplotype B5‐DR5 was found to be in negative LD in the control group, but Behçet's patients showed a strong positive LD between these two antigens. HLA haplotypes A2‐B12, B5‐DR2, and B12‐DR4 showed negative LD in the patients; A1‐B5 and B5‐DR5 had positive LD in the patients. HLA haplotype A2‐B5‐DR5 was found to be more frequent than expected in both patients and control gorups. A2‐B12‐DR4 showed a negative LD in the patients.

The strong LD patterns between HLA‐B and DR antigens in BD suggest that the susceptibility gene to BD could reside between the these two antigens.
Recurrent Annular Erythema in a Case of Seronegative Sjögren's Syndrome
Authors: Yamagami Yoshie , Ichikawa Kaoru , Mukuno Akira , Eto Hikaru
Published: April 2015

We describe a case of Sjögren's syndrome who repeatedly developed annular erythema on her extremities. Her anti‐nuclear antibody, anti‐SSA/Ro antibody, and anti‐SSB/La antibody were all negative. Characteristics of the annular erythema included a tendency to appear on the extremities especially in summer, spontaneous regression after 1–2 weeks, and residual slight pigmentation. The histological findings revealed dermal perivascular lymphocytic infiltration admixed with some neutrophils. Slight exsudative changes were found in the upper dermis. There were no epidermal changes. This case suggests the existence of annular erythema which may not be related to the anti‐SSA/Ro or anti‐SSB/La antibody. Unknown factors other than those antibodies may be involved in the pathogenesis of the annular erythema.
A Case of Cutaneous Ki‐1 Positive Anaplastic Large Cell Lymphoma in a Hemodialysed Patient
Authors: Kamada Noriaki , Kuwahara Takeichirou , Hatamochi Atsushi , Shinkai Hiroshi
Published: April 2015

A 66‐year‐old woman who suffered from chronic glomerulonephritis had been undergoing hemodialysis for about 10 years. A reddish papule on her waist developed gradually into a nodule (1.9 × 1.4 cm). Histopathological findings showed that the tumor cells had oval to reniform nuclei; multinucleated neoplastic cells and erythrophagocytosis were also present. Immunohistochemical analyses revealed that the membranes of the tumor cells stained for Ber‐H2 (Ki‐1) and epithelial membrane antigen (EMA), Vimentin was partially positive, but keratin, S‐100, chromogranin, leukocyte common antigen (LCA), UCHL‐1, MT‐1, L‐26, MB‐1 and C3D‐1 were all negative. Anti‐human T‐cell leukemia virus‐1 (HTLV‐1) was also negative. No gene rearrangement of the T‐cell receptor β‐, γ‐ and δ‐chain could be detected. From these results, we diagnosed cutaneous Ki‐1 anaplastic large cell lymphoma (ALCL), but the origin could not be determined. The relationship between lymphoma and chronic renal failure and/or hemodialysis was far from clear.
Pyodermia Chronica Glutealis Complicated by Acromegalic Gigantism
Authors: Nishijima Setsuko , Kasahara Mika , Suzuki Kenji , Kondoh Masako , Tsubura Airo
Published: April 2015

We report a case of pyodermia chronica glutealis complicated by acromegalic gigantism associated with hyperprolactinemia. The serum prolactin, growth hormone, adrenocorticotropic hormone, and 11‐deoxycortisol levels were elevated, but the estradiol and dehydroepiandrosterone‐sulphate levels were within normal limits. However, the testosterone level was very low. Histopathologically, we found sinus tracts and scarring in a specimen from the buttocks. We could not immunohistochemically detect clear androgen, growth hormone, or prolactin receptors at any site. The patient was a man with a height of 197 cm and weight of 140 kg, he had clinical features of active acromegaly such as excessive sweating and increased thickness of soft tissue. He was also diagnosed with diabetes mellitus. Under such conditions, bacteria could easily grow and lesions might have been aggravated by the heavy pressure from his weight, a possible causes of his pyodermia chronica glutealis.
Two Cases of Unilateral Axillary Paget's Disease
Authors: Ohno Haruhiko , Hatoko Mitsuo , Kuwahara Masamitsu , Ohnuma Yoshiyuki , Iida Takashi , Muramatsu Tsutomu , Shirai Toshihiko
Published: April 2015

We herein report two cases of unilateral axillary Paget's disease. Extramammary Paget's disease commonly occurs in the anogenital area. Unilateral axillary occurrence is relatively rare. One defect was reconstructed with a pedicled scapular flap, and the other was reconstructed with split‐skin graft after excision of the tumor. No recurrence was seen in either patient three years postoperatively. However, although the patient who had been reconstructed with a pedicled flap recovered uneventfully, the other patient, who had been reconstructed with a split‐skin graft, suffered from axillary contracture due to the shrinkage of the grafted skin after surgery. A skin graft requires fixation for a long period to prevent shrinkage, which causes axillary contracture. Therefore, from the viewpoint of quality of life, reconstruction using flaps is recommended for axillary lesions.
Generalized Erythematous Skin Eruptions Due to Trimethoprim Itself and Co‐Trimoxazole
Authors: Hattori Naoko , Hino Haruko
Published: April 2015

A 20‐year‐old Japanese woman (Case 1) and a 70‐year‐old Japanese man (Case 2) consulted us with slight fever and disseminated erythematous papules. Examinations revealed that the first case was a skin eruption due to trimethoprim itself and the second was due to both trimethoprim and sulphamethoxazole. To our knowledge, our Case 1 is the first reported case with an erythematous papular type skin eruption caused by trimethoprim itself, and our Case 2 is the first case of a skin eruption in reaction to both trimethoprim and sulphamethoxazole.
A Case of Seborrheic Keratosis Distributed along Skin Cleavage Lines
Authors: Li Xiaojie , Zhu Wenyuan
Published: April 2015

A 65‐year‐old woman with seborrheic keratosis following skin cleavage lines is reported. The mostly brownish‐yellow lesions were located on the back. The round, oval, spindle, comet, and slightly raised papules varied from 1 mm to 2 cm in diameter. The distribution of lesions was unusual; they tended to follow skin cleavage lines on her lower back and waist. The arrangement of lesions was streamlined. The skin biopsy specimen revealed hyperkeratosis, acanthosis, and papillomatosis. The acanthosis was caused by proliferation of squamous and basaloid cells.
Superficial Spreading Melanoma Arising in a Longstanding Melanocytic Nevus on the Sole
Authors: Cho Kwang Hyun , Han Kwang Ho , Minn Kyung Won
Published: April 2015

In Asians, the plantar surface is the commonest site for cutaneous melanoma, and most melanomas arising in this region are the acral lentiginous type. Herein we describe a rare case of superficial spreading melanoma arising in a longstanding melanocytic nevus on the sole of a Korean.
Local Cytokine Expression in Steroid‐Modified Tinea Faciei
Authors: Ohta Yukinori , Saitoh Norimitsu , Tanuma Hiroyuki , Fujimura Takao , Katsuoka Kensei
Published: April 2015

In tinea faciei, a dermatophyte infection of the face, early stage lesions show erythema with crust and/or vesicles, a condition often misdiagnosed as dermatitis. Steroid application retards the healing in some cases and may induce penetration of the dermatophyte hyphae into hair and hair follicles. In the present study, we examined local immunity mediated by cytokines derived from lesional T lymphocytes in late stage of this disease. Interferon‐gamma (IFN‐γ) and macrophage migration inhibitory factor (MIF) were highly expressed, but neither interleukin‐4 (IL‐4) nor interleukin‐5 (IL‐5) could be detected by RT‐PCR using cryosections. These data suggested that IFN‐γ and MIF may be important in the delayed‐type hypersensitivity (DTH) response against the fungus in the hair follicle in late stages.
A Pediatric Case of Atypical Mycobacterium avium Infection of the Skin
Authors: Noguchi Hiromitsu , Hiruma Masataro , Kawada Akira , Fujimoto Norihiro , Fujioka Akira , Ishibashi Akira
Published: April 2015

We report a case of cutaneous atypical mycobacteriosis in a 12‐year‐old healthy girl due to Mycobacterium avium. The cutaneous symptoms were three well‐defined subcutaneous nodules on both buttocks and on the posterior surface of the left thigh. One had a fistulous opening on the skin surface. Histopathological examination revealed epithelioid cell granulomas surrounded by dense lymphocytic infiltration and acid‐fast bacteria were seen with modified periodic acid‐carbol fuchsin staining. Using Ogawa's medium at 37°C, acid‐fast bacteria were isolated from the biopsied specimen and identified by the DNA‐DNA hybridization method as Mycobacterium avium. In drug susceptibility test, these were resistant to all antituberculous drugs. Oral administration of minocycline 100 mg/day for two months had little effect on the two remaining lesions, which were therefore excised. Based upon reported cases of Mycobacterium avium complex, we considered that our pediatric patient with multiple intradermal or subcutaneous nodules on the buttocks and the thigh exhibited the characteristic symptoms of M. avium infection.
A Case of Subcutaneous Cysticercosis
Authors: Matsushima Hironori , Hatamochi Atsushi , Shinkai Hiroshi , Shimizu Motota , Hatsushika Ryo
Published: April 2015

We report the fourth case of subcutaneous cysticercosis infected in Japan since 1975. The patient noticed a subcutaneous nodule on his left shoulder without symptoms for three years. No remarkable changes were found in laboratory findings and physical examination after surgical excision of the subcutaneous nodule. The adult worm of Taenia solium could not be found in the intestine. Histological findings revealed a cystic structure with a fibrous capsule and a protoscolex with suckers, hooks, and calcareous corpuscula. It was identified as a Cysticercus cellulosae hominis based on morphological characteristics. The patient has been living in the Kanto area of Japan and has never been outside Japan since he was born.
A Case of Dystrophic Epidermolysis Bullosa: Surgical Treatment for Hand Contracture Using Abdominal Skin Flap
Authors: Muramatsu Tsutomu , Hatoko Mitsuo , Shirai Toshihiko , Vanittanakom Pramote
Published: April 2015

The patient was a 15‐year‐old male. Since birth, he has suffered from recurrent blistering, especially on the extremities. Histology and electron microscopic findings of the cutaneous lesions were compatible with those of dystrophic epidermolysis bullosa. Contracture and mobility limitation of the hands had gradually deteriorated. Prior to the admission to our clinic, both hands' contracture had been surgically treated 4 times in another hospital; however, after treatment with skin grafting, hand contracture recurred each time within one year. This time, surgical treatment was carried out for his left hand contracture using an abdominal skin flap under local anesthesia. In comparison with the free skin graft, the abdominal skin flap improved hand contracture for a longer time. Abdominal skin flap is recommended as a method for the treatment of hand contracture of patients with dystrophic epidermolysis bullosa.
Primary Sjögren's Syndrome Followed by Chronic Myelogenous Leukemia: A Case Report with a Ten Year History
Authors: Minowa Rui , Miyagawa Sachiko , Fukumoto Takaya , Majima Toshimasa , Shimoyama Taketo , Fujimura Yoshihiro , Shirai Toshihiko
Published: April 2015

We describe a female patient with primary Sjögren's syndrome who subsequently developed chronic myelogenous leukemia. The patient received a bone marrow transplant (BMT) from a genotypically HLA‐identical brother after pre‐transplant preparation with busulfan and cyclophosphamide. Eighteen weeks later, cutaneous and mucosal chronic graft‐versus‐host disease developed, followed by death 11 months after transplantation. Anti‐Ro/SS‐A antibodies disappeared within 6 months post‐BMT, but antinuclear antibodies remained positive through the post‐transplant course.
Bullous Pemphigoid Associated with Shy‐Drager Syndrome
Authors: Okazaki Aiko , Iida Takashi , Muramatsu Tsutomu , Shirai Toshihiko , Murata Kenya , Takayanagi Tetsuya
Published: April 2015

We report a patient with Shy‐Drager syndrome who developed multiple tense blisters mainly on the extremities. Circulating anti‐basement membrane zone autoantibodies were detected by the indirect immunofluorescence method. Immunoblot analysis using normal human epidermal extracts demonstrated that this patient's serum reacted only with 230 kD bullous pemphigoid antigen (BPAG1). Concerning the pathoetiology of the association of bullous pemphigoid and Shy‐Drager syndrome, we discuss a sequence similarity between BPAG1 and dystonin, a candidate gene for dystonia musculorum.
Successful Treatment of Transient Acantholytic Dermatosis with Systemic Steroids
Authors: Erõs Nóra , Kovács Anikó , Károlyi Zsuzsanna
Published: April 2015

A sixty‐year‐old man, developed 2–5 mm sized, hyperemic, itchy papules, vesicles, erosions and crusts on hyperemic base on his chest, abdomen, back, gluteal region, and proximal sites of his upper and lower extremities. The direct and indirect immunoflurescence tests were negative. Histology revealed extensive acantholysis in the epidermis in the following forms: pemphigus vulgaris‐like suprabasal acantholysis, Darier‐like acantholytic dyskeratosis with corps ronds, Hailey‐Hailey‐like suprabasal clefts, and pemphigus foliaceus‐like superficial acantholysis with spongiosis. Using systemic steroids, topical drying, and reepithelising therapy, the patient was cured. He was symptom‐free the first, fourth, and thirteenth months after finishing steroid therapy.

We review the literature and the new subdivision of the disease according to the histological and clinical features.
Immunobead and Density Gradient Purification of Paget Cells: In vitro Studies of Proliferation
Authors: Mori Osamu , Miyasato Minoru , Karashima Tadashi , Hashimoto Takashi
Published: April 2015

Previous studies using primary monolayer cultures of epithelial cells from the involved epidermis of patients with mammary and extramammary Paget's disease investigated whether Paget cells proliferate as other malignant cells do. Although epithelial monolayers from the involved skin were maintained for approximately 45 days, no permanent cell lines were established. The proportion of carcinoembryonic antigen (CEA)‐positive cells did not increase in the long‐term cultures.

Herein, we report studies of whether there is a real reduction of Paget cell numbers or if this is merely a decrease in the expression of CEA by the cells. Furthermore, we investigated whether Paget cells survive longer when cultured free from any potential inhibitory keratinocytes or other epidermal cells.

Skin samples were obtained from one patient with mammary Paget's disease and three with extramammary Paget's disease; epidermal cells were cultured in vitro. An enrichment of Paget cells was carried out from the cultured epidermal cells by combining an anti‐epithelial membrane antigen monoclonal antibody, binding to immunobeads, and density gradient centrifugation in Nycodenz. The separated cells were re‐cultured in Keratinocyte‐SFM serum‐free media.

The proportion of CEA‐positive cells did not increase in the cultures, and the purified cells did not show any increase in survival times compared to the non‐purified cultured cells. These results suggest that the decrease of CEA‐positive cells noted during culture results from a decline in expression of CEA in the Paget cells. Paget cells in the involved epidermis do not proliferate significantly and thus differ from many other malignant cells.
A Case of Infantile Digital Fibromatosis with Spontaneous Regression
Authors: Kawaguchi Masakazu , Mitsuhashi Yoshihiko , Hozumi Yutaka , Kondo Shigeo
Published: April 2015

We reported a fourteen‐month‐old boy with infantile digital fibromatosis. At the age of seven months, a nodule appeared on the back of the left third toe, and developed into a slight red tumor divided into five hemispherical nodules. Histopathologically, spindle‐shaped tumor cells with an eosinophilic inclusion body in the cytoplasm were seen in the dermis. Electron microscopy showed a dense body in the cytoplasm of the tumor cells. One year and two months after the first visit, the tumor regressed without any aggressive treatment. Japanese cases of infantile digital fibromatosis were reviewed. The literature review and our case suggest that the tumor should be observed without any aggressive treatment unless it causes mobile dysfunction of the affected finger or toe.
Disseminated Cutaneous Rhinosporidiosis
Authors: Thappa Devinder Mohan , Venkatesan Sivaraman , Sirka Chandra Sekhar , Jaisankar Telanseri Jayakar , Gopalkrishnan  , Ratnakar Chaganti
Published: April 2015

Two cases of longstanding rhinosporidiosis developed widespread asymptomatic nodular skin lesions. Cutaneous examination showed multiple, discrete, sessile and pedunculated, smooth and warty, friable nodular lesions of variable sizes and shapes. Histopathology of representative skin lesions showed hyperplastic epidermis with sporangia containing spores in the upper dermis diagnostic of rhinosporidiosis. Epidemiological data about rhinosporidiosis at Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India, is presented. Possible modes of dissemination to the skin and differential diagnosis are discussed in relation to this rare manifestation of rhinosporidiosis.
Dermatomyositis and Nasopharyngeal Carcinoma
Authors: Abraham Zeev , Rosner Itzhak , Rozenbaum Michael , Goldenberg Katalin , Weller Boaz
Published: April 2015

A nasopharyngeal carcinoma was diagnosed in a 37‐year‐old man with a two year history of dermatomyositis. The physical and laboratory examinations excluded further medical problems. To our knowledge, this is the first case of dermatomyositis associated with nasopharyngeal carcinoma in a white Israeli Jewish patient.
Coagulase‐Negative Staphylococci Isolated from Various Skin Lesions
Authors: Akiyama Hisanori , Kanzaki Hiroko , Tada Joji , Arata Jirô
Published: April 2015

We isolated 162 coagulase‐negative staphylococci (48: from infection, 114: from colonization) from various skin diseases between January, 1995, and January, 1998. From eighteen infected cysts, 10 Staphylococcus epidermidis strains, 3 S. capitis strains, 2 S. hominis strains, 2 S. auricularis strains, and one S. saprophyticus strain were individually detected. Similarly, from ten folliculitis lesions, 6 S. epidermidis strains, 2 S. capitis strains, and 2 S. hominis strains, and from five furuncle lesions, 3 S. lugdunensis strains, one S. epidermidis strains, and one S. hominis strain were detected, respectively. Four abscesses with mild inflammatory signs were localized on the scalp; S. epidermidis strains alone were detected from them. From two felons, one S. lugdunensis strain and one S. haemolyticus strain were detected, respectively. Staphylococus epidermidis and S. lugdunensis strains seems to be more frequently associated with skin suppurative lesions than other strains. Staphylococcus hominis strains and S. capitis strains were suggested to be potential pathogens in the initiation of suppuration in various purulent skin lesions. Among the 28 S. epidermidis strains, 13 (46.4%) were methicillin‐resistant (oxacillin. minimum inhibitory concentration ≥4 μg/ml). Twelve (29.3%) out of the other 41 coagulase‐negative staphylococci were methicillin‐resisitant. Coagulase‐positive and ‐negative staphylococci showed no differences in susceptibility tests against various antistaphylococcal agents.
Squamous Cell Carcinoma of the Skin Associated with Sarcoid Reactions in the Regional Lymph Nodes
Authors: Setoyama Mitsuru , Nishi Masayuki , Uchimiya Hiroshi , Kanzaki Tamotsu
Published: April 2015

Sarcoid reactions in lymph nodes with or without metastasis from a primary malignant neoplasm are well‐known. However, it is extremely rare to find these reactions associated with cutaneous solid tumors; only one such case has appeared in the literature. Here we describe a case of an 83‐year‐old man with cutaneous squamous cell carcinoma accompanied by sarcoid reactions and metastatic foci in the regional lymph nodes. The possibilities of systemic sarcoidosis and tuberculosis were excluded after extensive examinations specific for these diseases. Some authors regard the sarcoid reaction to be a sign of a good prognosis on the basis of studies of a few patients with solid tumors. In our case, however, the patient died of pulmonary metastasis with pleuritis carcinomatosa shortly after surgery.

Systematic analysis of a sufficient number of cases should be carried out to evaluate the clinical significance of this type of reaction.
A Case of Superficial Leiomyosarcoma, and a Review of Japanese Cases
Authors: Wakasugi Shoji , Kayashima Ken‐ichi , Ono Tomomichi
Published: April 2015

We report a case of leiomyosarcoma in a 55‐year‐old Japanese female. She developed an erythematous nodule, 1.5 cm in diameter, on her right thigh. The totally excised specimen contained tumor cells with variously sized, chromatin‐rich nuclei. Gitter staining revealed the so‐called encased picture, immunohistopathological staining was positive for smooth muscle actin, and electron microscopy revealed filaments with focal densities. A diagnosis of leiomyosarcoma was made based on these findings, which suggested a muscle cell origin. Normal arrector pili muscles were continuous from the tumor, further suggesting the tumor's origin. The presence of Epstein‐Barr virus‐encoded RNA (EBER) was examined by in situ hybridization with negative results.
Pustular Drug Eruption Due to Bacampicilin Hydrochloride in a Patient with Psoriasis
Authors: Isogai Zenzo , Sunohara Akiyo , Tsuji Takuo
Published: April 2015

We report a case of pustular drug eruption due to bacampicilin hydrochloride which developed in a patient with pustular psoriasis. The patient was a 45‐year‐old Japanese woman with psoriasis which started as pustular psoriasis twenty years previously. In 1994, she developed generalized erythema with pustules accompanied by high fever and liver injury. Clinical and histological findings of this pustular eruption were different from her previous episodes of pustular psoriasis. Erythemas and pustules disappeared and her abnormal transaminase returned to normal rapidly when she discontinued bacampicilin hydrochloride. Her positive reaction to a patch test and a lymphocyte stimulation test also suggested that our case had a pustular drug eruption rather than pustular psoriasis induced by a drug.
Comparative Studies of the Detection Rates of Leishmania Parasites from Formalin, Ethanol‐fixed, Frozen Human Skin Specimens by Polymerase Chain Reaction and Southern Blotting
Authors: Uezato Hiroshi , Hagiwara Keisuke , Hosokawa Atsushi , Maruno Motoyoshi , Nonaka Shigeo , Oshiro Minoru , Nakashima Yasutsugu , Furuya Masato , Hashiguchi Yoshihisa
Published: April 2015

In this study, detection rates of Leishmania parasites from human skin were compared among three different types of specimens, formalin‐fixed, ethanol‐fixed, and frozen, by polymerase chain reaction (PCR) and Southern blotting. For this purpose, we used biopsy specimens collected from 19 leishmaniasis patients and performed PCR and Southern hybridization with the probe specific for Leishmania (Viannia) braziliensis complex. Among these 19, 16 specimens were from cutaneous leishmaniasis (CL), one, diffuse cutaneous leishmaniasis (DCL) and 2, mucocutaneous leishmaniasis (MCL) and were formalin‐fixed and paraffin‐embedded. The causative agents for one case of CL and one case of DCL were already identified as L. (Leishmania) complex. Six specimens of CL were preserved in 100% ethanol. Two specimens of MCL were frozen tissues. PCR using the formalin‐fixed and paraffin‐embedded specimens revealed positive bands at 70bp in 9 (47.4%) out of 19 specimens of CL, MCL and DCL. Southern blotting detected the signals in 12 (63.2%) out of the 19. PCR using the 100% ethanol‐fixed specimens revealed positive bands in 4 (66.7%) out of 6, and Southern blotting also detected the signals in 4 (66.7%) out of the 6. PCR and Southern blotting using 2 frozen specimens of MCL were always positive (100%). Although we failed to detect significant differences by Chi‐square test between the results from the formalin‐fixed, paraffin‐embedded specimens and those from 100% ethanol‐fixed ones, we concluded that ethanol‐fixed specimens, convenient for transportation and storage, would be more useful for diagnosis of leishmaniasis by PCR in a developing country.
Characteristics of UVA‐Induced Delayed Tanning: Seasonal Variation
Authors: Sakamaki Takeshi , Arai Seiichi , Kawada Akira
Published: April 2015

We studied seasonal variation in UVA‐induced delayed tanning and compared it to that in UVA + B‐induced delayed tanning. The minimal tanning dose (MTD) and the minimal melanogenic dose (MMD) were determined one week after UVA exposure or UVA + B exposure, respectively. The MTD determined in the summer (June to August) was significantly higher than that in winter (December to February). In addition, while MTD in the winter correlated well with skin color, there was no correlation between MTD and skin color in summer. MTD tended to correlate with self‐reported tanning history at the initiation of tanning in the winter, but they were not correlated with each other in the summer. The MMD measured in the summer was significantly lower than that in the winter. MMD correlated well with skin color in both seasons; the lighter the skin, the smaller the MMD. Also, a correlation was detected between MMD and self‐reported tanning history. These results suggest that the susceptibilities of delayed tanning to UVA and UVA + B are affected by different factors.
Management of Toenail Onychomycosis with 2% Butenafine and 20% Urea Cream: A Placebo‐controlled, Double‐blind Study
Authors: Syed Tanweer A. , Ahmadpour Oliver Abbas , Ahmad Seyed Ali , Shamsi Sadaf
Published: April 2015

Onychomycosis is an increasingly common and recalcitrant fungal nail infection worldwide. The purpose of this placebo‐controlled, double‐blind study was to determine the clinical efficacy, chemical avulsion, and tolerability of 2% butenafine hydrochloride and 20% urea incorporated in a cream to cure toenail onychomycosis in a preselected population. Sixty patients (38M, 22F), ranging between 18 and 60 years (mean 27.4), with more than 25% involvement of the big toenail were enrolled in the study. The diagnosis of onychomycosis was established by mycologic identification and reconfirmed by positive fungal culture. A precoded 25‐g tube was randomly assigned to each patient (50 active and 10 placebo) with instructions to apply the trial medication to their infected toenail twice daily with an occlusive dressing for one week. The affected nail was removed with a nail clipper. No occlusive dressing was maintained after the initial one week regimen. To assess the chemical avulsion of the infected toenail, mycologic cure, clinical effectiveness of the treatment, and overall success, patients were examined twice a week for 16 weeks and thereafter on a weekly basis for a further 36 weeks. The treatment was well tolerated by all the patients throughout the study, with no dropouts. Marked improvement was seen in 73.3% patients after weeks 8, 16 and 24 with clinically and mycologically confirmed negative fungal culture. Code disclosure revealed that active butenafine and urea cream cured significantly more patients than placebo (88% versus 0%; p<0.0001). Of the 60 patients 91.6% reported no drug‐related adverse symptoms. Five patients reported non‐objective mild inflammation without discontinuation of the treatment. During one year follow‐up of the study phase, none of the cured patients had a relapse. In conclusion, the mycologic and overall assessment of this study demonstrate that 2% butenafine HCl and 20% urea incorporated in a cream for keratinolysis is safe to use and significantly more effective than placebo in curing big toenail onychomycosis.
A Case of Pustular Ulcerative Dermatosis of the Scalp Associated with Ulcerative Skin Lesions on the Scrotum
Authors: Sadayama Takahiro , Muramatsu Tsutomu , Shirai Toshihiko
Published: April 2015

A 79‐year‐old man developed pustules, erosions, and ulcer with severe pain on the parietal regions of the scalp and the scrotum. In another hospital, mycobacterium was detected from the pustules of the scalp at Gaffky scale 1, and this patient was referred to our clinic. In our hospital, repeated cultures of the pus from the skin lesions of the scalp were negative for mycobacterium. Biopsy specimens obtained from the skin lesions on the scalp disclosed ulcerative granulation with infiltration of inflammatory cells. Antibiotics and antituberculotic agents were ineffective. In contrast, the ulcerative skin lesions on the scalp and scrotum responded well to topical and systemic glucocorticosteroids. Although this patient developed pustular ulcerative skin lesions not only on the scalp but also on the scrotum, we considered this case to be pustular ulcerative dermatosis of the scalp developing ulcerative skin lesions on the scrotum.
An Unusual Panniculitis Appearing in the Winter with Good Response to Tetracycline
Authors: Aroni Kyriaki , Aivaliotis Mackos , Tsele Efzossini , Charalambopoulos Dionysios , Davaris Panagiotis
Published: April 2015

Cold panniculitis is a form of physical panniculitis due to exposure of skin to severe cold. It usually appears on the cheeks of infants and children. It has also been reported on the thighs and buttocks of young females. Its clinical manifestations include red, cold, indurated plaques or nodules which appear one to three days after exposure to low temperatures and resolve spontaneously within several weeks without scarring.

The histopathological picture shows a perivascular infiltrate of lymphoid and histiocytic cells at the dermal‐subcutaneous junction in the early phase of the reaction (1). After 48 to 72 hours, a well developed panniculitis appears.

We report an unusual case of an adult female patient with recurrent panniculitis on her legs appearing in the winter but without any preceding repeated or prolonged exposure to cold. She responded dramatically to oral tetracycline. This drug was successful as a prophylactic agent as well.
Verruca Vulgaris Developing during Cyclosporin Therapy for Psoriasis Vulgaris
Authors: Irimajiri Junya , Yamamoto Toshiyuki , Kimura Kyoko , Yokozeki Hiroo , Nishioka Kiyoshi
Published: April 2015

Several kinds of side effects have recently been reported with cyclosporin (CsA) therapy. We describe two patients with psoriasis vulgaris who developed verrucae vulgaris during systemic CsA therapy.

In one case, a verrucous nodule appeared on the scalp and grew rapidly in a 54‐year‐old male with psoriasis vulgaris 29 months after starting CsA therapy. The total dose of CsA was 87.5 g, and average dose of CsA was 2 mg/kg/day.

In the other case, multiple verrucae vulgaris developed on the scalp, face, knee, and inguinal region in a 54‐year‐old male. He had been given CsA for 10 months, the total dose was 45.5 g, and the average dose was 3 mg/kg/day. He also had Sjögren's syndrome. Most of the verrucae vulgaris lesions spontaneously disappeared after stopping the CsA.
A Clinical, Microbiological, and Histopathologic Study of Trichostasis Spinulosa
Authors: Chung Tae‐Ahn , Lee Jae‐Bong , Jang Ho‐Sun , Kwon Kyung‐Sool , Oh Chang‐Keun
Published: April 2015

Trichostasis spinulosa (TSS) is a relatively common follicular disorder that can occur on the face and trunk, especially in the interscapular area. Its cause remains unclear. We examined clinically 30 patients with TSS and follicular materials extracted from each patient were examined microscopically. Bacterial culture and skin biopsy were done in 12 and 10 patients, respectively. Periodic acid Schiff (PAS) and Brown‐Brenn Gram stain were used for detection of pityrosporum (malassezia) and bacteria. The interscapular area (14/30), nose (8/30), and cheek (4/30) were common sites of TSS. Pityrosporum and bacteria in the extracted follicular material were found at the rates of 82.6% and 73.3%, respectively. In histologic examination, follicular hyperkeratosis and numerous vellus hairs enveloped within keratotic sheath were common features. Pityrosporum and bacteria were found at the rate of 70% in biopsied specimens on PAS and Brown‐Brenn Gram stain. In bacterial culture, Propionibacterium acne was most commonly identified in 75% (9 out of 12 patients). Pityrosporum and bacteria, especially Propionibacterium acne, were commonly found in the extracted follicular material and biopsied specimens. Thus, they may be related to the induction of follicular hyperkeratosis with retention of vellus hairs, and we suggest that these microorganisms may be one of the possible etiologic factors of TSS.
Effect of Nonenzymatic Glycosylation on the Titers of Circulating Autoantibodies in Pemphigus and Pemphigoid
Authors: Nakagawa Akemi , Kobayashi Nobuhiko , Yamashina Yukio , Nakatani Chie , Muramatsu Tsutomu , Mori Toshio , Shirai Toshihiko
Published: April 2015

Hyperglycemia is observed in some patients with autoimmune bullous diseases complicated by diabetes mellitus or treated with systemic corticosteroids. High concentrations of glucose can react with various proteins and change their structural and functional properties. We previously reported that nonenzymatic glycosylation of antibody can impair antigen‐antibody binding. We ascertained whether glycosylation of autoantibody decreases the autoantibody titer by examining 30 sera from patients with pemphigus and pemphigoid. Nonenzymatic glycosylation in the physiological range was induced by incubation of sera with 1650 mM D‐glucose at 4°C for 7 days. The titers of sera were determined by indirect immunofluorescence (IIF). In all cases, the immunofluorescence intensity of glycosylated sera was weaker than that of nonglycosylated sera. Glycosylated sera showed a lower antibody titer by 1 doubling dilution in 18 out of 30 cases, compared with nonglycosylated sera. The ten BP patients' sera were also analyzed by immunoblotting for reactivity with the BP180‐GST fusion proteins, SΔ1 and 4575. All BP sera reacted with SΔ1, and 5 out of 10 BP sera reacted with both SΔ1 and 4575. In all the sera that reacted only with SΔ1, the glycosylated sera showed a 1 doubling dilution decrease in autoantibody titer. Interestingly, in 4 out of 5 sera that reacted with both SΔ1 and 4575, there were no differences in the antibody titer between glycosylated and nonglycosylated sera.

These results indicate the possibility of a false decrease in autoantibody titers of sera from patients with autoimmune bullous diseases complicated with hyperglycemia. Although the false decrease in titers of autoantibodies induced by nonenzymatic glycosylation is not dramatic, it must be considered in order not to underestimate the disease activity of pemphigus in such cases.
Phacomatosis Pigmentovascularis Type IIb Associated with Sturge‐Weber Syndrome and Pyogenic Granuloma
Authors: Hagiwara Keisuke , Uezato Hiroshi , Nonaka Shigeo
Published: April 2015

A case of phacomatosis pigmentovascularis (PPV) in a 6‐year‐old girl with Sturge‐Weber syndrome, pyogenic granuloma, and other complications is described. It is relatively rare that a complete form of Sturge‐Weber syndrome was associated with PPV. A review of the literature on PPV, focusing on total number of reported cases and etiological speculations, is presented. To our knowledge, a total of 118 cases of PPV, including the present one, have been reported to date. Regardless of many speculations, the true etiology remains unknown. The average “density” of mast cells (MCs) per mm2 appearing in the central region of the pyogenic granuloma was calculated to be 86.3/mm2 and that in the adjacent nevus flammeus was 37.9/mm2. The “density” of mast cells in pyogenic granuloma separately calculated from ten other cases was 105.5 ± 28.6/mm2 (mean ± SD), compared with that in normal skin, 6.85 ± 4.9/mm2 (n=20). There was a significant difference between the two, indicating that MCs are closely associated with angiogenesis in pyogenic granuloma.