Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: Metabolic dysfunction-associated steatotic liver disease (MASLD) is positively associated with the prevalence and severity of psoriasis. The fibrosis-4 (FIB-4) index was developed to predict significant liver fibrosis. Using the FIB-4 index, the present study evaluated screening data for liver fibrosis, including MASLD, in patients with refractory psoriasis treated with biologics. METHODS: All adult patients with psoriasis who were prescribed biologics at Nippon Medical School from August 2023 to May 2024 were included in this study. The FIB-4 index was classified as high (≥2.67), intermediate (1.30-2.66), and low (<1.30). Patients younger than 65 years were referred to a hepatologist if the FIB-4 index was high. If the score was intermediate, type IV collagen 7S (4COL7S) was checked, and they were referred to a hepatologist if it was ≥4.8 ng/mL. Patients aged ≥65 years were referred to a hepatologist if the FIB-4 index was high. If it was 2.00-2.66, they were referred to a hepatologist if the 4COL7S level was ≥4.8 ng/mL. RESULTS: Data from 96 patients were analyzed. The FIB-4 index was high in 10 patients, intermediate in 35 patients, and low in 51 patients. Eleven of 96 registered patients were newly referred to a hepatologist. Of these 11 patients, 5 received lifestyle guidance. CONCLUSIONS: For patients with refractory psoriasis, close cooperation between dermatologists and hepatologists is essential to prevent progression of liver fibrosis.

DOI： 10.1272/jnms.JNMS.2024_91-613

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BACKGROUND: Basal cell carcinoma (BCC) is the most common cutaneous malignancy. BCCs occur mainly in exposed areas, such as the face and scalp. Therefore, surgical resection with narrow margins is highly desirable. However, narrow margins may increase the risk of positive histopathological margins. Outcomes for such treatment might be unfavorable, but evidence for such a conclusion is lacking. METHODS: Between April 2015 and November 2023, a total of 230 Japanese cases with BCC which underwent surgical resection with 2-mm, 3-mm, or 5-mm margins were followed in our hospital. We conducted a retrospective review that focused on the recurrence rate and histopathological margins. RESULTS: Recurrence was recorded if the follow-up time was longer than 3 months. One of the 198 cases (0.5%) developed a recurrence. The mean lateral and deep histopathological margins were 2,525.4 μm (30.8-14,034.6 μm) and 3,409 μm (199.9-16,523.6 μm), respectively. Recurrence rate was associated with tumor size and clinical tumor border. However, histopathological margin was not associated with recurrence rate, even when it was less than 1,000 μm. CONCLUSIONS: A narrow histopathological margin is acceptable for surgical resection of BCC in Japanese patients.

DOI： 10.1272/jnms.JNMS.2024_91-308

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BACKGROUND: Bullous pemphigoid (BP) is an autoimmune subepidermal blistering disease. Dietary habits may modulate the pathogenesis of BP. OBJECTIVES: We evaluated dietary habits in Japanese patients with BP and compared their results to those of age- and sex-matched healthy controls. We also examined the relationship between dietary habits versus IgG anti-BP180NC16A antibody or parameters of BP disease area index (BPDAI); cutaneous blisters/erosions, cutaneous urticaria/erythema, and mucosal blisters/erosions. MATERIALS & METHODS: Dietary habits were assessed by the validated, Brief-type self-administered Diet History Questionnaire. Severity of disease was assessed with BPDAI. RESULTS: Patients with BP showed a lower intake of retinol (vitamin A1) and beverages, and a higher intake of seasoning/spices, compared to controls. The bivariate and multivariable logistic regression analysis showed that BP was associated with a low intake of retinol and beverages. There were no significant correlations between IgG anti-BP180NC16A antibody levels and intake of nutrients/foods. The BPDAI score for cutaneous blisters/erosions significantly positively correlated with intake of carbohydrate and negatively with intake of retinol, vitamin A, animal fat, cholesterol, phosphorus, and vitamin B2. The BPDAI score for cutaneous urticaria/erythema significantly negatively correlated with intake of vitamin A. BP patients with mucosal blisters/erosions had a higher intake of cholesterol, n-6 polyunsaturated fatty acid, and eggs, and lower intake of seasoning/spices, compared to patients without BP. CONCLUSION: The supplementation of vitamin A might have prophylactic and/or therapeutic effects on BP.

DOI： 10.1684/ejd.2023.4527

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Language：Japanese   Publisher：(公社)日本皮膚科学会  

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DOI： 10.1093/bjd/ljad114

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Publisher：金原出版  

DOI： 10.18888/hi.0000003807

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Language：Japanese   Publisher：(公社)日本皮膚科学会  

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BACKGROUND: We previously evaluated blood screening data, including antinuclear antibodies (ANA), before initiating biologic treatment for patients with psoriasis in a real-world setting. However, we did not analyze change in ANA titers after the start of biologics. No previous study has comprehensively investigated change in ANA titers over time in individual patients or the effectiveness of certolizumab pegol or tildrakizumab. OBJECTIVES: This study evaluated change in ANA titers in individual patients during treatment with biologics, including certolizumab pegol and tildrakizumab. METHODS: 111 patients were included in this study. Change in ANA was regarded as significant when the ANA titer was ×80 or more in patients with a previously undetectable ANA titer or when it increased by fourfold or more in those with a detectable ANA titer before treatment. RESULTS: The ratios of patients with a significant change in ANA titer who were treated with a tumor necrosis factor (TNF) inhibitor, interleukin (IL) -17 inhibitor, or IL-23 inhibitor were 34.9% (15/43), 0.0% (0/32), and 0.0% (0/36), respectively. There were 4 patterns of significant change in ANA titer: (i) an increase (n=8), (ii) a decrease after an increase (n=4), (iii) a decrease after an increase with a drug change (n=2), and (iv) an increase after a decrease after an increase (n=1). No symptom suggesting lupus syndrome was noted. CONCLUSIONS: ANA titers must be carefully monitored throughout treatment with biologics, especially TNF inhibitors, and the possibility of lupus-like syndrome should be excluded.

DOI： 10.1272/jnms.JNMS.2023_90-115

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BACKGROUND: We previously analyzed data from blood examination screenings, including serum Krebs von den Lungen (KL) -6 level, before starting biologic treatment for psoriasis in a real-world setting. However, we did not follow change in KL-6 level after the initiation of biologics. Furthermore, there has been no follow-up study of certolizumab pegol, risankizumab, or tildrakizumab. This study evaluated change in serum KL-6 levels in patients during treatment with biologics, including certolizumab pegol, risankizumab, and tildrakizumab. METHODS: We analyzed data from 111 patients. Change in KL-6 level was regarded as significant if it increased to greater than 500 U/mL at least once and if the maximum level after treatment with biologics was at least 1.5 times that of the baseline level. RESULTS: KL-6 level significantly changed during treatment with TNF inhibitors, IL-17 inhibitors, and IL-23 inhibitors in 9 (20.9%), 2 (6.3%), and 2 (5.6%) patients, respectively. Mean age, mean baseline KL-6 level, and frequency of TNF inhibitor use were higher in patients with a significant change in KL-6 level than those in patients without a significant change. Ten patients had minor interstitial changes on chest CT scans but no clinical signs suggesting interstitial pneumonia. CONCLUSIONS: Older patients with psoriasis and high baseline KL-6 levels must be carefully monitored during treatment with biologics, especially TNF inhibitors. Monitoring of KL-6 level and chest CT scans is necessary to exclude the possibility of drug-induced interstitial pneumonia.

DOI： 10.1272/jnms.JNMS.2023_90-207

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Tumor necrosis factor (TNF) inhibitors, including adalimumab, are widely used to treat refractory psoriatic arthritis (PsA). Although isoniazid chemoprophylaxis is generally effective in preventing reactivation of latent tuberculosis infection (LTBI), prophylactic measures do not fully protect against development of active tuberculosis. We report a rare case of active tuberculosis despite chemoprophylaxis for LTBI in a patient receiving adalimumab for PsA. A 60-year-old Japanese woman who had received a diagnosis of psoriasis at age 35 years presented with arthralgia of the right hand, which she first noticed 2 months previously. Physical examination showed scattered erythematous papules and plaques with scales on her trunk, extremities, and scalp. Her right metacarpophalangeal and proximal interphalangeal joints were swollen and painful, and her right wrist and elbow were painful. PsA was diagnosed and adalimumab was initiated. Because an interferon-γ release assay (IGRA) showed a borderline result at screening, isoniazid was administered as chemoprophylaxis for LTBI. At 22 months after initiation of adalimumab, IGRA was positive and chest CT disclosed centrilobular nodules in both lungs and swelling of multiple lymph nodes. Culture of sputum at 24 months demonstrated Mycobacterium tuberculosis. Active tuberculosis was diagnosed, and treatment with a combination of isoniazid, rifampicin, ethambutol hydrochloride, and pyrazinamide was started. To ensure timely diagnosis and treatment of active tuberculosis, a tuberculosis expert should be consulted at an early stage, with regular screening and monitoring.

DOI： 10.1272/jnms.JNMS.2023_90-610

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DOI： 10.18888/hi.0000003685

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DOI： 10.18888/hi.0000003621

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Among human cutaneous malignancies, basal cell carcinoma is the most common. Solid advances in unveiling the molecular mechanisms of basal cell carcinoma have emerged in recent years. In Gorlin syndrome, which shows basal cell carcinoma predisposition, identification of the patched 1 gene (PTCH1) mutation was a dramatic breakthrough in understanding the carcinogenesis of basal cell carcinoma. PTCH1 plays a role in the hedgehog pathway, and dysregulations of this pathway are known to be crucial for the carcinogenesis of many types of cancers including sporadic as well as hereditary basal cell carcinoma. In this review, we summarize the clinical features, pathological features and hedgehog pathway as applied in basal cell carcinoma. Other crucial molecules, such as p53 and melanocortin-1 receptor are also discussed. Due to recent advances, therapeutic strategies based on the precise molecular mechanisms of basal cell carcinoma are emerging. Target therapies and biomarkers are also discussed.

DOI： 10.3390/ijms231911968

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Language：Japanese   Publisher：(公社)日本皮膚科学会  

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DOI： 10.18888/hi.0000003435

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Hailey-Hailey disease (HHD) is an autosomal dominant genodermatosis and the defective gene in HHD is ATP2C1, which encodes secretory pathway Ca2+ /Mn2+ ATPase type 1 (SPCA1). Here we report four Japanese HHD patients showing three kinds of mutations with premature termination codons in the ATP2C1 gene, including two novel ones. Patient 1 was a 39-year-old man with a novel heterozygous mutation, c.664dup in exon 8 (p.N215Kfs*26). Patient 2 was a 33-year-old man (the younger brother of patient 1) with the same mutation as patient 1. Patient 3 was a 55-year-old man with a previously reported heterozygous mutation, c.519dup in exon 7 (p.R174Tfs*4). Patient 4 was a 33-year-old woman with a novel heterozygous mutation, c.2640del in exon 27 (p.L881Ffs*10). The clinical characteristics of our four cases varied in disease severity and the response to treatment. The present cases enrich the database of mutational analysis for HHD.

DOI： 10.1111/1346-8138.16353

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Language：Japanese   Publisher：(一社)日本皮膚悪性腫瘍学会  

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Language：Japanese   Publisher：(公社)日本皮膚科学会  

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Language：Japanese   Publisher：(公社)日本皮膚科学会  

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Language：Japanese   Publisher：(一社)日本皮膚悪性腫瘍学会  

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Publisher：金原出版  

DOI： 10.18888/hi.0000003190

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Language：Japanese   Publisher：(公社)日本皮膚科学会  

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Psoriasis is a chronic immune-mediated inflammatory skin disease characterized by hyperproliferation of epidermal keratinocytes. Biologics have been available for the treatment of patients with refractory psoriasis since 2010 in Japan, and as of December 2021, 10 biologics were available. The Biologics Review Committee of the Japanese Dermatological Association for Psoriasis recommends blood examination tests for antinuclear antibodies (ANA), Krebs von den Lugen (KL)-6, hepatitis B surface antigen (HBsAg), hepatitis B surface antibodies (HBsAb), hepatitis B core antibodies (HBcAb), hepatitis C virus (HCV) antibodies, HIV antibodies, human T-cell leukemia virus (HTLV)-1 antibodies, β-D-glucan, and the T-cell spot (T-SPOT) test before initiation of biologics at screening. In this study, we evaluated the use of biologics for 127 psoriasis patients and the blood examination screening data before initiation of biologics in the real-world setting. Tumor necrosis factor inhibitors, interleukin (IL)-17 inhibitors and IL-23 inhibitors were initiated for 54 (42.5%), 36 (28.3%), and 37 (29.1%) patients, respectively. The numbers of patients positive for ANA, HBsAg, HBsAb, HBcAb, HCV antibody, HIV antibody, HTLV-1 antibody, and T-SPOT were 27 (21.3%), 0 (0%), 22 (17.3%), 20 (15.7%), three (2.4%), zero (0%), one (0.8%), and 4 (3.1%), respectively. The numbers of patients whose KL-6 and β-D-glucan levels were higher than the reference values were seven (5.5%) and seven (5.5%), respectively. In the real-world setting, it is sometimes unavoidable to use biologics for those patients with abnormal data although careful monitoring is necessary.

DOI： 10.1111/1346-8138.16333

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We report the case of an 80 year-old woman who developed bilateral lower extremity purpura and renal impairment with proteinuria a few days after a transient fever (day 0). High levels of both anti-streptolysin-O antibody (ASO) and anti-streptokinase antibody (ASK), as well as low levels of coagulation factor XIII in serum were noted. Skin biopsy was performed and showed a leukocytoclastic vasculitis with deposition of IgA and C3 in the cutaneous small vessels, indicating IgA vasculitis in the skin. After initiation of oral prednisolone, the skin lesions showed significant improvement. However, renal function and proteinuria gradually worsened from day 12. Kidney biopsy was performed on day 29, which demonstrated a necrotizing and crescentic glomerulonephritis with mesangial deposition of IgA and C3. In addition, the deposition of galactose-deficient IgA1 (Gd-IgA1) was positive on glomeruli and cutaneous small vessels, indicating that the purpura and glomerulonephritis both shared the same Gd-IgA1-related pathogenesis. In addition, the association between the acute streptococcal infection and the IgA vasculitis was confirmed by the deposition of nephritis-associated plasmin receptor (NAPlr) in glomeruli. The patient was treated with steroid pulse and intravenous cyclophosphamide, in addition to the oral prednisolone treatment. Renal function and proteinuria gradually improved, but did not completely recover, as is typically seen with courses of IgA vasculitis in the elderly. In this case, the streptococcal infectionrelated IgA vasculitis was confirmed pathologically by the deposition of both NAPlr and Gd-IgA1 in glomeruli, as well as Gd-IgA1 in the cutaneous small vessels.

DOI： 10.1007/s13730-022-00684-4

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Language：Japanese   Publisher：(公社)日本皮膚科学会  

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Language：Japanese   Publisher：(公社)日本皮膚科学会  

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Language：Japanese   Publisher：(公社)日本皮膚科学会  

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BACKGROUND: Three categories of biologics-tumor necrosis factor (TNF) inhibitors, interleukin (IL) -17 inhibitors, and IL-23 inhibitors-are available for treatment of refractory psoriasis. Recent studies have shown that laboratory biomarkers such as peripheral blood neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), monocyte-lymphocyte ratio (MLR), and serum C-reactive protein (CRP) levels are associated with psoriasis or its severity. This study evaluated associations of transition of NLR, PLR, MLR, and CRP with transition of disease activity in psoriasis patients treated with the three categories of biologics. METHODS: Data from 67 patients were analyzed. Associations of transition of psoriasis area and severity index (PASI) score with the abovementioned laboratory markers were evaluated by using a mixed effects model with PASI as the response variable, laboratory markers as fixed effects collectively, and patients as random effects. RESULTS: In an analysis of all the patients, serum CRP and NLR were associated with PASI score (P=0.006 and P=0.001, respectively). In patients treated with TNF inhibitors, CRP and NLR were associated with PASI score (P=0.043 and P=0.002, respectively). In patients treated with IL-17 inhibitors, NLR was associated with PASI score (P=0.001). CONCLUSIONS: NLR appears to be the most reliable biomarker of the effect of treatment with biologics, especially IL-17 inhibitors.

DOI： 10.1272/jnms.JNMS.2022_89-613

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DOI： 10.18888/hi.0000002969

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Other Link： https://search.jamas.or.jp/link/ui/2022045474

Language：Japanese   Publisher：金原出版(株)  

＜文献概要＞基底細胞癌は本邦でもっとも多い皮膚悪性腫瘍であり,その治療の原則は手術治療である。被髪頭部は可動性に乏しく,有毛部であるという特性をもつため,整容的な問題が生じないように再建術式を選択する必要がある。症例は79歳,男性。左頭部に生じた腫瘍径約30mm大の基底細胞癌に対して3mmマージンで切除し,約40mm大の欠損部に対してピンホイール皮弁を用いて再建した。術後3ヵ月のフォローでも皮弁の壊死は認めず,整容的にも良好な結果が得られた。脱毛斑を残さない被髪頭部の再建法としてピンホイール皮弁は有用であると考えた。

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Other Link： https://search.jamas.or.jp/default/link?pub_year=2021&ichushi_jid=J01266&link_issn=&doc_id=20211122060041&doc_link_id=10.18888%2Fhi.0000002961&url=https%3A%2F%2Fdoi.org%2F10.18888%2Fhi.0000002961&type=%E5%8C%BB%E6%9B%B8.jp_%E3%82%AA%E3%83%BC%E3%83%AB%E3%82%A2%E3%82%AF%E3%82%BB%E3%82%B9&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00024_2.gif

Language：Japanese   Publisher：金原出版(株)  

＜文献概要＞81歳,男性。肺腺癌の術後再発のため,上皮成長因子受容体に対するチロシンキナーゼ阻害薬であるアファチニブマレイン酸塩を投与されていた。投与開始3年後より四肢に紅斑を生じ,次第に両下腿に浮腫,多量の滲出液,潰瘍を生じるようになった。浮腫の原因となる心機能低下はなく,アファチニブマレイン酸塩による薬剤性浮腫による下腿潰瘍が考えられた。アファチニブマレイン酸塩を中止し,潰瘍治療および局所圧迫により下腿潰瘍は改善した。アファチニブマレイン酸塩内服中に難治性皮膚潰瘍をきたした場合は休薬を考慮する必要がある。

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Other Link： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2021&ichushi_jid=J01266&link_issn=&doc_id=20211122060025&doc_link_id=10.18888%2Fhi.0000002945&url=https%3A%2F%2Fdoi.org%2F10.18888%2Fhi.0000002945&type=%88%E3%8F%91.jp_%83I%81%5B%83%8B%83A%83N%83Z%83X&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00024_2.gif

Language：Japanese   Publisher：金原出版(株)  

＜文献概要＞32歳,女性。1年前より月経前後や咳嗽時に右鼠径部に疼痛が誘発される皮下腫瘤を自覚した。右鼠径部に有痛性・弾性硬の皮下腫瘤を触知し,MRIでは同部位に多房性の腫瘤を認めた。確定診断のため切除を行ったところ,腫瘤は鼠径管内に存在した。病理組織検査では,線維筋性組織内に島状の内膜様組織が散見され,鼠径管内に生じた子宮内膜症と診断した。異所性子宮内膜症に特徴的な画像所見はなく,月経随伴症状を伴わない場合,鼠径部に腫瘤を生じる他の疾患との鑑別が困難であり,治療の主体となる診療科の決定が困難な場合がある。生殖年齢女性の鼠径部に有痛性腫瘤がある場合は,本疾患を考慮し,詳細な問診を行う必要があると考える。

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Other Link： https://search.jamas.or.jp/default/link?pub_year=2021&ichushi_jid=J01266&link_issn=&doc_id=20211122060049&doc_link_id=10.18888%2Fhi.0000002969&url=https%3A%2F%2Fdoi.org%2F10.18888%2Fhi.0000002969&type=%E5%8C%BB%E6%9B%B8.jp_%E3%82%AA%E3%83%BC%E3%83%AB%E3%82%A2%E3%82%AF%E3%82%BB%E3%82%B9&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00024_2.gif

Language：Japanese   Publisher：(公社)日本皮膚科学会  

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BACKGROUND: Dupilumab, a fully human monoclonal antibody that blocks signalling pathways of interleukin (IL)-4 and IL-13, is effective in treating patients with atopic dermatitis (AD). We previously showed that transitions of serum thymus and activation-regulated chemokine (TARC) levels and eosinophil numbers were strongly associated with that of AD activity and that the transitions of serum lactate dehydrogenase (LDH) and immunoglobulin E (IgE) levels were weakly and not associated with that of AD activity, respectively, in patients treated without dupilumab. OBJECTIVES: The purpose of this study was to elucidate whether the association of the transition of laboratory marker levels and transition of disease activity in dupilumab-treated AD patients (present study) was different from that in patients who are not treated with dupilumab (previous study). METHODS: Sixty AD outpatients treated with dupilumab were included in this study. Associations between the transition of the eczema area and severity index (EASI) score and those of above-mentioned laboratory marker levels were evaluated using a mixed effects model of EASI as the response variable, laboratory markers as fixed effects and patients as random effects. RESULTS: The transitions of serum TARC and LDH levels were associated strongly with that of AD activity, but the transitions of serum IgE level and eosinophil numbers were associated with that of AD activity intermediately and weakly, respectively. CONCLUSIONS: Laboratory markers are useful for evaluating the effects of treatments for AD, but the meaning of each laboratory marker depends on the drugs used for treatment.

DOI： 10.1111/ajd.13719

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Publishing type：Research paper (scientific journal)   Publisher：Wiley  

DOI： 10.1111/1346-8138.16023

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Other Link： https://onlinelibrary.wiley.com/doi/full-xml/10.1111/1346-8138.16023

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Psoriasis is a chronic inflammatory skin disease characterized by accelerated tumor necrosis factor-α/interleukin (IL)-23/IL-17 axis. Patients with psoriasis manifest functional defects in CD4+CD25+ forkhead box protein 3 (Foxp3)+ regulatory T cells (Tregs), which suppress the excess immune response and mediate homeostasis. Defects in Tregs contribute to the pathogenesis of psoriasis and may attribute to enhanced inhibition and/or impaired stimulation of Tregs. IL-23 induces the conversion of Tregs into type 17 helper T (Th17) cells. IL-17A reduces transforming growth factor (TGF)-β1 production, Foxp3 expression, and suppresses Treg activity. Short-chain fatty acids (SCFAs), butyrate, propionate, and acetate are microbiota-derived fermentation products that promote Treg development and function by inducing Foxp3 expression or inducing dendritic cells or intestinal epithelial cells to produce retinoic acids or TGF-β1, respectively. The gut microbiome of patients with psoriasis revealed reduced SCFA-producing bacteria, Bacteroidetes, and Faecallibacterium, which may contribute to the defect in Tregs. Therapeutic agents currently used, viz., anti-IL-23p19 or anti-IL-17A antibodies, retinoids, vitamin D3, dimethyl fumarate, narrow-band ultraviolet B, or those under development for psoriasis, viz., signal transducer and activator of transcription 3 inhibitors, butyrate, histone deacetylase inhibitors, and probiotics/prebiotics restore the defected Tregs. Thus, restoration of Tregs is a promising therapeutic target for psoriasis.

DOI： 10.3390/jcm10173880

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Atopic dermatitis (AD) is a chronic eczematous disease characterized by T helper 2 (Th2) -shifted allergic immunity, skin barrier impairment, and pruritus. Oral intake of certain nutrients might help regulate AD. Serum 25-hydroxyvitamin D levels are often low in patients with AD, and oral vitamin D supplementation improves AD. Vitamin D increases regulatory T (Treg) cells, which promote tolerance to allergens and prevent allergic inflammation by inducing expression of filaggrin and cathelicidin in keratinocytes. Vitamin A strengthens Treg cells by inducing expression of forkhead box P3 and inhibits mediator release from mast cells and eosinophils. Serum levels of γ-linolenic acid and its metabolite, dihomo-γ-linolenic acid, are low in patients with AD, and oral γ-linolenic acid improves AD through anti-inflammatory prostaglandin D1 and E1 derived from dihomo-γ-linolenic acid. Eicosapentaenoic acid and docosahexaenoic acid ameliorate AD by suppressing production of leukotriene B4, increasing ceramides in the stratum corneum, and through their metabolites, resolvin E1 and D1, which resolve inflammation. The probiotics Lactobacillus and Bifidobacteria improve the intestinal permeability barrier and induce Treg cells. Zinc levels in serum, hair, and erythrocytes are diminished in patients with AD. Zinc induces forkhead box P3 expression and increases Treg cells, and zinc-finger protein A20 suppresses nuclear factor-κB-dependent expression of inflammatory cytokines and cell-adhesion molecules. Oral supplementation of the above nutrients might have therapeutic or preventive roles in AD.

DOI： 10.1272/jnms.JNMS.2021_88-317

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DOI： 10.1111/1346-8138.15974

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Language：Japanese   Publisher：金原出版(株)  

＜文献概要＞21歳,女性。顔面パック後に生じた左頬部の皮疹に対して,ヒドロコルチゾン酪酸エステル軟膏を外用したところ浸潤性紅斑を生じた。5年後,尋常性ざ瘡に対して,過酸化ベンゾイルゲルを外用したところ紅斑,丘疹を生じた。外用薬の成分別パッチテストでは,ヒドロコルチゾン酪酸エステル軟膏の主剤が陽性,基剤はすべて陰性であった。一方,過酸化ベンゾイルゲルの製品の希釈系列が陽性,基剤はすべて陰性であった。以上よりヒドロコルチゾン酪酸エステルと過酸化ベンゾイルによるアレルギー性接触皮膚炎と診断した。さらに使用経験のないステロイド外用薬でもパッチテスト陽性であり,ステロイド骨格や側鎖の類似性により交叉感作をきたしたと推測した。また,過酸化ベンゾイルはステロイド外用薬とは別個に感作されたと考えた。

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Other Link： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2021&ichushi_jid=J01266&link_issn=&doc_id=20210617060022&doc_link_id=10.18888%2Fhi.0000002692&url=https%3A%2F%2Fdoi.org%2F10.18888%2Fhi.0000002692&type=%88%E3%8F%91.jp_%83I%81%5B%83%8B%83A%83N%83Z%83X&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00024_2.gif

Language：Japanese   Publisher：(一社)日本皮膚悪性腫瘍学会  

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Language：Japanese   Publisher：(一社)日本皮膚悪性腫瘍学会  

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Language：Japanese   Publisher：(公社)日本皮膚科学会  

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Language：Japanese   Publisher：(公社)日本皮膚科学会  

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Language：Japanese   Publisher：(公社)日本皮膚科学会  

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Language：Japanese   Publisher：日本臨床皮膚科医会  

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DOI： 10.18888/hi.0000002444

CiNii Books

CiNii Research

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Other Link： https://search.jamas.or.jp/link/ui/2021163787

Language：Japanese   Publisher：金原出版(株)  

＜文献概要＞10歳,男児。出生時より右耳の発赤・腫脹を数回繰り返し,近医にて抗菌薬内服で対応していた。初診時,右耳前部に瘻孔がみられ,耳前脚部に淡紅色結節があり,周囲に発赤・腫脹を伴っていた。耳瘻孔を考え,抗菌薬内服を行ってから,手術を行った。耳介軟骨の一部を含めて切除した。病理組織学的には,真皮内に重層扁平上皮で裏打ちされた嚢腫構造がみられ,嚢腫内には角化物が含まれており,耳瘻孔と確定診断した。皮膚科領域において,炎症を伴う耳瘻孔と炎症性粉瘤の鑑別は困難である。耳介周囲に肉芽や膿瘍を認めた際は,感染の治療後に瘻孔や陥凹の有無を確認し,両者を鑑別する。耳瘻孔の診断となれば,手術の検討や合併症の評価が重要となる。

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Other Link： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2021&ichushi_jid=J01266&link_issn=&doc_id=20210323070024&doc_link_id=10.18888%2Fhi.0000002444&url=https%3A%2F%2Fdoi.org%2F10.18888%2Fhi.0000002444&type=%88%E3%8F%91.jp_%83I%81%5B%83%8B%83A%83N%83Z%83X&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00024_2.gif

Language：English   Publishing type：Research paper (scientific journal)  

Palmoplantar pustulosis (PPP) is a chronic dermatitis characterized by sterile intra-epidermal pustules associated with erythema and scales on the palms and soles. Tumor necrosis factor (TNF)-α/interleukin (IL)-23/IL-17 inflammatory pathway may be involved in the pathogenesis of PPP, and the skin lesions manifest the enhanced expression of IL-8 in keratinocytes and increased levels of antimicrobial peptide cathelicidin, leucine leucine-37 in vesicles/pustules. Some PPP patients are associated with arthro-osteitis, called pustulotic arthro-osteitis (PAO). Dietary habits may modulate the pathogenesis of PPP, however, have not been investigated in PPP patients. We evaluated dietary habits in adult Japanese PPP patients, using a validated, brief-type self-administered diet history questionnaire, and compared their results to those of age- and sex-matched healthy controls. The results in PPP patients with PAO were compared to those in the patients without. Japanese PPP patients showed higher body mass indices (BMIs), higher intakes of pulses and sugar/sweeteners, and lower intake of vitamin A, compared to those of healthy controls. The bivariate and multivariable logistic regression analysis showed that PPP was associated with high BMI, high intake of pulses, and low intake of vitamin A. The sodium intake and BMI were positively correlated with palmoplantar pustulosis area and severity index (PPPASI). The linear multivariate regression analysis revealed that sodium intake and BMI were predictors of PPPASI. The age and sodium intake in the patients with PAO were lower than those in the patients without. The bivariate and multivariable logistic regression analysis showed that PAO was negatively associated with age and sodium intake. This is the first study showing the dietary habits in patients with PPP. Further studies should clarify if the dietary intervention to correct the BMI and sodium intake will alter the progress of PPP.

DOI： 10.1111/1346-8138.15719

PubMed

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Language：Japanese   Publisher：(公社)日本皮膚科学会  

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Language：Japanese   Publisher：(公社)日本皮膚科学会  

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Language：English   Publishing type：Research paper (scientific journal)  

Psoriasis is a chronic inflammatory skin disease characterized by accelerated tumor necrosis factor-α (TNF-α) /interleukin (IL) -23/IL-17 axis, epidermal hyperproliferation, and dysregulated differentiation. Psoriasis is occasionally associated with autoimmune liver diseases such as autoimmune hepatitis (AIH) or primary biliary cholangitis (PBC), caused by autoimmunity against hepatocyte- or cholangiocyte-specific autoantigens, respectively. Overlap syndrome is a condition in which patients have features of both AIH and PBC. It has been reported that AIH, PBC, or the overlap syndrome can be triggered by certain drug therapies. A 65-year-old Japanese man developed increased serum levels of aspartate and alanine aminotransferases, and positive anti-nuclear and anti-mitochondrial M2 antibodies, along with neutropenia, at 4 weeks of treatment with an anti-IL-17 receptor A antibody brodalumab for generalized pustular psoriasis. Histological evaluation of the liver revealed interface hepatitis and non-suppurative destructive cholangitis, which is compatible with the overlap syndrome of AIH and PBC. This is the first case of AIH/PBC overlap syndrome during treatment with brodalumab for generalized pustular psoriasis. The relationship between brodalumab and AIH/PBC overlap syndrome should be further elucidated. The risk of autoimmune liver diseases in patients with psoriasis treated with brodalumab should be carefully considered.

DOI： 10.1272/jnms.JNMS.2021_88-517

PubMed

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Publishing type：Research paper (scientific journal)   Publisher：Korean Dermatological Association and The Korean Society for Investigative Dermatology  

DOI： 10.5021/ad.2021.33.6.593

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Other Link： https://anndermatol.org/DOIx.php?id=10.5021/ad.2021.33.6.593

Language：English   Publishing type：Research paper (scientific journal)  

PURPOSE: Alopecia areata (AA) is characterized by non-scarring, patchy hair loss caused by autoimmune reactions to anagen hair follicles. The pathogenesis of AA may be affected by the diet. However, the dietary habits of patients with AA have not been precisely examined. Therefore, the aim of this study was to investigate the dietary habits of patients with AA in comparison to those of healthy controls. PATIENTS AND METHODS: We evaluated the dietary habits of 70 adult Japanese patients with AA using a brief-type self-administered diet history questionnaire and compared them to the habits of age- and sex-matched healthy controls. RESULTS: Japanese patients with AA had a higher body mass index (BMI) and higher intakes of vitamin C and fruit than the controls. Logistic regression analysis showed that AA was associated with BMI. Retinol intake was positively correlated with severity of alopecia tool (SALT) score, and linear regression analysis revealed that retinol intake was a predictor of SALT score. Retinol intake among patients with moderate to severe AA (ie, a SALT score >25) was higher than that in patients with mild AA (a SALT score ≤25). The mean age of AA patients with atopic dermatitis (AD) was lower than that of AA patients without AD; however, there were no differences in nutrient or food intake between these two groups. Logistic regression analysis showed that the comorbidity AD was negatively associated with age. CONCLUSION: AA was associated with a high BMI, and high retinol intake was a predictor of SALT score. Further studies should be conducted to clarify whether dietary intervention to reduce BMI or limit retinol intake can alter the development or severity of AA.

DOI： 10.2147/CCID.S335440

PubMed

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Language：Japanese   Publisher：(一社)日本皮膚悪性腫瘍学会  

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Language：English  

DOI： 10.1111/1346-8138.15691

PubMed

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DOI： 10.1111/1346-8138.15622

PubMed

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Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: Chronic spontaneous urticaria (CSU) is defined as the spontaneously appearing weals and/or angioedema for more than 6 weeks. Dietary habits can modulate the pathogenesis of CSU. However, dietary intakes of nutrients or food in CSU patients, compared with healthy controls, have not been examined in quality and quantity. METHODS: We evaluated dietary habits in adult Japanese patients with chronic spontaneous urticaria using a validated, brief-type self-administered diet history questionnaire and compared the results to those of age- and sex-matched healthy controls. The severity of CSU was evaluated using the Urticaria Control Test. RESULTS: Japanese CSU patients showed higher body mass indices, higher intakes of eggs, vegetables other than green/yellow vegetables/mushrooms/algae, cholesterol, folic acid, dietary fibres, vitamin D, vitamin K, Cu, Fe, Pi, Ca, Mg, Na and salt, and lower intake of alcohol, compared to controls. The logistic regression analysis showed that CSU was associated with high body mass index and high intake of eggs. The intake of beverages was higher in uncontrolled CSU patients (Urticaria Control Test ≦11 points) than in controlled patients. The logistic regression analysis showed that uncontrolled CSU was associated with high intake of beverages. The intake of coffee, caffeine-rich and non-alcohol beverage, in uncontrolled CSU patients was higher than that in controlled patients. CONCLUSIONS: Chronic spontaneous urticaria was associated with high body mass index and high intake of eggs. Uncontrolled CSU was associated with high intake of beverages. Further studies should elucidate the relationships of these results with the development or exacerbation of CSU.

DOI： 10.1111/ajd.13283

PubMed

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Language：English   Publishing type：Research paper (scientific journal)  

Psoriasis is a chronic inflammatory skin disease characterized by accelerated tumor necrosis factor-α/interleukin-23/interleukin-17 axis, hyperproliferation and abnormal differentiation of epidermal keratinocytes. Psoriasis patients are frequently associated with obesity, diabetes, dyslipidemia, cardiovascular diseases, or inflammatory bowel diseases. Psoriasis patients often show unbalanced dietary habits such as higher intake of fat and lower intake of fish or dietary fibers, compared to controls. Such dietary habits might be related to the incidence and severity of psoriasis. Nutrition influences the development and progress of psoriasis and its comorbidities. Saturated fatty acids, simple sugars, red meat, or alcohol exacerbate psoriasis via the activation of nucleotide-binding domain, leucine-rich repeats containing family, pyrin domain-containing-3 inflammasome, tumor necrosis factor-α/interleukin-23/interleukin-17 pathway, reactive oxygen species, prostanoids/leukotrienes, gut dysbiosis or suppression of regulatory T cells, while n-3 polyunsaturated fatty acids, vitamin D, vitamin B12, short chain fatty acids, selenium, genistein, dietary fibers or probiotics ameliorate psoriasis via the suppression of inflammatory pathways above or induction of regulatory T cells. Psoriasis patients are associated with dysbiosis of gut microbiota and the deficiency of vitamin D or selenium. We herein present the update information regarding the stimulatory or regulatory effects of nutrients or food on psoriasis and the possible alleviation of psoriasis by nutritional strategies.

DOI： 10.3390/ijms21155405

PubMed

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Language：Japanese   Publisher：金原出版(株)  

＜文献概要＞66歳,女性。腰部脊柱管狭窄症にリドカイン(1%キシロカイン),トリアムシノロンアセトニド(ケナコルト-A )を用いて仙骨硬膜外ブロック注射を施行したところ,1〜2分後に呼吸困難感,胸痛を自覚し,その後意識消失した。アナフィラキシーショックと診断され,前医で加療後,原因精査のため紹介受診した。被疑薬剤のトリアムシノロンアセトニド注射液中の成分を用いた皮内テストで,添加物として含まれているカルボキシメチルセルロースが陽性となった。カルボキシメチルセルロースはセルロースを原料とする高分子で,人体に対して不活性とされているため,増粘剤として医薬品やさまざまな食品,日用品に使用されている。本剤によるアナフィラキシーの本邦報告例は7例のみと比較的まれであるが,他の物質によるアレルギーと誤認識されている症例が少なからずあるものと推測する。

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Language：Japanese   Publisher：(公社)日本皮膚科学会  

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Language：Japanese   Publisher：金原出版(株)  

66歳女性。左上肢の疼痛と紅色丘疹小水疱を主訴に、帯状疱疹と診断のもとバラシクロビル内服を開始したが、症状の改善が乏しく精査加療目的で入院となった。入院時よりアシクロビルの点滴静注を開始したが、入院4日目に左C5-C6の運動麻痺が出現した。本症例は皮疹のデルマトームと同じ髄節レベルの運動麻痺であったことより、帯状疱疹後の運動麻痺と考えられた。そこで、入院5日目よりステロイドパルス(メチルプレドニゾロン)療法を開始したところ、徐々に外転可動領域の改善が認められた。以後、入院10日目からはプレドニゾロンに変更し、入院14日目には外転可動領域は180°と入院前と同様レベルまで改善し、入院20日目に退院となった。

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Language：Japanese   Publisher：(公社)日本皮膚科学会  

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Language：Japanese   Publisher：(公社)日本皮膚科学会  

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Language：Japanese   Publisher：(公社)日本皮膚科学会  

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Language：Japanese   Publisher：(公社)日本皮膚科学会  

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Language：Japanese   Publisher：(公社)日本皮膚科学会  

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Language：Japanese   Publisher：(株)南江堂  

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2020&ichushi_jid=J00974&link_issn=&doc_id=20200310080027&doc_link_id=issn%3D0022-1961%26volume%3D125%26issue%3D3%26spage%3D455&url=http%3A%2F%2Fwww.pieronline.jp%2Fopenurl%3Fissn%3D0022-1961%26volume%3D125%26issue%3D3%26spage%3D455&type=PierOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00005_2.gif

Language：Japanese   Publisher：(公社)日本皮膚科学会  

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Language：Japanese   Publisher：(公社)日本皮膚科学会  

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Language：English   Publishing type：Research paper (scientific journal)  

We report the case of a 59-year-old Japanese woman who developed linear IgA bullous dermatosis during treatment for ulcerative colitis that manifested as pruritic vesicles with erythema on the trunk and scalp. Histopathological examination revealed subepidermal bulla with neutrophil and eosinophil infiltration in the upper dermis. Direct immunofluorescence revealed linear IgA deposits at the basement membrane zone, and indirect immunofluorescence using split skin revealed IgA reaction to the epidermal side (lamina lucida type). We reviewed 33 reported cases of linear IgA bullous dermatosis associated with ulcerative colitis and found that ulcerative colitis preceded the onset of linear IgA bullous dermatosis in 94% of the patients and that IgA-positive patients in split skin indirect immunofluorescence all showed the lamina lucida type, indicating that target antigens for serum IgA antibodies may reside in the lamina lucida. Regarding the pathogenetic association of ulcerative colitis and linear IgA bullous dermatosis, intestinal inflammation may induce the exposure and presentation of intestinal antigens that are cross-reactive to cutaneous antigens, stimulating autoimmune response to antigens of cutaneous basement membrane zones.

DOI： 10.1111/ajd.13121

PubMed

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Language：Japanese   Publisher：金原出版(株)  

＜文献概要＞81歳,女性。初診の4ヵ月前より四肢・躯幹に浮腫性紅斑,水疱が出現した。皮膚生検の結果,類天疱瘡の診断となった。ステロイド投与を開始したが,投与17日目に胸部CTで右肺塞栓があり,ヘパリン投与を開始した。その後貧血進行,巨大下腿血腫を認めたため,抗凝固療法は中止した。血漿交換療法と免疫グロブリン大量静注療法を行い,皮疹は軽快した。海外のコホート研究によると,類天疱瘡患者はコントロール群と比較し肺塞栓症を3.12倍,肺炎を2.94倍発症しやすい。類天疱瘡患者に肺塞栓症が生じた本邦報告例は,2000〜2018年には3例であり類天疱瘡と肺塞栓症の合併は非常にまれと思われるが,肺塞栓症は致死的になりうるので注意すべきである。

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2020&ichushi_jid=J01266&link_issn=&doc_id=20200214130008&doc_link_id=10.18888%2Fhi.0000001788&url=https%3A%2F%2Fdoi.org%2F10.18888%2Fhi.0000001788&type=%88%E3%8F%91.jp_%83I%81%5B%83%8B%83A%83N%83Z%83X&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00024_2.gif

Language：Japanese   Publisher：(公社)日本皮膚科学会  

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Language：Japanese   Publisher：(公社)日本皮膚科学会  

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Language：English   Publishing type：Research paper (scientific journal)  

A 39-year-old Japanese woman presented with a pruritic infiltrated erythematous plaque on the right cheek. Histopathologic analysis of the erythema showed dermal edema, separation of collagen bundles, and nodular perivascular and periadnexal infiltration of lymphocytes in the whole dermis, without epidermal changes. Alcian blue staining intensity was elevated between the collagen bundles, indicating dermal mucinosis. The nodular infiltrates consisted of CD3+ T cell clusters and CD20+ B cell clusters (ratio, approximately 3:1) and included numerous CD123+ cells, indicative of plasmacytoid dendritic cells. Blood analysis revealed serum antinuclear antibody at a titer of 1:160 (homogeneous, speckled pattern). Lupus erythematosus tumidus with pseudolymphomatous infiltrates was diagnosed. Hydroxychloroquine treatment partially improved symptoms; however, the addition of prednisolone was required for complete resolution. Lupus erythematosus tumidus is sometimes accompanied by pseudolymphomatous infiltrates. Dermal mucinosis and the presence of numerous plasmacytoid dendritic cells are useful in differentiating lupus erythematosus tumidus from pseudolymphoma.

DOI： 10.1272/jnms.JNMS.2020_87-208

PubMed

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Language：English   Publishing type：Research paper (scientific journal)  

Autoimmune hepatitis (AIH) is a chronic inflammation of the liver caused by hepatocyte-specific autoantigens. Psoriasis is a chronic inflammatory skin disease characterized by a skewed interleukin-17 immune response and dysregulated epidermal hyperproliferation and differentiation. Patients with psoriasis have a higher risk of AIH. Some evidence indicates that AIH is triggered by treatment with certain drugs. Brodalumab is a human monoclonal antibody against interleukin-17 receptor A and is used to treat psoriasis. A 70-year-old Japanese man with psoriasis had elevated serum levels of transaminases and bilirubin, positive antinuclear antibodies, and high serum IgG levels after 11 months of brodalumab treatment. Histological analysis of liver tissue revealed interface hepatitis with lymphoplasmacytic infiltration. AIH was diagnosed and treated with prednisolone, which improved his symptoms. This is the first case of AIH during brodalumab treatment for psoriasis. The relationship between brodalumab and AIH should be further examined, and the risk of AIH in psoriatic patients treated with brodalumab should be carefully considered.

DOI： 10.1272/jnms.JNMS.2020_87-607

PubMed

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Language：English  

DOI： 10.1111/1346-8138.15081

PubMed

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Language：Japanese   Publisher：(一社)日本皮膚免疫アレルギー学会  

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Language：Japanese   Publisher：金原出版(株)  

＜文献概要＞40歳,女性。左手から手首にかけて全周性に発赤・腫脹があった。全指の色調は蒼白で冷感があり知覚鈍麻も認めたため,コンパートメント症候群と診断し,緊急入院のうえ減張切開術を施行した。画像上は有意な所見はなかったが,臨床所見と経過より壊死性筋膜炎からコンパートメント症候群を生じたと考えて早期に減張切開に踏み切り,良好な経過を示した。コンパートメント症候群は外傷によって生じることが多いが,皮膚感染症に合併することもある。このことを念頭に置き,画像所見に頼らず,臨床経過によっては早期に外科的処置を検討する必要がある。

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2019&ichushi_jid=J01266&link_issn=&doc_id=20191122180043&doc_link_id=10.18888%2Fhi.0000001693&url=https%3A%2F%2Fdoi.org%2F10.18888%2Fhi.0000001693&type=%88%E3%8F%91.jp_%83I%81%5B%83%8B%83A%83N%83Z%83X&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00024_2.gif

Language：English  

DOI： 10.1111/1346-8138.14880

PubMed

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Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：金原出版(株)  

＜文献概要＞79歳,男性。2017年1月に当科を受診。臨床的にはパンツ型紅斑を呈していた。組織学的に癌性リンパ管症を伴う外陰部乳房外Paget病と診断した。多発骨転移,多発リンパ節転移があったためStage IVと診断した。放射線療法とドセタキセル投与にて紅斑局面はほぼ消失した。統合失調症の既往があり,外来での放射線療法,化学療法の施行が困難だったため,上記治療は基本的に入院で施行した。当初は一般病棟入院としたが,徘徊・不眠症状が強く入院継続困難となり,精神科病棟に転棟し精神科管理の下で,幻聴などの陽性症状なく安定した精神状態を維持できた。統合失調症の合併症のある癌患者では,癌治療のための入院中にせん妄の問題を生じることが多い。しかし細かな精神科回診などを行えば,ほとんどの例で入院継続が可能である。

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Language：English   Publishing type：Research paper (scientific journal)  

Psoriasis is characterized by T-helper 17 cell-dominant abnormal immunity, and hyperproliferation and abnormal differentiation of epidermal keratinocytes. Some patients are associated with arthritis. Dietary habits can modulate the pathogenesis of psoriasis. Previous studies in Western countries showed higher body mass indices, higher intake of fat and lower intake of fish or vegetables in psoriatic patients compared with the reference groups. We evaluated dietary habits in adult Japanese psoriatic patients, using a validated brief-type self-administered dietary history questionnaire, and compared the results to those of age- and sex-matched healthy controls. The results in psoriatic patients with arthritis were compared with those in the patients without. Japanese psoriatic patients showed higher body mass indices, higher intake of fish/shellfish, pulses, sugar/sweeteners, vitamin B12 and vitamin D, and lower intake of meat, compared with those of healthy controls. The logistic regression analysis showed that psoriasis was associated with high body mass index and low intake of meat. The intake of confection in patients with high Psoriasis Area and Severity Index was higher than that in those with low index. The intake of β-carotene, vitamin A and green/yellow vegetables in psoriatic patients with arthritis were higher than those in the patients without. The dietary habits in Japanese psoriatic patients are rather different from those in Western patients. This is the first study showing the differences in dietary habits between psoriatic patients with arthritis and those without. Further studies should elucidate the relationships of these results with skin and joint lesions in psoriatic patients.

DOI： 10.1111/1346-8138.15032

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Language：Japanese  

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Language：Japanese   Publisher：(公社)日本皮膚科学会  

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Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：金原出版(株)  

＜文献概要＞79歳,男性。数年前より左前腕に圧痛のある結節を自覚し,当科を初診した。左前腕に12×8mm大の下床との可動性良好な弾性硬の皮下結節を認めた。造影CTではリング状に造影された。全摘除術を行い,病理組織では,血管周皮細胞様パターンがあり,一部に血管を同心円状に細胞が取り巻く像を認めた。αSMA陽性,S100とCD34は陰性であった。これらより,周皮細胞/血管周囲腫瘍である筋周皮腫,グロムス腫瘍,筋線維腫,血管平滑筋腫のうち,組織学的に筋周皮腫と診断した。自験例では,造影CTでリング状に造影されたことが特徴的であった。リング状に造影される疾患は脳内病変を除くとまれであり,本疾患の特徴であるかもしれない。

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Other Link： https://search.jamas.or.jp/default/link?pub_year=2019&ichushi_jid=J01266&link_issn=&doc_id=20190722170015&doc_link_id=10.18888%2Fhi.0000001485&url=https%3A%2F%2Fdoi.org%2F10.18888%2Fhi.0000001485&type=%E5%8C%BB%E6%9B%B8.jp_%E3%82%AA%E3%83%BC%E3%83%AB%E3%82%A2%E3%82%AF%E3%82%BB%E3%82%B9&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00024_2.gif

Language：English   Publishing type：Research paper (scientific journal)  

Dietary habits can modulate the pathogenesis of atopic dermatitis. We evaluated these habits in adult Japanese patients with atopic dermatitis using a validated, brief-type self-administered diet history questionnaire and compared the results to those of age- and sex-matched healthy controls. Patients with atopic dermatitis showed higher intakes of carbohydrate and potatoes and lower intakes of alcohol, niacin, meat and oils/fats compared with those of the healthy controls. The results of logistic regression analysis showed that the intake of alcohol was negatively associated with atopic dermatitis (odds ratio, 0.905; 95% confidence interval, 0.832-0.983; P = 0.0181). The intakes of vitamin B6 and fruit were positively correlated with the severity scoring of atopic dermatitis. Multiple regression analysis revealed that vitamin B6 intake was a predictor of the severity scoring of atopic dermatitis (β = 26.98508709, t = 2.3995292, P = 0.01933781). The intakes of vegetable fat, n-6 polyunsaturated fatty acid, and confections were lower in the severe atopic dermatitis group (severity scoring of atopic dermatitis, ≥33) than those in the mild group. Atopic dermatitis is negatively associated with alcohol intake, and intake of vitamin B6 is a predictor of severity scoring of atopic dermatitis. The intake of n-6 polyunsaturated fatty acid is lower in the severe atopic dermatitis group than that in the mild group. Further study is warranted on the relationships of these results with abnormal immune responses, impaired skin barrier or pruritus in atopic dermatitis.

DOI： 10.1111/1346-8138.14881

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Language：Japanese   Publisher：(公社)日本皮膚科学会  

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BACKGROUND: The American Joint Committee on Cancer (AJCC) 8th Edition Cancer Staging System was implemented in 2018; however, it has not been validated in an Asian melanoma population. OBJECTIVE: The purpose of this study was to validate the new system using a cohort of Japanese melanoma patients. METHODS: The AJCC 7th and 8th Editions were used for TNM classification of patients in a database established by the Japanese Melanoma Study Group. Patient data with sufficient information to be applicable to the AJCC 8th staging were selected. The Kaplan-Meier method was used to estimate disease-specific survival and relapse-free survival. RESULTS: In total, data for 3097 patients were analyzed. The 5-year disease-specific survival according to the 7th and 8th Edition staging system were as follows: IA = 98.5%/97.9%; IB = 95.4%/96.2%; IIA = 94.2%/94.1%; IIB = 84.6%/84.4%; IIC = 72.2%/72.2%; IIIA = 76.2%/87.5%; IIIB = 60.7%/72.6%; IIIC = 42.0%/55.3% and IIID = none/26.0%. The 5-year relapse-free survival according to the 7th and 8th Edition staging was as follows: IA = 94.5%/92.7%; IB = 85.4%/85.3%; IIA = 80.1%/79.4%; IIB = 71.4%/70.6%; IIC = 56.8%/55.7%; IIIA = 56.8%/69.4%; IIIB = 42.6%/56.8%; IIIC = 20.0%/33.3% and IIID = none/6.5%. CONCLUSION: The results show that new staging system could efficiently classify our Japanese melanoma cohort. Although there was no difference in Stage I and II disease between the 7th and 8th Edition systems, we should be careful in managing Stage III disease since the survival curves of the 8th Edition staging were completely different from the 7th Edition. Moreover, our results indicate that adjuvant therapies for Stage IIB and IIC should be developed, since the relapse-free survival for these stages were equivalent to Stage IIIA and IIIB, respectively.

DOI： 10.1016/j.jdermsci.2019.04.003

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Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: The incidence of melanoma among those of an Asian ethnicity is lower than in Caucasians; few large-scale Asian studies that include follow-up data have been reported. OBJECTIVES: To investigate the clinical characteristics of Japanese patients with melanoma and to evaluate the prognostic factors. METHODS: Detailed patient information was collected from the database of Japanese Melanoma Study Group of the Japanese Skin Cancer Society. The American Joint Committee on Cancer seventh Edition system was used for TNM classification. The Kaplan-Meier method and Cox proportional hazards model were used to estimate the impact of clinical and histological parameters on disease-specific survival in patients with invasive melanoma. RESULTS: In total, 4594 patients were included in this analysis. The most common clinical type was acral lentiginous melanoma (40.4%) followed by superficial spreading melanoma (20.5%), nodular melanoma (10.0%), mucosal melanoma (9.5%), and lentigo maligna melanoma (8.1%). The 5-year disease-specific survival for each stage was as follows: IA = 98.0%, IB = 93.9%, IIA = 94.8%, IIB = 82.4%, IIC = 71.8%, IIIA = 75.0%, IIIB = 61.3%, IIIC = 41.7%, and IV = 17.7%. Although multivariate analysis showed that clinical classifications were not associated with survival across all stages, acral type was an independent poor prognostic factor in stage IIIA. CONCLUSIONS: Our study revealed the characteristics of melanoma in the Japanese population. The 5-year disease-specific survival of each stage showed a similar trend to that of Caucasians. While clinical classification was not associated with survival in any stages, acral type was associated with poor survival in stage IIIA. Our result might indicate the aggressiveness of acral type in certain populations.

DOI： 10.1002/cam4.2110

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Language：Japanese   Publisher：(一社)日本皮膚悪性腫瘍学会  

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DOI： 10.1111/1346-8138.14601

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Language：Japanese   Publisher：(公社)日本皮膚科学会  

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DOI： 10.1111/ajd.12868

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Language：English   Publisher：WILEY  

DOI： 10.1111/ajd.12868

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Publishing type：Research paper (scientific journal)   Publisher：Wiley  

DOI： 10.1111/1346-8138.14766

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Other Link： https://onlinelibrary.wiley.com/doi/full-xml/10.1111/1346-8138.14766

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Publishing type：Research paper (scientific journal)   Publisher：Wiley  

DOI： 10.1111/1346-8138.14728

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Other Link： https://onlinelibrary.wiley.com/doi/full-xml/10.1111/1346-8138.14728

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DOI： 10.1111/1346-8138.14601

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Language：Japanese   Publisher：(NPO)日本皮膚外科学会  

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DOI： 10.18888/hi.0000000859

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DOI： 10.1111/1346-8138.14190

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DOI： 10.1111/1346-8138.14190

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Publishing type：Research paper (scientific journal)   Publisher：Wiley  

DOI： 10.1111/1346-8138.14474

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Language：Japanese   Publisher：(公社)日本皮膚科学会  

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Language：English   Publisher：Blackwell Publishing Ltd  

DOI： 10.1111/1346-8138.14129

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DOI： 10.1111/ajd.12643

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DOI： 10.1111/ajd.12643

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Medical Association of Nippon Medical School  

Verrucous carcinoma (VC) is an uncommon, distinct type of well-differentiated squamous cell carcinoma. Here we present two cases of VC, one arising from the lower leg and the other from genital skin. Case 1, a female patient, aged 95 years, had a brownish verrucous plaque on her right lower leg. Histo-pathologically, epithelial tumor cells grew pushing the stroma, while the basement membrane was intact. No prominent cellular atypia or hyperchromatin was found. Case 2, a male patient, aged 53 years, had a verrucous plaque at the border between his scrotum and inner aspect of his thigh. A pathological diagnosis of VC was made using an excisional specimen. Making a definitive diagnosis of VC is challenging but crucial. Pathological diagnosis using a small specimen might cause underdiagnosis or over-diagnosis. To avoid this, pertinent pathological diagnosis using an ample specimen is required. We also revisited the definition of VC to precisely understand its nature.

DOI： 10.1272/jnms.2018_85-7

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Verrucous carcinoma (VC) is an uncommon, distinct type of well-differentiated squamous cell carcinoma. Here we present two cases of VC, one arising from the lower leg and the other from genital skin. Case 1, a female patient, aged 95 years, had a brownish verrucous plaque on her right lower leg. Histopathologically, epithelial tumor cells grew pushing the stroma, while the basement membrane was intact. No prominent cellular atypia or hyperchromatin was found. Case 2, a male patient, aged 53 years, had a verrucous plaque at the border between his scrotum and inner aspect of his thigh. A pathological diagnosis of VC was made using an excisional specimen. Making a definitive diagnosis of VC is challenging but crucial. Pathological diagnosis using a small specimen might cause underdiagnosis or overdiagnosis. To avoid this, pertinent pathological diagnosis using an ample specimen is required. We also revisited the definition of VC to precisely understand its nature.

DOI： 10.1272/jnms.2018_85-7

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：MEDICAL ASSOC NIPPON MEDICAL SCH  

Giant cell tumors of the tendon sheath (GCT-TS) are one of the most common tumors of the hand, along with ganglions. However, occurrence in the toes is far less common. Here we present a rare case of GCT-TS at the middle phalanx level of the flexor digitorum longus tendon sheath. Magnetic resonance imaging showed low intensity both on T1 and T2 weighted images. To the best of our knowledge, our case is the first report of a GCT-TS arising at the middle phalanx level of the flexor digitorum longus tendon sheath of the fourth toe. Although GCT-TS are rare in the toe, they must be included in the differential diagnoses of soft tissue tumors arising in the toes.

DOI： 10.1272/jnms.84.308

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DOI： 10.1111/1346-8138.13625

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DOI： 10.1111/1346-8138.13636

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DOI： 10.1111/1346-8138.13625

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Language：Japanese   Publisher：(公社)日本皮膚科学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：MEDICAL ASSOC NIPPON MEDICAL SCH  

An external dental fistula is a skin manifestation caused by an underlying dental problem. We report a rare case of external dental fistula associated with a fixed cantilever denture. A 77-year-old Japanese woman presented with an enlarging reddish granulomatous lesion on her right cheek that was diagnosed as an external dental fistula. A fixed cantilever denture had initially been attached to her upper jaw with her seven bona fide teeth. However, six teeth were completely lost and the denture was attached to only one tooth, which showed apical periodontitis. Subsequently, the external dental fistula developed. We should keep in mind that a patient with a fixed cantilever denture can suffer from apical periodontitis and a subsequent external dental fistula due to a failure to maintain appropriate oral hygiene.

DOI： 10.1272/jnms.84.198

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DOI： 10.1111/1346-8138.13567

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DOI： 10.1111/1346-8138.13567

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DOI： 10.1111/1346-8138.13815

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DOI： 10.1111/1346-8138.13815

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DOI： 10.1111/1346-8138.13615

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DOI： 10.1111/1346-8138.13615

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Language：Japanese   Publisher：(公社)日本皮膚科学会  

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DOI： 10.1111/1346-8138.13643

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Language：Japanese   Publisher：(一社)日本皮膚悪性腫瘍学会  

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DOI： 10.1111/1346-8138.13643

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DOI： 10.1111/ijd.13397

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Language：English   Publisher：WILEY-BLACKWELL  

DOI： 10.1111/ijd.13397

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Language：Japanese   Publisher：(公社)日本皮膚科学会  

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DOI： 10.18888/hi.0000000156

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Language：English  

An external dental fistula is a skin manifestation caused by an underlying dental problem. We report a rare case of external dental fistula associated with a fixed cantilever denture. A 77-year-old Japanese woman presented with an enlarging reddish granulomatous lesion on her right cheek that was diagnosed as an external dental fistula. A fixed cantilever denture had initially been attached to her upper jaw with her seven bona fide teeth. However, six teeth were completely lost and the denture was attached to only one tooth, which showed apical periodontitis. Subsequently, the external dental fistula developed. We should keep in mind that a patient with a fixed cantilever denture can suffer from apical periodontitis and a subsequent external dental fistula due to a failure to maintain appropriate oral hygiene.

DOI： 10.1272/jnms.84.198

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Language：English  

Giant cell tumors of the tendon sheath (GCT-TS) are one of the most common tumors of the hand, along with ganglions. However, occurrence in the toes is far less common. Here we present a rare case of GCT-TS at the middle phalanx level of the flexor digitorum longus tendon sheath. Magnetic resonance imaging showed low intensity both on T1 and T2 weighted images. To the best of our knowledge, our case is the first report of a GCT-TS arising at the middle phalanx level of the flexor digitorum longus tendon sheath of the fourth toe. Although GCT-TS are rare in the toe, they must be included in the differential diagnoses of soft tissue tumors arising in the toes.

DOI： 10.1272/jnms.84.308

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY-BLACKWELL  

Basal cell carcinoma is the most common cutaneous malignant tumor and usually arises from the facial skin and is diagnosed as the solid tumor. However, rarely it arises from genital skin and/or proceeds with ulcerative manner. We report a case of male basal cell carcinoma arising from penile base, which showed urinary disturbance. Tumor resection including total penectomy and skin resection was performed then scrotal myofasciocutaneous flap was used to cover the defect. Scrotal myofasciocutaneous flap was useful for covering the defect in the genital lesion. Moreover, this simple closure was helpful for early postoperative ambulation especially for aged male patients.

DOI： 10.1111/dth.12375

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Other Link： http://search.jamas.or.jp/link/ui/2016373711

Language：Japanese   Publisher：(NPO)日本皮膚外科学会  

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Language：Japanese   Publisher：The Japanese Skin Cancer Society  

A 29-year-old Japanese woman presented with a brownish papule, 5×8 mm in size, on the lateral aspect of the right fifth toe, which had developed within 3 years. The papule was asymmetrical with hyperkeratosis on the surface, at the center of the lesion. Dermoscopy showed biphasic features consisting of a starburst pattern and a region of regression structures at the distal half of the lesion. Histological examination revealed nests of large spindle cells extending from the epidermis into the dermis. Kamino bodies were observed in the epidermal nests, and the tumor cells exhibited maturation.The nests in the epidermis of the sweat gland, and the asymmetric features of the epidermal nests made it difficult to distinguish typical Spitz nevus from malignant melanoma and atypical Spitz nevus. However, the lateral aspect of the toe is a specific site, which often appears to be histologically atypical. Therefore, the patient was diagnosed with typical Spitz nevus.[Skin Cancer (Japan) 2016 ; 31 : 26-29]

DOI： 10.5227/skincancer.31.26

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Language：Japanese   Publisher：(公社)日本皮膚科学会  

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Language：Japanese   Publisher：日本皮膚病理組織学会  

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Language：Japanese   Publisher：(公社)日本皮膚科学会  

J-GLOBAL

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Language：Japanese   Publisher：(一社)日本皮膚悪性腫瘍学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Wiley  

DOI： 10.1111/1346-8138.13391

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Language：English   Publisher：LIPPINCOTT WILLIAMS & WILKINS  

DOI： 10.1097/DSS.0000000000000611

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Language：English   Publisher：WILEY-BLACKWELL  

DOI： 10.1111/j.1365-4632.2011.05187.x

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Language：English   Publisher：SPRINGER HEIDELBERG  

DOI： 10.1007/s00296-010-1695-8

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DOI： 10.1016/j.jaad.2011.03.013

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：AMER SOC BIOCHEMISTRY MOLECULAR BIOLOGY INC  

Dendritic cells (DCs) are a group of professional antigen-presenting cells, and many genes are known to be associated with their maturation. We compared the transcriptional profiles of immature and mature mouse Langerhans cells using the suppressive, subtractive hybridization method and identified a novel gene of unknown function, termed herein transmembrane protein 123 (Tmem123), of which mRNA expression was enhanced in mature but not in immature Langerhans cells. Its expression was also enhanced in other mature DCs such as bone marrow-derived DCs (BMDCs) and splenic DCs. Interestingly, CD40 expression was up-regulated on mature BMDCs cultured with colchicine concurrently with the enhanced expression of Tmem123 compared with that of fresh BMDCs. Furthermore, the expression of CD40 was enhanced on Tmem123-transfected DC2.4 cells, a mouse BMDC-derived cell line, compared with that on mock-transfected DC2.4 cells. This enhancement of CD40 expression did not occur after deletion of lysosome/endosome targeting YXX phi motifs (where X is any amino acid and phi is a bulky hydrophobic amino acid) in the Tmem123 cytoplasmic tail. By stimulation with anti-CD40 monoclonal antibody, these transfectants secreted an increased amount of IL-12/23 p40 compared with mock-transfected DC2.4 cells. Thus, our study demonstrates that Tmem123 may be used as a new maturation marker in DCs and that this molecule may be closely associated with the cell surface expression of CD40.

DOI： 10.1074/jbc.M110.118877

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Publishing type：Research paper (scientific journal)   Publisher：Oxford University Press (OUP)  

DOI： 10.1111/j.1365-2230.2010.03928.x

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY-BLACKWELL  

Subungual melanoma is a rare form of malignant melanoma. It is extremely difficult to differentiate it histologically from benign melanonychia striata or melanocytic nevus, especially in the early stage. We divided 50 cases of subungual melanoma into four groups according to clinical progress, and examined their histological findings in each respective stage. In the early stage (19 cases), atypical melanocytes were polygonal showing slight nuclear atypia with no mitoses at all. In six out of 19 cases (31.6%), the atypical melanocytes proliferated more in the hyponychium than in the nail matrix, and only very few in the nail bed. Periungual pigmentation (Hutchinson&apos;s sign) appeared from the early stage in almost all cases. With stage progression (middle stage, 13 cases; progressive stage, 13 cases; and bone invasive stage, five cases) the number of atypical melanocytes and their degree of nuclear atypia increased, and the ascent of atypical melanocytes and pagetoid spread became conspicuous. Mitoses became apparent only from the progressive stage. From these observations, we would like to propose three new pathological clues of early stage subungual melanoma: (i) "skip lesion", proliferation of the tumor cells are more prominent in the hyponychium than in the nail bed or nail matrix; (ii) histological confirmation of Hutchinson&apos;s sign; and (iii) epithelial thickening and/or compact arrangement of the elongated basal cells.

DOI： 10.1111/j.1346-8138.2008.00551.x

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：FEDERATION AMER SOC EXP BIOL  

The epidermis (containing primarily keratinocytes and melanocytes) overlies the dermis (containing primarily fibroblasts) of human skin. We previously reported that dickkopf 1 (DKK1) secreted by fibroblasts in the dermis elicits the hypopigmented phenotype of palmoplantar skin due to suppression of melanocyte function and growth via the regulation of two important signaling factors, microphthalmia-associated transcription factor (MITF) and beta-catenin. We now report that treatment of keratinocytes with DKK1 increases their proliferation and decreases their uptake of melanin and that treatment of reconstructed skin with DKK1 induces a thicker and less pigmented epidermis. DNA microarray analysis revealed many genes regulated by DKK1, and several with critical expression patterns were validated by reverse transcriptase-polymerase chain reaction and Western blotting. DKK1 induced the expression of keratin 9 and a-Kelch-like ECT2 interacting protein (alpha KLEIP) but down-regulated the expression of beta-catenin, glycogen synthase kinase 3(3, protein kinase C, and proteinase-activated receptor-2 (PAR-2), which is consistent with the expression patterns of those proteins in human palmoplantar skin. Treatment of reconstructed skin with DKK1 reproduced the expression patterns of those key proteins observed in palmoplantar skin. These findings further elucidate why human skin is thicker and paler on the palms and soles than on the trunk through topographical and site-specific differences in the secretion of DKK1 by dermal fibroblasts that affects the overlying epidermis.

DOI： 10.1096/fj.07-9475com

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Language：English   Publisher：BLACKWELL PUBLISHING  

DOI： 10.1111/j.1346-8138.2008.00427.x

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：NATURE PUBLISHING GROUP  

Melanosomes are unique membrane-bound organelles specialized for the synthesis and distribution of melanin. Mechanisms involved in the trafficking of proteins to melanosomes and in the transport of mature pigmented melanosomes to the dendrites of melanocytic cells are being characterized, but details about those processes during early stages of melanosome maturation are not well understood. Early melanosomes must remain in the perinuclear area until critical components are assembled. In this study, we characterized the processing of two distinct melanosomal proteins, tyrosinase (TYR) and Pmel17, to elucidate protein processing in early or late steps of the secretory pathway, respectively, and to determine mechanisms underlying the subcellular localization and transport of early melanosomes. We used immunological, biochemical, and molecular approaches to demonstrate that the movement of early melanosomes in the perinuclear area depends primarily on microtubules but not on actin filaments. In contrast, the trafficking of TYR and Pmel17 depends on cytoplasmic dynein and its interaction with the spectrin/ankyrin system, which is involved with the sorting of cargo from the plasma membrane. These results provide important clues toward understanding the processes involved with early events in melanosome formation and transport.

DOI： 10.1038/sj.jid.5701019

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：NATL ACAD SCIENCES  

SOX (SRY type HMG box) proteins are transcription factors that are predominantly known for their roles during development. During melanocyte development from the neural crest, SOX10 regulates microphthalmia-associated transcription factor, which controls a set of genes critical for pigment cell development and pigmentation, including dopachrome tautomerase and tyrosinase. We report here that another SOX factor, SOX9, is expressed by melanocytes in neonatal and adult human skin and is up-regulated by UVB exposure. We demonstrate that this regulation is mediated by cAMP and protein kinase. We also show that agouti signal protein, a secreted factor known to decrease pigmentation, down-regulates SOX9 expression. In adult and neonatal melanocytes, SOX9 regulates microphthalmia-associated transcription factor, dopachrome tautomerase, and tyrosinase promoters, leading to an increase in the expression of these key melanogenic proteins and finally to a stimulation of pigmentation. SOX9 completes the complex and tightly regulated process leading to the production of melanin by acting at a very upstream level. This role of SOX9 in pigmentation emphasizes the poorly understood impact of SOX proteins in adult, tissues.

DOI： 10.1073/pnas.0705117104

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：NATURE PUBLISHING GROUP  

Dickkopf 1 (DKK1), which is expressed at high mRNA levels by fibroblasts in the dermis of human skin on the palms and soles, inhibits the function and proliferation of melanocytes in the epidermis of those areas via the suppression of beta-catenin and microphthalmia-associated transcription factor (MITF). In this study, we investigated the protein expression levels of DKK1 between palmoplantar and non-palmoplantar areas and the effects of DKK1 on melanocyte gene expression profiles and on Wnt signaling pathways using DNA microarray technology, reverse transcriptase-PCR, Western blot, 3-dimensional reconstructed skin, immunocytochemistry, and immunohistochemistry. DKK1-responsive genes included those encoding proteins involved in the regulation of melanocyte development, growth, differentiation, and apoptosis (including Kremen 1, G-coupled receptor 51, lipoprotein receptor-related protein 6, low-density lipoprotein receptor, tumor necrosis factor receptor super-family 10, growth arrest and DNA-damage- inducible gene 45 beta, and MITF). Of special interest was the rapid decrease in expression of MITF in melanocytes treated with DKK1, which is concurrent with the decreased activities of beta-catenin and of glucose-synthase kinase 3 beta via phosphorylation at Ser9 and with the upregulated expression of protein kinase C alpha. These results further clarify the mechanism by which DKK1 suppresses melanocyte density and differentiation, and help explain why DKK1-rich palmoplantar epidermis is paler than non-palmoplantar epidermis via mesenchymal-epithelial interactions.

DOI： 10.1038/sj.jid.5700629

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Language：English   Publisher：NATURE PUBLISHING GROUP  

DOI： 10.1038/sj.jid.5700466

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：FEDERATION AMER SOC EXP BIOL  

Melanin synthesized by epidermal melanocytes protects the skin against UVR-induced DNA damage and skin cancer. Exposure to UVR increases the synthesis of the photoprotective eumelanin on activation of MC1R, a melanoma susceptibility gene. We studied the expression of MC1R under UVR and alpha-MSH stimulation in skin of different ethnic origins and in melanocytes of various pigmentary levels. This study identifies and characterizes a novel MC1R isoform (MC1R350) generated by alternative splicing of the classically known MC1R (MC1R317). We demonstrate that the melanin content of melanocytes shows a significant positive correlation with MC1R317 levels but correlates inversely with the amount of MC1R350, suggesting that this latter isoform could act as a negative regulator of melanin synthesis. We confirmed that hypothesis by showing that while MC1R317 signaling significantly increases the expression of MITF and tyrosinase, two key factors in the melanin synthesis pathway, MC1R350 dramatically hampers their expression. In the skin, we show that UVR does not increase MC1R350 expression but does significantly increase MC1R317. Taken together, our results strongly suggest that MC1R350 acts as a negative regulator of skin pigmentation and demonstrate for the first time that MC1R isoform-specific expression is closely related to skin pigmentation and photoprotection.

DOI： 10.1096/fj.06.5922fje

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Language：English   Publisher：BLACKWELL PUBLISHING  

DOI： 10.1111/j.1600-0749.2006.00308.x

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：BLACKWELL PUBLISHING  

In the period 1994-2002, we saw 71 patients with sclerotic skin changes; 66 were diagnosed with systemic sclerosis (SSc) while five (7%) were diagnosed with pseudoscleroderma associated with various malignancies. The mean duration of disease in these five patients was significantly shorter than that of patients with SSc. The incidence of positive antinuclear antibodies, Raynaud's phenomenon or oesophageal involvement in patients with pseudoscleroderma was significantly lower than that in patients with SSc. The distributions of skin sclerosis varied in each case. Serum basic fibroblast growth factor (bFGF) levels in the five patients with pseudoscleroderma were very elevated compared with levels in controls. Elevated expression of bFGF was detected on fibroblasts of affected skin and in one lung-cancer tissue sample obtained by excision.

DOI： 10.1111/j.1365-2230.2006.02092.x

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：MOSBY, INC  

Background: Basic fibroblast growth factor (bFGF) and vascular endothelial growth factor (VEGF) are angiogenic cytokines, that have been reported to elevate serum levels in patients with collagen diseases such as systemic sclerosis and dermatomyositis as well as in those with inflammatory bowel diseases.
Objective: In this study, the serum levels of bFGF and VEGF were measures by using enzyme-linked immunosorbent assay in 20 patients with polyarteritis nodosa (PAN; 5 with systemic PAN and 15 with cultaneons PAN) and in 20 control subjects. We also investigated the expression of bFGF and VEGF ill cutaneous lesions of patients by using immunohistochemical methods.
Results: Basic FGF was undetectable in the scrum of control subjects, but detectable levels were found in 4 of 5 patients with classical PAN and 3 of 15 patients With cutaneous PAN. The serum bFGF level in these patients with systemic PAN was significantly elevated in comparison with that in healthy control subjects. The VEGF level was 178 +/- 41 pg/mL, in the serum of healthy individuals. The mean VEGF level in patients with systemic or cultaneous PAN was significantly higher than that in healthy controls. Serum bFGF and VEGF levels in patients with systemic PAN were Significantly elevated in comparison with those having cutaneous PAN. Immunohistochemical studies showed elevated bFGF expression on damaged endothelial cells in necrotizing vasculitis lesions. Elevated expression of bFGF was also observed on fibroblasts around the vasculitis. Some of the infiltrating cells around vasculitis lesions expressed VEGF.

DOI： 10.1016/j.jaad.2005.02.018

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCI IRELAND LTD  

Background: Fusion of the collagen type I alpha 1 (COL1A1) gene with the platelet-derived growth factor B-chain (PDGFB) gene has been pointed out in dermatofibrosarcoma protuberans (DFSP). Various exons of the COL1A1 gene have been shown to be involved in the fusion with exon 2 of the PDGFB gene. Objective: We studied the breakpoints of the COL1A1 gene using the tumor specimens from three patients with DFSP. Methods: Reverse transcriptase-polymerase chain reaction (PCR) was performed using cultured DFSP tumor cells or frozen tissue. Nucleotide sequence analysis was carried out using the PCR products to identify the breakpoints. Results: Cases 1, 2 and 3 were diagnosed as ordinary DFSP, DFSP with fibrosarcomatous Lesion (DFSP-FS) and lung metastasis of DFSP-FS, respectively. The COL1A1-PDGFB fusion transcripts were detected from the tumor specimens. Sequence analysis revealed that the ends of exons 42, 29 and 38 in the COL1A1 gene were fused with the start of exon 2 in the PDGFB gene in case 1, 2 and 3, respectively. Conclusion: This study identified a novel COL1A1 breakpoint, namely, exon 42 of the COL1A1 gene. Detection of the aberrant fusion transcript seems to be useful at differential diagnosis both in primary and metastatic lesions. (C) 2003 Japanese Society for Investigative Dermatology. Published by Elsevier Ireland Ltd. All rights reserved.

DOI： 10.1016/S0923-1811(03)00179-8

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Language：Japanese   Publisher：The Japanese Skin Cancer Society  

A case of burn scar carcinoma was reported. A 65-year-old man discovered a finger-sized mass on the top of his head 4 months prior to his first visit to our department. He came with a fist-sized tumor and an ulcer of the same size beside it. He had a burn scar caused 60 years ago by an "iron" (Japanese hearth) . Histopathological examinations revealed squamous cell carcinoma. Cranial CT/MRI showed that the tumor was invading the brain. Metastasis to pleura, periaortic lymph nodes, and cervical vertebrae made curative excision difficult. During the course of his radiation therapy (total 42Gy), pressure fracture of the cervical vertebrae occurred, resulting in tetraparesis. Additional radiation of 33Gy was applied to his neck fracture, followed by chemotherapy using low-dose cisplatin (5mg/day, for 5 days/week) . Although the tumor was decreasing in size, a sudden onset of respiratory failure occurred, which resulted in his death 2 months after his first visit. [Skin Cancer (Japan) 2003; 18: 75-79]

DOI： 10.5227/skincancer.18.75

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Other Link： http://search.jamas.or.jp/link/ui/2003264897

Language：English   Publishing type：Research paper (scientific journal)   Publisher：BLACKWELL PUBLISHING LTD  

Background Fusion of the collagen type I alpha 1 (COL1A1 ) gene with the platelet-derived growth factor B-chain (PDGFB ) gene has been described in dermatofibrosarcoma protuberans (DFSP). Various exons of the COL1A1 gene have been shown to be involved in the fusion with exon 2 of the PDGFB gene.
Objectives We examined the breakpoint of the COL1A1 gene using the tumour specimen from the patient with DFSP.
Methods Reverse transcriptase-polymerase chain reaction (PCR) was performed using cultured DFSP tumour cells. Nucleotide sequence analysis was carried out using the PCR product to identify the breakpoint.
Results The COL1A1 -PDGFB fusion transcript was detected from the tumour specimen. Sequence analysis revealed that exon 18 of the COL1A1 gene was fused with exon 2 of the PDGFB gene.
Conclusions This study identified a novel COL1A1 breakpoint, namely, exon 18 of the COL1A1 gene.

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：BLACKWELL PUBLISHING LTD  

Matrix metalloproteinase-9 (MMP-9) and its inhibitor, tissue inhibitors of metalloproteinases-1 (TIMP-1) are involved in tissue inflammation and fibrotic processes. We previously reported an elevated serum TIMP-1 level in patients with systemic sclerosis (SSc). We measured serum TIMP-1 and active MMP-9 levels in 62 patients with SSc, 10 patients with rheumatoid arthritis (RA) and 15 normal controls using a modified enzyme-linked immunosorbent assay. The active MMP-9 level in the serum of the patients with RA or SSc was not significantly different from that of controls. Serum MMP-9 activity in patients with diffuse cutaneous SSc was significantly decreased compared with that of limited cutaneous SSc or normal controls. The MMP-9 activity and modified-Rodnan total skin thickness score in patients with SSc were negatively correlated. Serum MMP-9 activity and TIMP-1 level in patients with SSc were not correlated. Serum MMP-9 activity might be a useful indicator of disease activity, especially skin severity, in SSc patients.

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ACADEMIC PRESS INC  

We investigated the role of tissue inhibitor of :metalloproteinase (TIMP)-1 and TIMP-2 in the growth regulation. Primary (PM-WK and KHm-4), recurrent primary (RPM-EP and RPM-MC), lymph node metastatic (MM-AN, MM-BP and MM-RU), and a visceral metastatic (MM-LH) melanoma cell lines were used. Reverse transcriptase-coupled polymerase chain reaction and Western blotting revealed that all expressed and produced TIMP-1 and TIMP-2 except for PM-WK, which neither expressed nor produced TIMP-1. TIMP-1 and TIMP-2 secretion levels were measured by enzyme-linked immunosorbent assay in supernatants of cells. We found that the TIMP-1 production level was correlated with the cell migration rate. Moreover, TIMP-1 enhanced the cell migration of PM-WK. The growth of the primary melanoma cell lines was stimulated by TIMP-1 and inhibited by TIMP-2. In contrast, the growth of the visceral metastatic melanoma cell line was stimulated by TIMP-2. (C) 2001 Academic Press.

DOI： 10.1006/bbrc.2001.5789

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Language：Japanese   Publisher：Japanese Dermatological Association  

Radiotherapy plays an important role in the management of appropriately selected skin carcinomas. We reported four patients with cutaneous squamous cell carcinomas treated with four different types of radio therapy: preoperative, intraoperative, postoperative, and irradiation without operation. The purposes of pre and intraoperative radiotherapy are to enable operations in patients with inoperable carcinomas by reducing tumor size, and to suppress the spread of carcinoma cells during the operation. Irradiation subsequent to surgery (postopeative radiotherapy) is chosen as an adjuvant therapy in order to eliminate possible residual tumor cells. The indications for irradiation alone (without operation) are limited to patients who are not healthy enough to undergo surgery, but, even in such patients, irradiation is often very effective, and an absolute cure can even be expected if their squamous cell carcinomas are sensitive enough to irradiation. There are a number of available options for the primary management of skin carcinomas. The appropriate roles of dermatologists treating skin carcinomas are to be well versed in radiotherapy and to choose the most effective and QOL-preserving treatment among various therapeutic options.

DOI： 10.14924/dermatol.111.147

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Other Link： https://jlc.jst.go.jp/DN/JALC/00090366215?from=CiNii

Language：Japanese   Publisher：The Japanese Skin Cancer Society  

We have experienced thirty-nine cases of cutaneous malignant melanoma for twelve years from 1987 to 1998 at the Department of Dermatology, University of Tokyo. The number of patients is increasing but this phenomenon is mostly due to increase of in situ patients. We assume that because of the prevalence of knowledge on pigmented lesions, those patients consult us in early stage. [Skin Cancer (Japan) 2000; 15: 45-48]

DOI： 10.5227/skincancer.15.45

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Other Link： http://search.jamas.or.jp/link/ui/2001044458

Language：Japanese   Publisher：The Japanese Skin Cancer Society  

We report 6 malignant melanomas of the nail apparatus in situ. All cases showed melanonychia striata extended over whole nail with the periungual pigmentation (Hutchinson's sign) clinically. Proliferations of atypical melanocytes were seen limited in epidermis histopathologically. The nail surface profiles by dermatoscope were composed of linear pigmentation, whereas the periungual pigmentation showed diffuse irregularly shaped pigmentation distributed in a disorderly fashion as well as acral lentiginous melanomas in situ. In contrast, both the ungual and the periungual surface profiles of pigmented nevi showed longitudinal linear pigmentation. These distinctive features of surface profiles are very helpful for the differential diagnosis of the longitudinal melanonychia striata with the periungual pigmentation.

DOI： 10.5227/skincancer.14.149

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Other Link： http://search.jamas.or.jp/link/ui/2000171641

Language：Japanese   Publisher：The Japanese Skin Cancer Society  

We report a case of squamous cell carcinoma of the left leg caused by previous irradiation to the giant pigmented nevus. In treating skin cancers originated from radiation dermatitis, we think it is important to resect surrounding radiation dermatitis lesions as well as tumor itself.

DOI： 10.5227/skincancer.13.229

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Other Link： http://search.jamas.or.jp/link/ui/1999177791

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Language：English   Publishing type：Rapid communication, short report, research note, etc. (scientific journal)   Publisher：John Wiley and Sons Inc  

DOI： 10.1002/cia2.12188

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Language：Japanese   Publisher：(一社)日本皮膚悪性腫瘍学会  

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Language：Japanese   Publisher：(一社)日本皮膚悪性腫瘍学会  

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Language：Japanese   Publisher：日本皮膚科学会-西部支部  

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Language：Japanese   Publisher：(公社)日本皮膚科学会  

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Language：Japanese   Publisher：(株)協和企画  

＜症例のポイント＞脂肪腫は脂肪細胞を由来とする発生頻度の高い良性腫瘍であり、上腹部、背部、頸部、肩部、四肢近位部に好発するが、外陰部に発生することはまれである。今回、われわれは外陰部脂肪腫を2例経験したため文献的考察も含め報告する。自験例では通常の脂肪腫と異なり、外陰部脂肪腫に伴う圧痛、および摘出後の圧痛の消失を認めた点が特徴であった。(著者抄録)

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Language：English   Publishing type：Rapid communication, short report, research note, etc. (scientific journal)   Publisher：WILEY  

DOI： 10.1111/ced.13037

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Language：Japanese   Publisher：(NPO)日本肺癌学会  

J-GLOBAL

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Language：Japanese   Publisher：(NPO)日本肺癌学会  

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J-GLOBAL

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Language：Japanese   Publisher：(公社)日本皮膚科学会  

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Language：Japanese   Publisher：(公社)日本皮膚科学会  

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Language：English   Publishing type：Research paper, summary (international conference)   Publisher：OXFORD UNIV PRESS  

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Other Link： http://search.jamas.or.jp/link/ui/2015233232

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Other Link： http://search.jamas.or.jp/link/ui/2015106068

Language：Japanese   Publisher：(NPO)日本皮膚外科学会  

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Other Link： http://search.jamas.or.jp/link/ui/2014065835

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Other Link： http://search.jamas.or.jp/link/ui/2014039585

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Other Link： http://search.jamas.or.jp/link/ui/2013367144

Language：Japanese   Publisher：金原出版(株)  

76歳男性。輸血後急性C型肝炎に続発した肝硬変・肝細胞癌の治療中であり、10年前からは下腿に浮腫および色素沈着を来し、5年前からは同じく下腿に潰瘍が出現、うつ滞性皮膚炎皮膚炎による潰瘍として加療されていた。今回、消化器内科にて肝細胞癌に対してラジオ波焼灼術施行後に下腿潰瘍の精査加療目的で皮膚科へ受診となり、混合型クリオグロブリン血症と診断された。また、ホスファチジルセリン依存性抗プロトロンビンIgM抗体が検出され、これらによる血栓傾向が潰瘍形成に寄与していると考えられた。以後、まず混合型クリオグロブリン血症に対して治療が開始されたが、原疾患の治療が第一選択であるものの、以前ペグインターフェロン+リバビリン療法を行った際に下肢浮腫の増悪を認めたため断念、そこで血栓傾向に対してワルファリンカリウム1mgと075mgの隔日内服投与ほか、更にスルファジアジン銀と亜鉛華軟膏の外用が行われた。その結果、滲出液の減少と潰瘍の縮小がみられた。尚、本症例の臨床的経過からも難治性下腿潰瘍の症例においてはクリオグロブリンや抗リン脂質抗体の検査を積極的に行うことが必要と考えられた。

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Other Link： http://search.jamas.or.jp/link/ui/2013186680

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CiNii Books

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Other Link： http://search.jamas.or.jp/link/ui/2013160871

Language：Japanese   Publisher：(公社)日本皮膚科学会  

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Other Link： http://search.jamas.or.jp/link/ui/2012340354

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Other Link： http://search.jamas.or.jp/link/ui/2012292031

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Other Link： http://search.jamas.or.jp/link/ui/2012136799

Language：Japanese   Publisher：(公社)日本皮膚科学会  

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Language：Japanese   Publisher：金原出版(株)  

55歳女。体幹に紅斑局面および膿疱が多発し、汎発性膿疱性乾癬(GPP)の診断でシクロスポリン(CyA)内服を開始したところ腎障害が出現し、プレドニゾロン+メトトレキサートの併用に変更したが、顔面浮腫などが出現した。腎障害の原因としてCyA腎症が考えられたため、CyAの減量を行い、更に外用剤をマキサカルシトール軟膏からタカルシトール軟膏へ変更した。腎機能が改善してきたため、CyAからエトレチナート(ETR)への変更を行ったところ膿疱が再燃し、ETRを中止してインフリキシマブ(IFX)を投与した。しかし、膿疱新生がみられ、IFXにETRの併用を行ったところ膿疱新生は止まり、併用治療開始4ヵ月後の現在も経過良好である。

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Other Link： http://search.jamas.or.jp/link/ui/2012031898

Language：English   Publishing type：Research paper, summary (international conference)   Publisher：WILEY-BLACKWELL  

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Other Link： http://search.jamas.or.jp/link/ui/2011264547

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Other Link： http://search.jamas.or.jp/link/ui/2011031452

Language：English   Publishing type：Research paper, summary (international conference)   Publisher：WILEY-BLACKWELL PUBLISHING, INC  

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Language：English   Publisher：FEDERATION AMER SOC EXP BIOL  

Melanosomes are organelles specialized for the production of melanin pigment and are specifically produced by melanocytic cells. More than 150 pigmentation-related genes have been identified, including glycoprotein nonmetastatic melanoma protein b (GPNMB). A recent proteomics analysis revealed that GPNMB is localized in melanosomes, and GPNMB is a membrane-bound glycoprotein that shows high homology with a well-known melanosomal structural protein, Pmel17/gp100. In this study, we show that GPNMB is expressed in melanocytes of normal human skin, as well as in human melanoma cells. GPNMB is heavily glycosylated and is enriched in mature (stage III and IV) melanosomes in contrast to MART-1 and Pmel17, which are abundant in early (stage I and II) melanosomes. MART-1 and Pmel17 play critical roles in the maturation of early melanosomes; thus, we speculate that GPNMB might be important in the functions of late melanosomes, possibly their transport and/or transfer to keratinocytes. We also demonstrate that a secreted form of GPNMB is released by ectodomain shedding from the largely Golgi-modified form of GPNMB and that the PKC and Ca2+ intracellular signaling pathways regulate that shedding. We conclude that GPNMB is a melanosomal protein that is released by proteolytic ectodomain shedding and might be a useful and specific histological marker of melanocytic cells.-Hoashi, T., Sato, S., Yamaguchi, Y., Passeron, T., Tamaki, K., Hearing, V. J. Glycoprotein nonmetastatic melanoma protein b, a melanocytic cell marker, is a melanosome-specific and proteolytically released protein. FASEB J. 24, 1616-1629 (2010). www.fasebj.org

DOI： 10.1096/fj.09-151019

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Language：English   Publishing type：Research paper, summary (international conference)   Publisher：NATURE PUBLISHING GROUP  

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Language：English   Publisher：FEDERATION AMER SOC EXP BIOL  

Ectodomain shedding is a proteolytic mechanism by which a transmembrane protein is converted into a secreted form. Pmel17/gp100 is a melanocyte-specific membrane-bound glycoprotein that has amyloid characteristics and forms fibrillar structures in melanosomes after a complex sequence of post-translational processing and trafficking events, including cleavage by a furin-like proprotein convertase (PC). A secreted form of Pmel17 (termed sPmel17) was also thought to be released due to cleavage by a PC. We used multidisciplinary approaches to demonstrate that sPmel17 is released by ectodomain shedding at the juxtamembrane and/or intramembrane motif and to show that this is independent of cleavage by a PC. We further show that sPmel17 consists of 2 fragments linked by disulfide bonds and that the shedding is inhibited at low temperature but not by metalloproteinase inhibitors. Moreover, treatment with a phorbol ester or a calmodulin inhibitor induces Pmel17 shedding. We also refine the reactivity of HMB50 and NKI/beteb, 2 monoclonal antibodies commonly used as melanoma-specific markers. The fact that those antibodies require physically separated domains of Pmel17 sheds interesting light on its 3-dimensional conformation. We conclude that sPmel17 is released by regulated proteolytic ectodomain shedding.-Hoashi, T., Tamaki, K., Hearing, V. J. The secreted form of a melanocyte membrane-bound glycoprotein (Pmel17/gp100) is released by ectodomain shedding. FASEB J. 24, 916-930 (2010). www.fasebj.org

DOI： 10.1096/fj.09-140921

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Language：Japanese   Publisher：(公社)日本皮膚科学会  

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Other Link： http://search.jamas.or.jp/link/ui/2009034875

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Language：English   Publishing type：Research paper, summary (international conference)   Publisher：BLACKWELL PUBLISHING  

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Language：English   Publisher：WILEY-BLACKWELL  

Accidental whole-body overexposure of radiation occurs very rarely. Radiation exposure causes DNA breaks in the cells and shows various clinical features, which are time dependent, dose dependent and tissue dependent. Neutron rays are more destructive than gamma rays but their actual effect on humans have been under-reported. We observed the time-dependent and the dose-dependent dermatological changes in a patient who was severely irradiated by neutron and gamma rays, with the aim of clarifying the clinicopathological features of severely irradiated skin. The detection of DNA breaks in keratinocytes was performed by the terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick end labelling technique. The degenerative changes of the skin and the re-epithelialization varied in a time dependent and dose dependent manner. DNA breaks were significantly higher in irradiated keratinocytes. Neutron rays caused depth-dependent degeneration of the skin. Evaluation of DNA breaks in the skin cells might be a clue to estimate local dosimetry.

DOI： 10.1111/j.1365-2133.2007.08306.x

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Publisher：Elsevier BV  

DOI： 10.1074/jbc.m601643200

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Language：English   Publishing type：Rapid communication, short report, research note, etc. (scientific journal)   Publisher：BLACKWELL PUBLISHING  

DOI： 10.1111/j.1600-0749.2006.00310.x

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Language：English   Publishing type：Research paper, summary (international conference)   Publisher：NATURE PUBLISHING GROUP  

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Language：English   Publishing type：Research paper, summary (international conference)   Publisher：BLACKWELL PUBLISHING INC  

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Language：English   Publishing type：Research paper, summary (international conference)   Publisher：BLACKWELL PUBLISHING INC  

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Language：English   Publisher：AMER SOC BIOCHEMISTRY MOLECULAR BIOLOGY INC  

More than 125 genes that regulate pigmentation have been identified to date. Of those, MART-1 has been widely studied as a melanoma-specific antigen and as a melanosome-specific marker. Whereas the functions of other melanosomal proteins, such as tyrosinase, tyrosinase-related protein-1, dopachrome tautomerase, and Pmel17, are known, the function of MART-1 in melanogenesis, is unclear. A role for MART-1 in pigmentation is expected because its expression pattern and subcellular distribution is quite similar to the other melanosomal proteins and usually correlates with melanin content. We investigated the function of MART-1 using a multi-disciplinary approach, including the use of siRNA to inhibit MART-1 function and the use of transfection to re-express MART-1 in MART-1-negative cells. We show that MART-1 forms a complex with Pmel17 and affects its expression, stability, trafficking, and the processing which is required for melanosome structure and maturation. We conclude that MART-1 is indispensable for Pmel17 function and thus plays an important role in regulating mammalian pigmentation.

DOI： 10.1074/jbc.M413692200

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PubMed

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Language：English   Publishing type：Research paper, summary (international conference)   Publisher：BLACKWELL PUBLISHING INC  

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Language：Japanese   Publisher：(公社)日本皮膚科学会  

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Language：Japanese   Publisher：金原出版(株)  

症例1:70歳男.約1年前より右足に紅色結節がみられ,半年前より増大した.初診時,右足第II趾DIP関節伸側より遠位にかけて拇指頭大でドーム状に隆起する弾性硬の暗赤色腫瘤を認めた.症例2:56歳女.2年前より左小指に腫瘤が出現し,初診時,左小指DIP関節外側に,爪甲大で弾性硬な黄白色の腫瘤を認めた.いずれも病理組織で組織球様細胞の増殖と破骨型巨細胞の出現,また,ヘモジデリンの沈着が散在性にみられた.腫瘍細胞はビメンチン染色,CD68染色共に陽性であったが,前者が優位であった.腱鞘巨細胞腫の診断で腫瘍切除術を行った.症例1は術後6ヵ月現在,再発はみられない.症例2は切除3ヵ月後に再発・再切除したが,その後の再発はみられない.腱鞘巨細胞腫は切除後の再発率が高い良性腫瘍であることを念頭に置き,手術適応,術式を検討することが重要であると思われた

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Language：English   Publishing type：Research paper, summary (international conference)   Publisher：BLACKWELL PUBLISHING INC  

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Language：Japanese   Publisher：(公社)日本皮膚科学会  

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Language：Japanese   Publisher：(公社)日本皮膚科学会  

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Language：Japanese   Publisher：日本小児皮膚科学会  

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Language：Japanese   Publisher：(公社)日本皮膚科学会  

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Language：Japanese   Publisher：(公社)日本皮膚科学会  

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Language：Japanese   Publisher：(公社)日本皮膚科学会  

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Language：Japanese   Publisher：(公社)日本皮膚科学会  

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Language：Japanese   Publisher：(公社)日本皮膚科学会  

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Language：English   Publishing type：Research paper, summary (international conference)   Publisher：BLACKWELL PUBLISHING INC  

Web of Science

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Language：English   Publishing type：Research paper, summary (international conference)   Publisher：BLACKWELL PUBLISHING INC  

Web of Science

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Language：English   Publishing type：Research paper, summary (international conference)   Publisher：BLACKWELL SCIENCE INC  

Web of Science

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Language：Japanese   Publisher：金原出版(株)  

3歳女児.右足首に光沢のある硬化局面を認め,四肢,顔面にも硬化局面が出現.跛行を伴った.抗核抗体,抗ヒストン抗体陽性,抗ssDNA抗体,可溶性IL-2レセプター濃度高値.組織学的に真皮の膠原線維の膨化,増生,リンパ球主体の血管周囲性炎症細胞浸潤を認めた.以上よりgeneralized morpheaと診断し,ステロイド内服治療.症状の改善と共に抗ssDNA抗体価が低下した

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Language：English   Publishing type：Research paper, summary (international conference)   Publisher：BLACKWELL SCIENCE INC  

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Language：Japanese  

CiNii Books

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Language：Japanese   Publisher：日本小児皮膚科学会  

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