Fumio Shigemi

Immunohistological analysis of P53 expression in human skin tumors

The p53 expression in various skin tumors was immunohistologically evaluated using two mouse monoclonal anti-p53 antibodies, PAb421 and PAb1801. The p53 expression was not detected in the normal epidermal cells. Nuclear staining suggested that the p53 expression was observed in 10 of 26 squamous cell carcinomas (SCCs) from 24 patients, in one undifferentiated carcinoma, one proliferating trichilemmal cyst, one malignant proliferating trichilemmal tumor and in one metastatic carcinoma of breast cancer. None off four cases of Bowens disease (SCC in situ) showed nuclear staining. In the SCCs, five of 20 primary lesions, three of four recurrent lesions and both of two metastatic lesions had positive nuclei. There was one case of SCC in which a primary lesion was negative but a recurrent lesion was positive. Thus, p53 expression was more frequently observed in SCCs at more clinically advanced stages. This may suggest that p53 has some relevance to progression of SCC. Nuclear staining was not detected in any of the following cases: two cases of seborrheic keratosis, one eccrine poroma, one keratoacanthoma, 11 basal cell epitheliomas, two mammary Pagets disease, three genital Pagets disease, one sebaceous carcinoma, four malignant melanomas, six lymphomas, two leukemia cutis and two angiosarcomas.

Immunohistochemical demonstration of peptidylarginine deiminase in human sweat glands.

Human skin is known to contain protein-bound citrulline. This is the product of enzymatic deimination of arginine residues catalyzed by peptidylarginine deiminase. We probed frozen sections of human skin with a rabbit antiserum raised to rat skeletal muscle peptidylarginine deiminase using the avidin-biotin-peroxidase complex technique. This led us to interesting findings. No staining was observed in epidermis, inner root sheaths of hair follicles, sebaceous glands, and hair erector muscle. However, we noticed specific staining of the cytoplasm of secretory and myoepithelial cells of both eccrine and apocrine sweat glands. The procedure also stained neoplastic cells present in specimens dissected from extramammary Pagets disease. The data mean that peptidylarginine deiminase may be used as a new marker in the classification of skin neoplasms showing sweat gland differentiation. Possible localization of multiple types of peptidylarginine de-iminases in human skin is discussed.

A CASE OF SENSITIZATION TO ORAL CORTICOSTEROIDS

A 29 year‐old woman who developed generalized erythematous eruptions after oral treatment with predonisolone tablets for facial dermatitis is described. Patch tests showed a positive reaction to both predonisolone tablets diluted in cream and a commercial predonisolone ointment. After oral challenges with 5mg predonisolone in tablet form and 4mg predonisolone powder, similar eruptions reappeared the next day. In both patch and dose testing with many kinds of corticosteroids, the patient showed a cross‐sensitivity to methyl‐predonisolone and its acetate only.

FIBRINOLYTIC THERAPY FOR PROGRESSIVE SYSTEMIC SCLEROSIS AND TISSUE FIBRINOLYTIC ACTIVITY IN AFFECTED SKIN

In our present study, impairment of tissue fibrinolytic activity was observed in the affected skin of patients with progressive systemic sclerosis (PSS) by fibrinolytic autography. We treated PSS with a fibrinolytic agent, urokinase, based on the idea that the impairment of tissue fibrinolytic activity is implicated in the development of PSS. Two patients with PSS have responded favorably well to administration of Urokinase.

TISSUE FIBRINOLYTIC ACTIVITY OF ALLERGIC CONTACT DERMATITIS

One of our co‐workers was sensitized with a 1% DNCB solution in acetone. Biopsies were obtained from skin lesions 1, 2, 4, 8, 12, 24, 30, 36 and 48 hours after a challenge with 0.1% DNCB solution. In the upper dermis, a rapid decrease of tissue fibrinolytic activity was found which disappeared after 30 hours. In the lower dermis, biphasic changes were observed. Tissue fibrinolytic activity increased one hour and 12–36 hours after challenge, whereas at 48 hours, when erythema was most intensive, it decreased in comparison to the normal activity.

Statistical Survey of Patients with Drug Eruption at Department of Dermatology, Tokushima University (1963—1977)

昭和38年1月 か ら昭和52年12月 までの15年 間に, 徳島大学皮膚科を訪れた患者総数 は50, 452例 であつた。 この うち,問 診,検 査,臨 床症状な どか ら薬疹 と診断 さ れ た927例 を対象 と して,年 次別,月 別,性 別,年 令別 の変動を観察 し,各 症例の発疹型,原 因薬剤 につ いて も 検討 した。 発疹型の分類 について は種 々の提案があ るが,こ こで は細 かい分類を避けて,固 定疹型,汎発疹型,TEN(toxic epidermal necrolysis)型,葦 麻疹型,光 線過敏 型,座 瘡型 に分け,上 記のいずれに も属 さない ものを そ の他 と した。 原因薬剤の決定 は誘発試験,貼 布試験な どで確認 した 症例 もあるが,問 診を重視 した症例 も多 い。医師により 処方 された薬剤について は可能 なかぎり直接処方 内容を 照会 し,原 因薬剤 を追求 した。また,複 数の薬剤 が使用 され,い ずれ とも判定 しえなかつた場合 は原因薬剤不明 観 察 結 果

Solitary Skin Lymphosarcoma

左上腕にくるみ大の腫瘤を単発したリンパ肉腫の70才女子例を報告した。リンパ管造影, ガリウムシンチを含む諸検査で, リンパ節, 内臓に著変を認めず, 皮膚に限局したリンパ肉腫と診断した。切除後, 局所の放射線治療を行なつたが, 2年後にも再発はなく, 全身状態も良好である。

THE PATTERN OF FIBRINOLYTIC ACTIVITY IN HUMAN SKIN FOLLOWING EXPOSURE TO MIDDLE‐WAVELENGTH ULTRAVIOLET LIGHT OR PSORALEN AND LONG‐WAVE ULTRAVIOLET LIGHT

This experiment was carried out in order to investigate the time sequence of tissue fibrinolytic activity in human skin following UVB or UVA after topically applicated psoralen using Todds technique of fibrinolytic autography.

The Treatment of Bowen’s Disease with 5-Fluorouracil (5-FU) Ointment by Occlusive Dressing

Topical 5-FU therapy has proved successful in three cases of Bowen’s disease after one or two years no recurrence. This is thought the best therapy for intra-epidermal carcinoma (Bowen’s disease).