Biomedical subjects
Publications and source records attributed to I Katayama.
A patient with psoriasis vulgaris developed verruciform xanthoma (VX) on the scrotum during psoralen photochemotherapy (PUVA). Although it is uncertain whether VX was induced by PUVA therapy, we report the first case of VX which appeared in a patient with psoriasis during PUVA therapy. We speculate that UV light may be one of the etiologic factors triggering VX in this case.
BACKGROUND: Multiple dermatofibromas (DFs) are often associated with systemic lupus erythematosus (SLE). An increased number of mast cells is observed in the upper portion or over the lesion of DF. OBJECTIVE: To investigate the role of the serum of a patient with multiple DFs, we examined its growth effects on fibroblasts. METHOD: 3H-Thymidine incorporation was used to examine the effects of the serum of an SLE patient with multiple DFs on fibroblasts derived from DF and normal skin. RESULTS: The serum of the SLE patient with multiple DFs exhibited a stronger growth-stimulatory activity on normal and DF-derived fibroblasts in a dose-dependent manner, compared to that of SLE without DFs or normal sera. The growth effects were inhibited in 40% by antiplatelet-derived-growth-factor antibody and almost completely inhibited by antibody against basic fibroblast growth factor. Cultured fibroblasts derived from the upper portion of the DF lesion, which included most of the numerous mast cells, demonstrated a higher level of 3H-thymidine uptake after stimulation of autologous serum compared to that from the mid and lower portions of DF. CONCLUSION: These results suggested the existence of various fibroblast growth factors derived from the mast cells in SLE patients with multiple DFs.
BACKGROUND: Multiple dermatofibromas (DFs) have been reported to develop in various disorders, especially in systemic lupus erythematosus (SLE). OBJECTIVE: To investigate the role of mast cells in the formation of multiple DFs in association with autoimmune disorders, we quantified the number of mast cells. METHODS: Three cases who developed multiple DFs with positive antinuclear antibodies are described; a 54-year-old woman with a 10-year history of SLE with 13 lesions, a 33-year-old woman with 11 lesions and a 46-year-old woman with SLE and Sjögren syndrome with 10 nodules. Distribution and number of mast cells were examined in the removed lesions of DFs. RESULTS: In 2 cases, mast cells in the upper portion of the lesions were increased in number in comparison with the solitary DF, nevocellular nevus and normal skin. These 2 cases had early DFs from the onset; in the remaining case in which mast cell number was not increased, they were old or fading lesions. CONCLUSION: It is suggested that mast cells may play a role in induction and exacerbation of the fibrotic process of multiple DFs, and they are supposed to be a reactive hyperplasia in association with systemic autoimmune disorders.
We describe a case of primary multiple cutaneous plasmacytosis successfully treated by intralesional steroid therapy. Plasma interleukin-6 (IL-6) levels reduced in parallel with the disease activity. Intralesional steroid reduced IL-6 production by peripheral blood mononuclear cells, while neither PUVA therapy nor intralesional recombinant interferon-gamma resulted in a benefit and plasma IL-6 levels did not decrease. It was suggested that IL-6 might play an important role in the pathogenesis of this condition.
We have analyzed 8 patients (6 men and 2 women, aged 52 to 70 years) with psoriasis associated with hepatitis C virus (HCV) infection among 79 psoriatic patients. Psoriasis preceded in 6 cases. One patient had generalized pustular psoriasis (GPP), and the others had psoriasis vulgaris (PV). The psoriasis area and severity index (PASI) score ranged from 2.7 to 32.4. Two of the patients were treated with interferon-gamma. Anti-HCV antibodies were detected in all cases by second generation enzyme-linked immunosorbent and recombinant immunoblot assay. HCV messenger RNA was demonstrated by reverse transcriptase polymerase chain reaction in the tissue sections of the lesions of 1 of the patients with PV and the patient with GPP, providing evidence for active viral replication in the skin lesion. HCV-related chronic active hepatitis might cause several immunological abnormalities. It is suggested that this infection might be one of the triggering factors of psoriasis.
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Perifollicular fibroma (PF) is a cutaneous hamartomatous proliferation of the pilar connective tissue sheath. It occurs predominantly on the face or neck in a solitary or multiple form. Histologically, it is characterized by a concentric arrangement of collagen fibers surrounding hair follicles. Other related proliferations include fibrofolliculoma and trichodiscoma, which are often complicated or have histological overlapping features, so they may represent the same spectrum of pilar mesodermal proliferation. Some individuals with multiple PFs have colonic polyposis, some of which develop into carcinomas, and there are suggestions of autosomal dominant inheritance. It appears that patients with multiple PFs and/or other connective tissue hamartomas may be at risk for colonic polyposis. Cutaneous signs may lead to an early discovery of digestive diseases.
The effect of interleukin 1 (IL-1) was studied on leukemic cells from 12 patients with B cell chronic lymphoid leukemias including two cases of hairy cell leukemia (HCL), two cases of HCL-variant (HCL-V), one case of prolymphocytic leukemia (PLL), and seven cases of chronic lymphocytic leukemia (CLL). In most cases, IL-1 induced differentiation characterized by increments of sIg gamma+, sIg mu+ and PCA-1+ cells, and a decrement of CD5+ cells, and activation characterized by increments of CD23+ and HC2+ cells, but induced the proliferation of leukemic cells only in two HCL-V cases. Among these effects, increment of sIg+ cells was observed more frequently in non-CLL (4/5 cases) than in CLL (2/7 cases), and increments of sIg gamma+, CD23+ and PCA-1+ cells were induced more frequently by IL-1 beta than by IL-1 alpha. These results suggest that IL-1, especially IL-1 beta, plays a significant role in the differentiation and activation of leukemic cells, but has only a minor role as an extrinsic/leukemic cells in B cell chronic lymphoid leukemias, particularly those with more mature cells such as PLL and HCL.
PURPOSE: In a prospective crossover study, we evaluated the safety and antiemetic activity of granisetron, a 5-hydroxytryptamine3 (5-HT3) receptor antagonist, compared with conventional antiemetics regimen, including metoclopramide, in pediatric cancer patients. PATIENTS AND METHODS: Twenty-two children with malignant diseases were enrolled. The chemotherapy included cytarabine 3 g/m2 (regimen A), cisplatin 90 mg/m2 (regimen B), and actinomycin D 900 micrograms/m2 plus ifosfamide 3 g/m2 (regimen C). Granisetron 40 micrograms/kg was infused over 30 min just before each chemotherapy treatment. RESULTS: A complete response was obtained more often with granisetron than with conventional antiemetics (59.1% vs. 0%, p < 0.001). In terms of efficacy by chemotherapy type, complete response with granisetron was obtained in eight of 10 patients with regimen A, three of eight with regimen B, and two of four with regimen C. Major efficacy (vomiting fewer than two times) was also obtained more with granisetron than with conventional antiemetics (81.8% vs. 4.6%, p < 0.001). The number of vomiting episodes in the first 24 h was less with granisetron than with conventional antiemetics (1.1 +/- 1.46 vs. 9.0 +/- 4.97, p < 0.001). Normal appetite and activity were retained in more patients with granisetron than with conventional antiemetics. Extrapyramidal reactions, akathisia, and sedation were not seen in any case with granisetron. CONCLUSIONS: Granisetron 40 micrograms/kg is well tolerated and more effective than are conventional antiemetic regimens containing metoclopramide for children receiving cancer chemotherapy.
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Three cases of keratosis follicularis squamosa (Dohi) and one case of papillomatose confluente et reticulee were successfully treated with oral minocycline (50-100 mg/day). The clinical effect first appeared at 2 weeks after the initiation of therapy and no recurrence was observed for more than 3 months without minocycline. Gram positive cocci were demonstrated inside the hair follicle and horny layers in all 4 case. Minocycline might modulate abberant keratinization through its bactericidal effects in these keratinizing disorders.
A 63-year-old woman with dermatomyositis (DM) developed multiple punched-out ulcers of the skin. She had not only a past history of gastric cancer 10 years prior to the onset of DM, but also a familial history of cancer. A skin biopsy from one of the ulcers revealed both vasculitis and membrano-cystic lesion in the same specimen. She died of interstitial pneumonitis one year after the onset of DM. Vasculitis and membrano-cystic lesion may be an important marker of a poor prognosis in DM.
A patient with progressive systemic sclerosis and high levels of serum IgE developed multiple papules at/on an area of non-sclerotic skin. Histologic examination of the papule revealed the typical features of scleroderma. For several years, the patient had been working on polishing watches with an abrasive agent composed mainly of aluminum, chromium dioxide, and silica. An association of the abrasive agent, especially of the silica component, with the scleroderma was circumstantially suspected. To the best of our knowledge, this is the first report of nodular scleroderma which occurred in the course of PSS being associated with chemical agents.
Two cases of eccrine poroma with calcification were described, both of which were those of the Winkelmann-MacLeod type. They occurred on the face and lower leg. We supposed that calcification in both cases was dystrophic in nature due to minor pressure or injury. The feature of calcification within the nests of eccrine poroma has rarely been reported. However, it seemed to be physiologically consistant that calcification occurs in eccrine poroma which originates from eccrine sweat glands.
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