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Biomedical subjects

H Tagami

Publications and source records attributed to H Tagami.

At least 55 records · Page 3Linked to original sources

Keratoacanthoma developing in prurigo nodularis treated with cryotherapy.

We describe an elderly woman in whom keratoacanthoma developed from one nodule of prurigo nodularis that had been treated with cryotherapy for 3 months. Since in our case keratoacanthoma developed after treatment with liquid nitrogen for prurigo nodularis which had been constantly scratched in the past, we hypothesize that irritations of cryotherapy in addition to repeated mechanical traumas of scratching might have played a role in the formation of this tumor.

Aged

Metaplastic bone formation in the subcutaneous nodule of a patient with mixed connective tissue disease.

Cutaneous ossification is a rare phenomenon in collagen diseases, despite the rather frequent occurrence in these diseases of dystrophic calcinosis. We observed metaplastic woven bone formation associated with calcification in biopsy material obtained from a 49-year-old woman suffering from mixed connective tissue disease together with multiple subcutaneous indurations. This is the first case of the presence of metaplastic bone formation in a patient with mixed connective tissue disease.

Female

Comparison of immune reactivity profiles against various environmental allergens between adult patients with atopic dermatitis and patients with allergic respiratory diseases.

To clarify the pathomechanisms underlying the involvement of different organs by atopic dermatitis (AD) and allergic respiratory disease (ARD), we compared the immune reactivities to various environmental allergens between 46 adult patients who suffered only from AD but were without any history of ARD and 41 patients who had only ARD, using a RAST FEIA (radioallergosorbent test/fluoroenzyme immunoassay) and a scarification patch test. We also studied 42 healthy adult subjects in a similar fashion. Total serum IgE antibody levels were found to be far higher in the AD group than in the ARD and healthy control group, and RAST revealed that the AD group was sensitized to far larger numbers of allergens such as food mix, cereal mix, fungus mix and Candida albicans than were the other groups. The ARD group displayed a high incidence in RAST, comparable to that of the AD group, only against Japanese cedar and grass pollen mix antigen. However, the most remarkable difference in the immune reactivity profiles was that the AD group showed a uniquely higher RAST score and a lower incidence of positive patch test reactions to C. albicans antigen than did the ARD group. The reactivities in the ARD group to C. albicans antigen did not differ from those in the control group. Our present data suggest that a more pronounced shift from Th1 to Th2 cells, reactive against various allergens, takes place in AD patients.

Adolescent

Non-pigmented nodular plantar melanoma in 12 Japanese patients.

In the Japanese, melanoma most commonly involves the plantar surface. Among 61 patients with plantar melanoma, we diagnosed 50 patients as acral lentiginous melanoma (ALM), nine as nodular melanoma, and two as superficial spreading melanoma. Partial or complete loss of pigment was observed in four of the nine nodular melanoma cases and in the nodular portions of eight ALM cases. All 12 such nodular lesions were ulcerated. The clinical diagnosis of malignant melanoma was easily made in the eight patients with ALM by the characteristic pigmentary changes around the nodule. The presence of some remaining pigment was found to be helpful in making the diagnosis in two lesions of nodular melanoma which, at first, had been clinically diagnosed as eccrine poromas. One of two completely amelanotic nodular melanomas was strongly suspected to be a melanoma because there was a history of a pre-existing pigmented macule before the development of the nodule. The other one required histopathological differentiation from Merkel cell carcinoma. Based on these findings and compared with melanoma on other parts of the body, pigmentation noted in the ulcerative nodule of plantar melanoma seems to disappear easily. This causes difficulty in distinguishing it from other skin tumours.

Aged

Normal recovery of the stratum corneum barrier function following damage induced by tape stripping in patients with atopic dermatitis.

Patients with atopic dermatitis (AD) constantly inflict mechanical damage to their skin by scratching induced by pruritus. On excoriated lesions of the cheek we found exceedingly high levels of transepidermal water loss (TEWL) as compared to those in the normal skin of healthy subjects. However, it is not clear whether the skin of patients with AD also shows an abnormally slow recovery after mechanical damage. We compared the recovery of the barrier function of the stratum corneum (SC), after its complete removal by tape stripping, in patients with AD and age-matched healthy control subjects. On the normal-looking skin of the flexor forearm, we found no difference in the recovery process of the water barrier function of the SC between the two groups. This suggests that ability to reconstruct SC barrier function after mechanical damage is not impaired in AD patients.

Adult

Interferon-gamma and interleukin-10 inhibit antigen presentation by Langerhans cells for T helper type 1 cells by suppressing their CD80 (B7-1) expression.

CD80(B7-1) and CD86(B7-2) co-stimulatory molecules have been reported to activate Th1/Th2 development pathways differentially. It is well known that Langerhans cells (LC), potent antigen-presenting dendritic cells in the epidermis, express several co-stimulatory molecules and that this expression is modulated by several cytokines. Based on the recently reported effect of interferon (IFN)-gamma and interleukin (IL-)-10 on the expression of CD80 and CD86 by LC, we examined the effects of these cytokines on the expression of CD54 (intercellular adhesion molecule-1) and CD40 in addition to CD80 and CD86 on LC, and correlated the expression of each co-stimulatory molecule with antigen presentation for a Th1 clone by cultured LC (cLC) treated with these cytokines. LC cultured for 72 h significantly up-regulated MHC class II antigen expression and all the co-stimulatory molecules were examined. As previously reported, IL-10 or IFN-gamma inhibited the up-regulation of CD80 expression. Granulocyte/macrophage-colony-stimulating factor (GM-CSF) partially restored the suppression of CD80 expression induced by IFN-gamma on cultured LC, while it had virtually no effect on the inhibition induced by IL-10. Antigen presentation for the myoglobin-specific syngeneic Th1 clone by cLC, which were pre-incubated with these cytokines, correlated well with their CD80 expression. In addition, among the antibodies for CD80, CD86, CD28 or CD40, the suppression of the Th1 clone stimulation by LC was found to occur only with anti-CD80 and anti-CD28 antibodies. Finally, we studied the effects of IFN-gamma and IL-10 on GM-CSF production by epidermal keratinocytes (KC). We could show that only IFN-gamma, but not IL-10, suppressed GM-CSF production by KC. These findings suggest that both IFN-gamma and IL-10 suppress antigen presentation by LC for Th1 cells by suppressing their CD80 expression. The inhibitory effect of IFN-gamma on CD80 expression on LC appears to be partially mediated through the suppression of GM-CSF production by KC.

Animals

Reduced proliferative responses of peripheral blood mononuclear cells specifically to Candida albicans antigen in patients with atopic dermatitis--comparison with their normal reactivity to bacterial superantigens.

Although reduced cutaneous reactivities to Candida albicans have been reported in patients with atopic dermatitis (AD), there is still controversy as to whether the in vivo lymphocyte proliferation response is normal or reduced. We have also reported that patients with AD manifest a decreased cutaneous response only to C. albicans antigen in scarification patch tests. The purpose of this study was to examine whether patients with AD show normal lymphocyte transformation responses to C. albicans antigen. Peripheral blood leucocytes (PBL) from 21 patients with AD and 14 healthy control (HC) subjects were cocultured with optimal concentrations of C. albicans antigen and of superantigens (staphylococcal enterotoxin A and B). PBL from the patients with AD showed a significantly lower response to C. albicans antigen, but there was no statistically significant difference in PBL responses to superantigens between the patients with AD and the HC subjects. This decreased proliferative response of PBL was particularly noticeable in those whose RAST scores for C. albicans antigen were high. These results suggest the development of a specific anergy to C. albicans antigen in patients with AD.

Adolescent

Interleukin-1 beta and granulocyte-macrophage colony-stimulating factor mediate Langerhans cell maturation differently.

It has been reported that the in vivo maturation of Langerhans cells after hapten painting is mediated by IL-1 beta while Langerhans cell maturation after in vitro culture is mediated by granulocyte-macrophage colony-stimulating factor (GM-CSF). To clarify the reason for this discrepancy, we examine the expression of Ia antigen and several co-stimulatory molecules on Langerhans cells that were activated by in vitro culture, by hapten painting, or by an intradermal injection of several cytokines. Both cultured Langerhans cells and those activated by hapten painting increased the expression of Ia antigen and all the co-stimulatory molecules (i.e., intercellular adhesion molecule-1 [ICAM-1], B7-1, B7-2, and CD40). In contrast, an intradermal injection of interleukin-1 beta (IL-1 beta) or tumor necrosis factor-alpha (TNF-alpha) increased the expression of Ia antigen, ICAM-1, B7-2, and CD40, but not that of B7-1. These data indicate that IL-1 beta or TNF-alpha is not sufficient to induce B7-1 expression on Langerhans cells in vivo. Subsequently we examined the effect of anti-cytokine antibodies (Abs) on the expression of those molecules on cultured Langerhans cells. While none of the Abs to IL-1 beta, TNF-alpha, or GM-CSF changed the upregulation of Ia antigen, ICAM-1, or CD40 on cultured Langerhans cells, anti-GM-CSF Ab suppressed that of B7-1 and B7-2. Taken together, our present results suggest that IL-1 beta is required for the upregulation of Ia, ICAM-1, B7-2, and CD40, while GM-CSF is required for the upregulation of B7-1 and B7-2, although it still remains unclear why the injected GM-CSF could not augment B7-1 expression on Langerhans cells in vivo and why anti-IL-1 beta Ab did not suppress the upregulation of Ia, ICAM-1, or CD40 on cultured Langerhans cells.

Animals

Successful treatment of a therapy-resistant severely pruritic skin eruption of malignancy-associated dermatomyositis with high-dose intravenous immunoglobulin.

Malignancy-associated dermatomyositis developing in a middle-aged Japanese female was successfully treated by removal of her gastric cancer. However, five years later, concomitant with catching a cold, her severely pruritic skin lesions recurred on exposed areas. Six years after the start of corticosteroid therapy for her annoying skin lesion, we started to treat her with high-dose intravenous immunoglobulin (IVIG) infusion therapy because of the difficulty of reducing the dosage of oral prednisone, that had secondarily induced adverse effects. After five courses of the therapy, her recalcitrant, pruritic, erythematous skin lesions improved dramatically, enabling a satisfactory reduction in the dosage of oral prednisone. There were no significant adverse side effects with IVIG.

Dermatomyositis

Phospholipases induce melanogenesis in organ-cultured skin.

Guinea pig skin becomes more pigmented following exposure to UV rays. This melanization was accompanied by enhanced intensity of tyrosinase-staining and increased number of tyrosinase-positive melanocytes (MELty+), with resultant enhancement of melanin synthesis. To clarify the regulatory mechanism for melanization following UV irradiation, organ-cultured guinea pig skins have been used to examine their melanogenic responses to exogenous stimulation. This organ culture system responded well to UV irradiation, by increasing melanogenic activity. Also, in this system, phospholipases (PL), arachidonic acid, interleukin-1 alpha and melanocyte-stimulating hormone, but not endothelin-1 or phosphatidylinositol-specific PLC (PI-PLC), stimulated melanogenesis to various extents as indicated by the number of MELty+ and morphological changes. Among them, the PLA2 and PLD were found to have a potent stimulatory property for melanocytes. They might affect melanocytes directly or indirectly through an effect on keratinocytes. These results suggest that PLA2 and PLD play a key role in epidermal hyperpigmentation after UV irradiation or inflammation.

Animals

Clinicopathological study of acral melanoma in situ in 44 Japanese patients.

BACKGROUND: Acral lentiginous melanoma (ALM) has been a major focus of interest in Japan in the last 2 decades. A remarkable improvement recently made in the prognosis of ALM at our institution may possibly be explained by early detection including melanoma in situ. OBJECTIVE: We have retrospectively studied 44 cases of melanoma in situ in the past 25 years from 1970 to 1994, 61% of which have been seen in the last 5 years. RESULTS: Of 190 cases of invasive malignant melanoma including 20 melanomas involving the mucous membrane, 96 were ALM. Accordingly, the number of cases of melanoma in situ involving the acral regions was also prominent. Of 44 melanomas in situ, 29 occurred in the acral regions. Eight lesions localized on the face were compatible with lentigo maligna both clinically and histologically. All 6 mucosal lesions occurred on the oral mucosa. The remaining lesion appeared on the back of a psoriatic patient treated with photochemotherapy. Forty-two specimens showed histologically a lentiginous proliferation including atypical solitary cells within the lower portion of the epidermis, especially in the basal layer. The remaining 2 specimens were histologically of the pagetoid type. CONCLUSION: Corresponding to the fact that ALM are predominant in the Japanese, the most common sites of melanoma in situ are also the acral regions.

Adolescent

Contact dermatitis of the ear due to a rubber earplug.

We report a case of contact dermatitis of the ear canal due to rubber earplugs. A 31-year-old Japanese woman had a 2-year history of eczema confined to her ears. Applications of various topical steroids had shown no beneficial effect upon her lesions. Considering contact dermatitis as a possible diagnosis we performed patch tests. Positive eczematous patch test results were obtained with mercaptobenzothiazole, tetramethylthiuram disulfide and her rubber earplugs, which she had used whenever she took a bath. The eruption cleared after the patient stopped using the rubber earplugs.

Adult