[Immunofluorescence technic and skin diseases with bacterial participation].
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Biomedical subjects
Publications and source records attributed to S Imamura.
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The indirect hemagglutination (HA) test using freeze-dried tanned formalinized sheep erythrocytes sensitized with deoxycholate-extracted leptospiral antigen was investigated for its applicability to serodiagnosis of leptospirosis. The sensitized erythrocytes suspension containing an adequate concentration of glycine was lyophilized and used for the HA test. The lyophilized sensitized cells are rehydrated after at least 10 months storage without any loss of HA titer. The sensitivity of such cell suspension tested on sera from cases of leptospirosis equals that of the suspension before freeze-drying.
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Based on clinical and histological studies in 25 patients, we have confirmed that plane warts show a characteristic phenomenon of spontaneous regression totally distinct from that described in common warts. This regression developed during various treatments in nine cases, and in 16 cases, it occurred spontaneously. In all the patients, there was a sudden and systemic onset of inflammation in every flat wart. Within two to six weeks, all the warts completely involuted. Histologically, there were variable degrees of epidermal changes depending on the stage of inflammation. However, a mononuclear cell infiltration with epidermal invasion was demonstrated in every biopsy specimen. This evidence further supports the earlier concept that this regressive phenomenon of plane warts is mediated by cellular immunity. It represents a natural experimental model of rejection of tumors induced by papovavirus in humans.
The regressing process of plane warts can be divided into two phases: initial changes of wart virus-infected cells that later result in degeneration of warts, and recovery phase in which degenerating warts are rejected from the level of the basal layer followed by regeneration of normal epidermal cells from the surrounding epidermis. Electron microscopic observations of recovery phase of wart regression showed (1) the epidermal lesion was clearly divided into degenerating wart possessing altered viruses and regerating epidermis; (2) melanocytes were demonstrated in degenerating warts; and (3) a new granular layer was evident beneath regressing wart in late recovery. Throughout the recovery process, infiltration of lymphocytes and macrophages was observed only in regenerating epidermis.
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17 patients with generalized vitiligo and 5 patients with localized vitiligo were treated with oral corticosteroids. Six patients with generalized vitiligo showed over 75% repigmentation in at least one of the patches. Two patients with generalized vitiligo and 1 patient with localized vitiligo showed a partial repigmentation of 25-75%, while 5 patients with generalized vitiligo and 1 patient with localized vitiligo showed a minimal repigmentation of less than 25%. Four patients with generalized vitiligo and 3 patients with localized vitiligo failed to respond. Repigmentation became evident within 4 weeks in most cases, and in general was more markedly noted in exposed areas.
An unusual vesculobullous disease and myasthenia gravis occurred concurrently with a malignant thymoma in a Japanese male. The bullous dermatosis had combined clinical and histological features of both dermatitis herpetiformis and pemphigus. Serum showed striated muscle antibodies and intercellular epithelial autoantibodies; the latter had been demonstrated even prior to the development of the skin lesions. Thus, immunologically, this dermatosis was confirmed to be a variety of pemphigus.
Pemphigus-like antibodies were demonstrated in a patient with dermatitis herpetiformis. The patient was a 28-year-old Japanese who showed itchy tense bullae on the back, chest and shoulders. We speculate the antibodies are similar to those found in burns, drug eruptions and certain other skin diseases.
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A 25-year-old Oriental woman developed systemic lupus erythematosus during a course of treatment with carbamazepine for long-standing idiopathic epilepsy. Serum IgA was virtually absent, while secretory IgA was quantitated in a small amount in the saliva and gastric juice. Results of immunofluorescent studies on the rectal mucosa and bone marrow did not show any IgA-producing plasma cells. Antibodies against IgA, IgM, milk protein, and bovine serum were detected in the serum. The ability to develop both circulating antibodies and delayed hypersensitivity against test antigens was suppressed. Enumerations of T lymphocytes and IgG and IgM B lymphocytes were within normal limits, whereas IgA B lymphocytes were decreased in number. Results of chromosomal analyses disclosed various abnormalities.
The localization of gram-positive cocci in the normal skin and in the lesions of acne vulgaris was investigated using fluorescein-labeled antiserum raised to gram-positive, coagulase-negative cocci. The cocci were found in 10 of 19 specimens from normal facial skin and in 3 of 11 specimens from the normal skin of the rest of the body. The bacteria were found mostly in the openings of follicles, but in 6 of 10 facial skin specimens, they were also present deeply in the lumina of the dilated sebaceous follicles near the sebaceous glands. Cocci were found in 5 of 6 noninflammatory acne comedones. In inflammatory acne they were demonstrated not only in the follicular canals but also sparsely in the infiltrate surrounding the follicles.
We describe two cases of kerion caused by Trichophyton rebrum and Microsporum gypseum. In the histological sections, a PAS stain revealed a small number of hypha-like rods and spore-like round bodies in the dermis of patient 1. Except for some clusters of PAS-positive materials, no definite fungal elements were observed in the dermis of patient 1, whereas a considerable number of hyphae were demonstrated within a hair shaft. Immunofluorescence staining, using fluorescein-labeled T mentagrophytes antiserum, disclosed the presence of fungal antigens, not only within a hair shaft, but also in the inflammatory infiltrate in the dermis of both patients.
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