Nihon Hifuka Gakkai zasshi. The Japanese journal of dermatology最新文献

Serum type IV collagen 7S and laminin P1 levels were measured with radioimmunoassay in 33 patients with systemic scleroderma (PSS), 6 localized scleroderma (LS), and one mixed connective tissue disease (MCTD). Serum type IV collagen 7S levels were higher in PSS (5.11 +/- 1.11 ng/ml:m +/- SD) and LS (4.68 +/- 0.46 ng/ml) than in normal controls (3.90 +/- 0.85 ng/ml) (p less than 0.001). Serum laminin P1 levels were also significantly higher in PSS (1.75 +/- 0.34 U/ml) and LS (1.38 +/- 0.20 U/ml) compared to the controls (1.19 +/- 0.16 U/ml) (p less than 0.001 and p less than 0.01, respectively). A significant correlation between these two values in PSS was found (r = 0.465, p less than 0.02). These results suggest that the measurements of these values may serve as a marker of PSS.

From 1975 to 1989, 12 patients with pemphigus vulgaris (PV) and 19 with pemphigus foliaceus (PF) were treated with systemic or topical corticosteroids at the Nara University Hospital. All 12 patients with PV were treated with oral corticosteroids (initial dose of prednisolone: 15-70 mg/day) and 4 of 12 patients showed prolonged clinical remission (up to 9 years) without corticosteroids. Of 19 patients with PF, 16 patients were treated with oral corticosteroids (initial dose of prednisolone: 8-40 mg/day) and 3 patients were treated with only topical application of corticosteroids. In PF, 7 of 16 patients treated with systemic corticosteroids and all 3 patients treated with topical corticosteroids also showed prolonged clinical remission (up to 10 years). These observations suggest that most of the patients with pemphigus respond well to the treatment of relatively small or moderate dosage of corticosteroids.

A 35-year-old male from Kagoshima prefecture developed nodules with asymptomatic erythema on both upper eyelids, both hands and upper right leg in April 1986. On April 10, 1987, biopsy of skin lesions revealed numerous atypical CD4 positive lymphocytes which had invaded the dermis around the vessels. Analysis of serum showed positive antibody titer (X40) against the human T lymphotropic virus type I (HTLV-I) with some flower cells evident in peripheral blood; however, no infiltration into bone marrow or lymph nodes could be seen. Lymphocytes from peripheral blood and from the skin lesion of the right leg showed monoclonal integration of HTLV-I proviral DNA. Chronic active hepatitis B virus (HBV) was also a complicating factor. Familial study revealed all three family members to be infected with HTLV-1 as well as HBV. Proviral integration of HTLV-I was the intermediate type in two out of the three. From the results, a diagnosis of smoldering adult T cell leukemia-lymphoma (ATLL) was made in this patient with high risk to family members. Herein we discuss the development of ATLL in this case and infection among family members.

To investigate the influence of ursodesoxycholic acid (URSO) on griseofulvin (GF)-induced protoporphyria mice, analysis of hepatic, erythrocytic, and fecal porphyrin levels and histopathological examinations were performed in dd-Y strain mice treated with 0.5% GF and/or 0.5% URSO. We observed no difference of hepatic and fecal porphyrin levels between the GF group and GF with URSO group, although an elevation of erythrocytic porphyrin levels was seen in the GF with URSO group. However, remarkable hepatic atrophy revealed in the GF with URSO group. Furthermore, a strong emission of red fluorescence was observed in the liver under long wave ultraviolet. Histopathologically, many focal necrosis was found in the liver specimen treated with GF and URSO. We expected that URSO might facilitate the excretion of porphyrin from bile to feces because of suppression of transfer from serum to erythrocyte like cholic acid (CA). But, the action of URSO appears to be different from that of CA. We consider that the 0.5% concentration of URSO plays a role in the cytotoxic effect to the liver.

Case 1 was a 20-year-old male with a nodule on the scrotum. Case 2 was a 14-year-old female with a dome-shaped, reddish-brown nodule on the nose. Case 3 was a 30-year-old male with a dome-shaped, reddish-brown nodule on the forearm. All of the excised specimens showed typical features of solitary reticulohistiocytic granuloma. There were histiocytes and multi-nucleated giant cells in the dermal tumorous nests. They were stained positively with PAS reaction and anti-lysozyme antibody, but were stained negatively with S-100 protein antibody. To clarify the nosology of the reticulohistiocytic granuloma, we reviewed the literatures of multicentric reticulohistiocytosis and adult xanthogranuloma. Multicentric reticulohistiocytosis was considered to be a systemic disease and different from solitary reticulohistiocytic granuloma. However, adult xanthogranuloma showed clinical similarities to solitary reticulohistiocytic granuloma instead of the differences in the histopathologic features.

DNA-flow cytometry was performed on paraffin-embedded tissues from 7 cases of keratoacanthoma (KA) and squamous cell carcinoma (SCC). Proliferation index of tumor cells (% greater than 4SD) was defined as the percentage of cells that exceeded the diploid peak (G0G1) plus 4 standard deviations (SD). Proliferation index (% greater than 4SD) was lower than 20% in six out of 7 cases of KA, but higher than 25% in six out of 7 cases of SCC. One case of SCC showed a DNA aneuploidy. These results indicate that DNA-flow cytometry analysis using paraffin-embedded tissues may be a useful tool in differential diagnosis between keratoacanthoma and squamous cell carcinoma.

The agarose gel electrophoretic analysis of molluscum contagiosum virus (MCV) DNA obtained from 92 Japanese patients revealed the presence of four different BamHI cleavage patterns of MCV DNAs, classified as MCV-1,2,3 and 4. MCV-1 was found in 69% of the patients, MCV-2 in 4%, MCV-3 in 25%, and MCV-4 in 2%. Almost all the isolates from children and all female adult cases were infected with either MCV-1 or 3. No obvious clinical differences were seen between these two types. MCV-4 was found in only two adult male cases. The sizes of the lesions induced by MCV-4 appeared to be larger than those of other types. Six sets of siblings were shown to be infected with the same types, whereas two sets were infected with the different types. Some different MCV types were found in the cases attending the same swimming pools.

A malignant hemangioendothelioma (MHE) developed on the frontal scalp of an 83-year-old woman was treated with intralesional injection of recombinant interleukin-2 (rIL-2, TGP-3, Takeda Chemical Industries LTD, Osaka) which had lead the lesion to complete remission for 2 years and 9 months. After the period of the complete remission, the patient developed MHE lesion on the occipital scalp which rapidly enlarged to more than 10 cm in diameter within 7 days, though there was no recurrence of MHE on the frontal scalp at that time. Intra-arterial rIL-2 injection was conducted through the occipital artery which circulates around the tumor lesion, but resulted unsuccessful because of the obstruction of the artery. Continuous intra-arterial rIL-2 injection through bilateral superficial temporal arteries was conducted, and then the tumor lesion came to complete remission on both clinical and histological data. So far, the patient has been showing no local recurrence or metastasis for the period of 8 months. We conclude that continuous intra-arterial rIL-2 injection immunotherapy through superficial temporal arteries is the best way of all the treatment in cases with recurrent MHE located on occipital scalp.

A polymerase chain reaction (PCR) using specific oligonucleotide primers and Taq polymerase was developed for the detection of Rickettsia tsutsugamushi, the causative agent of tsutsugamushi disease. Oligonucleotide primers were synthesized on the basis of DNA sequences encoding 58 kD antigen of R. tsutsugamushi. Specific DNA amplification of 358 bp and 109 bp DNA fragments were demonstrated using patient's blood. This PCR method would enable to make a rapid and sensitive diagnosis of tsutsugamushi disease.

The human adult intraepidermal eccrine sweat duct (IESD) were studied by the transmission electron microscope. The formation of the intracytoplasmic cavities was demonstrated in the luminal cell of the adult IESD, and the relation between the intracytoplasmic cavities and the IESD formation was as follows. On the eccrine sweat duct ridge, these intracytoplasmic cavities enlarged, broke through the cell membrane and coalesced into the intercellular lumen. Furthermore, several intercellular lumina were merged into the intraepidermal ductal lumen. In the lower to upper squamous layers, small intracytoplasmic cavities were formed around the intraepidermal duct and were fused into the duct. Simultaneously, the contents of the intracytoplasmic cavities were discharged into the ductal lumen. Intracytoplasmic cavities in these layers were ordinarily formed and concerned in not only the reconstruction of the duct but also the secretory function. The intracytoplasmic cavities were surrounded with the same microvilli as lined the intraepidermal ductal lumen. Many clear vesicles (about 0.1 microns in diameter) were observed near the intracytoplasmic cavities, but multivesicular dense bodies (MDB) were not seen near the cavities. These vesicles were considered to participate in the formation of the intracytoplasmic cavities.