Severe mosquito bite hypersensitivity, natural killer cell leukaemia, latent or chronic active Epstein-Barr virus infection and hydroa vacciniforme-like eruption.
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Biomedical subjects
Publications and source records attributed to A Hidano.
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We describe a light, electron microscopic, and immunohistochemical study of basal cell carcinoma with eccrine differentiation. The cytoplasm did not stain with fat stain on cryostat sections, but contained numerous gland-like structures. Immunohistochemistry on formalin fixed, paraffin embedded tissues using antibodies to human involucrin, thirteen kinds of cytokeratin, S-100 protein, and carcinoembryonic antigen (CEA) was performed. We found that tumor cells were positive for keratin, PKK1, MA-903, No 8, No 19, AE 1, AE 3, and 5 + 8. Tumor cells were negative for S-100 protein, CEA, and the other antigens examined. Electron microscopy demonstrated short microvilli and amorphous materials within the intracytoplasmic cavity. We concluded that this tumor is basal cell carcinoma with eccrine differentiation.
We distributed a questionnaire to highlight the effects of post transfusion graft-versus-host disease (PT-GVHD) and to elucidate the risk factors that would predispose people to the disease. The questionnaire described the pathogenesis and the clinical profiles of PT-GVHD and was distributed to doctors in Japan whose hospital conducted more than 1000 units of blood transfusions a year. Doctors were asked about their awareness and experience of PT-GVHD cases. Those who had seen cases of PT-GVHD were then asked to detail clinical course and laboratory data. Of the 14,083 doctors who replied to the first question, 47.4% did not realise that PT-GVHD could occur in immunocompetent hosts. From 304 cases where detailed information was supplied, 171 were considered clinically compatible with PT-GVHD. From these it seems that the risk factors linked to PT-GVHD are cardiovascular surgery, cancer, fresh and consanguineous blood transfusion, and being male. Patients with any of these factors should have some prophylactic therapy such as irradiation of blood before transfusion.
Thirty-two cases are described of a relatively rare form of benign connective tissue proliferation characterized by ectopic fatty tissue in the dermis. The lesions usually appear as large, solitary, slow-growing, pedunculated to dome-shaped, skin-colored nodules or plaques showing predilection for the buttock and upper thigh. Other areas involved include the back, shoulder, knee, neck, and ear. Twenty patients were women and 12 were men, 19 to 78 years of age (mean, 46.9 years). The size of the lesions ranged from 4 to 69 mm (mean, 49 mm). Histologically, the lesions were characterized by the presence of mature adipose tissue infiltrating around the periadnexal adventitial dermis and between adnexal structures and admixing with dense stromal collagen. Marked deposition of mucopolysaccharides was noted in the majority of the lesions. Clinical follow-up in all 32 patients showed no evidence of recurrence. Because of their distinctive clinicopathologic features, we prefer to designate these lesions as solitary, pedunculated lipofibroma. In addition, seven of the patients had diabetes mellitus, suggesting a possible relation between the two conditions.
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A case of transfusion-associated graft-versus-host disease (TA-GVHD) in a patient with non-Hodgkin's lymphoma is reported. The patient, a 67-year-old woman, was diagnosed as having diffuse, mixed type non-Hodgkin's lymphoma, at clinical stage IIIA. She was treated with combination chemotherapy and received multiple blood transfusions for anemia and thrombocytopenia. Although white cells (WBCs) were reduced in the transfused components by WBC-reduction filters, the patient developed TA-GVHD that was confirmed by skin biopsy. It is suggested that the WBC reduction attained with these filters does not prevent TA-GVHD in immunocompromised patients. It is recommended that all blood components should be irradiated before transfusion to such patients.
By sending questionnaires to the major dermatological clinics in Japan, we examined the outcome and causes of death in 182 cases of dermatomyositis (DM) observed between 1983 and 1987. The mortality rate in adults was 26.7%. Associated malignancy occurred in 47 cases (25.8% of adults), and 16 of them died of neoplasms. In contrast to 43 carcinomas, only 1 patient died of lymphoma. Associated interstitial pneumonitis (IP) appeared in 31 cases. IP started simultaneously or within 6 months after the diagnosis of DM in the majority of these cases. Of the 13 fatal cases due to IP, 8 died of respiratory failure within two months of the onset of lung disease. In the malignancy group, periungual erythema was noted in a higher proportion. Raynaud's phenomenon was more frequently noted in the IP group. DM overlapped with other collagen diseases in 14 cases.
We report a 38-year-old woman who developed an erythematous nodule on her earlobe after wearing pierced-type 18-carat gold earrings. Biopsy specimens revealed dense cellular infiltration predominantly composed of lymphocytes and plasma cells in the dermis and subcutaneous tissue with formation of lymph follicles. Morphological and immunohistochemical analyses were compatible with lymphadenosis benigna cutis.
A 52-year-old woman presented with psoriasis vulgaris, Sjögren's syndrome, and Hashimoto's thyroiditis with a 5-year history. She had a number of immunological abnormalities and typical psoriatic plaques over her entire body. The relationship between psoriasis, Sjögren's syndrome, and Hashimoto's thyroiditis is discussed from the viewpoint of immunology, and similar cases in the literature are reviewed. This is the first report of a coexistence of psoriasis vulgaris, Sjögren's syndrome, and Hashimoto's thyroiditis.
A 44-year-old man who had suffered for 6 years from multiple myeloma developed multiple papules on the face and chest. Histological examination of these papules revealed the infiltration of predominantly histiocytic cells into the dermis and into parts of the epidermis. These cells were seen on electron-microscopic study to have Langerhans granules in the cytoplasm, which led to a diagnosis of Langerhans-cell histiocytosis concomitant with multiple myeloma. Possible explanations for this unusual association are discussed.
A case of multicentric reticulohistiocytosis complicated by severe progressive erosive arthritis in a 40-year-old man is described. The diagnosis was confirmed by biopsies of the cutaneous nodule and the synovial tissue of the right knee joint. Destructive changes in the multiple joints rapidly progressed and resulted in severe progressive erosive arthritis. Immunohistochemical staining revealed that the histiocytes reacted positively to interleukin 1 beta and platelet derived growth factor B, leading to the speculation that these cytokines may play a role in the synovial proliferation seen in patients with multicentric reticulohistiocytosis.
A 68-year-old Japanese woman presented with a brownish macule, containing two papules, on her left fourth toe. Histological examination revealed an intradermal epithelioid cell tumour with irregularly shaped, bizarre giant cells. In the upper portion of the tumour, the epithelioid cells contained abundant melanin. A low amount of 5-S-cysteinyldopa and a diploid DNA distribution histographic pattern were helpful in differentiating the lesion from malignant melanoma. This location of a Spitz naevus is exceptional.
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Stratum corneum lipids are an important determinant for both water-retention function and permeability-barrier function in the stratum corneum. However, their major constituent, ceramides, have not been analyzed in detail in skin diseases such as atopic dermatitis that show defective water-retention and permeability-barrier function. In an attempt to assess the quantity of ceramides per unit mass of the stratum corneum in atopic dermatitis, stratum corneum sheet was removed from the forearm skin by stripping with cyanoacrylate resin and placed in hexane/ethanol extraction to yield stratum corneum lipids. The stratum corneum was dispersed by solubilization of cyanoacrylate resin with dimethylformamide, and after membrane filtration, the weight of the stratum corneum mass was measured. The ceramides were quantified by thin-layer chromatography and evaluated as microgram/mg stratum corneum. In the forearm skin of healthy individuals (n = 65), the total ceramide content significantly declined with increasing age. In atopic dermatitis (n = 32-35), there was a marked reduction in the amount of ceramides in the lesional forearm skin compared with those of healthy individuals of the same age. Interestingly, the non-lesional skin also exhibited a similar and significant decrease of ceramides. Among six ceramide fractions, ceramide 1 was most significantly reduced in both lesional and non-lesional skin. These findings suggest that an insufficiency of ceramides in the stratum corneum is an etiologic factor in atopic dry skin.
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Four cases of dermal melanocytosis with symmetrical areas of hyperpigmentation involving the face and extremities are reported. Light and electron microscopic studies showed changes similar to those seen in naevus of Ota.
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