Makoto Yanagihara

Silicone granuloma on the entry points of acupuncture, venepuncture and surgical needles

We describe a case of epithelioid granuloma on the entry points of needles used for acupuncture, venepuncture and for taking skin biopsy. The acupuncture needles used at each session were silicone coated. Silicon was detected in the vacuoles of macrophages and multiple nucleated giant cells by X‐ray microanalysis. To our knowledge, this is the first case of silicone granuloma arising on the entry points of acupuncture, venepuncture and surgical needles.

The pathogenesis of the transepithelial elimination of the collagen bundles in acquired reactive perforating collagenosis. A light and electron microscopical study.

Two cases of acquired reactive perforating collagenosis with poorly controlled diabetes mellitus were studied by histochemistry and by electron microscopy. In excoriated wounds, the necrotic mass on the bottom of the ulcer contained the collagen bundles which were continuous with the collagen bundles in the reticular layer. In the developing stage, the epidermis regenerated between the necrotic mass and the reticular dermis, and the collagen bundles in the reticular dermis were in continuity with those in the necrotic mass through the epithelial tunnels. The collagen in the epidermal channels did not degenerate ultra‐structurally. In the mature lesion, collagen bundles being eliminated through the epidermis were surrounded by the fibroblasts at the basal cell layer. Collagen fibers were seen in the cytoplasm of these fibroblasts. From these findings, the mechanisms of the formation of the eruption in acquired reactive perforating collagenosis might be as follows: 1) In the developing stage, the regeneration of epidermis progresses between the necrotic mass and the reticular dermis, and among the collagen bundles. As a result, the collagen bundles remain in the channels of the epidermis. And then, 2) the regenerated epidermis makes the thick horny layer. As a result, the necrotic masses are lifted up and the collagen bundles are pulled up from the dermis through the epidermal channels.

Measles Virus was Present in the Inner Cell of the Acrosyringium in the Skin Rash

Abstract: A case of measles in a 26‐year‐old Japanese man is reported. A skin specimen taken on the third eruptive day from a maculopapular eruption on his chest was immunohistopathologically and electron microscopically examined using a rabbit polyclonal antibody against the nucleocapsid protein of the measles virus. The measles virus antigen was found in the inner cells of the acrosyringium and hair follicles. The measles virus nucleocapsid was electron microscopically identified in the nuclei of the inner cells of the acrosyringium. The findings suggest that the sweat from skin lesions might contain the measles virus.

The ultrastructural findings of Charcot-Leyden crystals in stroma of mastocytoma.

Charcot-Leyden crystals (CLCs) have been found in many conditions associated with eosinophilia, but their occurrence in skin diseases is very rare. We report ultrastructural observations on the presence of CLCs in the cutaneous lesions of two cases of mastocytoma. Electron microscopy documented CLCs located in phagosomes of morphologically activated macrophages as well as free CLCs in the stromal tissue, close association between CLCs formation and damaged and lysed eosinophils was present. These findings provided evidence that the formation of CLCs in mastocytoma implicated the individual and interrelated biology of mast cells, eosinophils and macrophages. Phagosomes probably acted as the site of CLCs formation. The clinic and pathologic role of CLCs in mastocytoma deserves further investigation.

Immunohistochemical study of human eccrine sweat ducts with anti-keratin antibodies : presence of a layer between luminal and peripheral cell layers

It is known that human eccrine sweat ducts are composed of luminal cells and peripheral cells. In this study, the immunohistochemical staining properties of human eccrine sweat ducts were investigated using seven different anti-keratin antibodies by light microscopy. Anti-keratin antibody MA904, which reacts with 68-kDa keratin peptide specifically stained an intermediate cell layer between the luminal cell layer and the peripheral cell layer in the ducts. Anti-keratin antibody CK8,60 stained both the luminal cell layer and the intermediate cell layer. Anti-keratin antibody MA903 stained all of the layers. Anti-keratin antibodies CK4.26, PKK1, and MAK-6 weakly to faintly stained the luminal cells. Anti-keratin antibody PKK3 stained no cells in the ducts. These results suggest that each cell layer has its own characteristic staining pattern with anti-keratin antibodies. Moreover, the presence of an intermediate cell layer was confirmed by immunoelectron microscopy using anti-keratin antibody MA904.

Case of multiple cutaneous granular cell tumors

Granular cell tumor is an uncommon, benign tumor, which mainly occurs on the skin, tongue and oral cavity as a single nodule. Multiple granular cell tumors are rare, with the incidence reported to vary from 7–29% in adult cases of the tumor. We describe a case of multiple cutaneous granular cell tumors in the right lumber and back regions along with a brief review of the published work on multiple cutaneous granular cell tumors.

Usefulness of Histopathologic Examination of Thick Scales in the Diagnosis of X‐Linked Dominant Chondrodysplasia Punctata (Happle)

Most patients with X‐linked dominant chondrodysplasia punctata (X‐DCDP) have whorled, thick, or spiky adherent hyperkeratosis on their whole body. Histopathologically, there are large keratotlc plugs of hair follicles where calcium deposits. This is the characteristic finding in this disease. We performed histopathologic examination of skin specimens from two newborn babies with X‐DCDP. The desquamated thick scales from the hyperkeratotic lesions had calcium in the center of the keratotic plugs. Histopathologic examination of thick scales is easy and helpful in diagnosing X‐DCDP.

Functional morphology of lesions of psoriasis vulgaris transplanted into nude mice at an early stage.

We examined the growth and differentiation of transplanted psoriatic skin in nude mice at an early stage. Psoriatic lesions from three patients were biopsied. Each biopsied specimen was cut into five blocks, which were individually transplanted to nude mice by the embedding method. Two weeks later, growth and differentiation of transplanted specimens were examined by bromodeoxyuridine (BrdU) labelling method and by electron microscopy. Electron microscopically, basal cells were longitudinally high, and the cellular processes were elongated. Basal laminae were multilayered. In the cytoplasm of the basal cells, many mitochondria, endoplasmic reticula, and ribosomes were seen, and tonofibrillar formation was poor. In cell groups in the upper parts of these lesions, both nuclei and cytoplasm showed degeneration. Psoriatic skin transplanted to nude mice exhibited newly formed psoriatic skin and initial epidermal necrosis. The BrdU labelling method labelled cells scattered in the lower part of the epidermis. Psoriatic skin transplanted to nude mice resembled that before transplantation in both ultrastructural findings and growth pattern.

Follicular Keratosis of the Chin Treated with 1.24R-Dihydroxyvitamin D3 Ointment

Abstract:  In follicular keratosis of the chin, keratotic follicular papules occur on the chin and jaw due to localized prolonged pressure and friction on the naked skin. We present one patient with this disorder. The dermatoscopic examination revealed many well‐demarcated yellow spindle bodies in the patchy lesion. Therapy with 1.24R‐dihydroxyvitamin D3 ointment was effective during the treatment but had no residual positive effect.

Investigation of the association between mercury sensitization and HLA-DR6

HLA molecules, polymorphic membrane glycoproteins, are classified into 2 groups: those expressed on the surface of almost all nucleated cells (HLA class I molecules), and those found on the surface of cells mainly involved in the immune response (HLA class II molecules) (1). In guinea pigs and mice, the genes that control delayed hypersensitivity reactions have been shown to be linked with those of the major histocompatibility antigens (2). The immune response genes (Ia) of mice have their homologues in the human HLA-DR locus. Although significant increases in HLA-DRw6 antigen in nickel-contact-sensitive patients have been reported (3), other attempts to investigate the link between HLA typing and metal contact sensitivity have resulted in conflicting results for nickel, cobalt and chromium (1). However, there have been no reports of previous investigations of the association between mercury sensitization and HLA-DR. Previously ( 4), we investigated various factors related to mercury sensitization of 156, 4th year medical students between 1993 and 1994. We found that mercurysensitized students had a significantly higher frequency of eczema caused by cosmetics, shampoos, soaps and hair creams, and had significantly more teeth modified with metals compared to controls. In addition, their urinary mercury concentrations were significantly higher than those of the non-sensitized group. However, mercury sensitization was not significantly associated with