Naoki Maekawa

Detection of lysyl oxidase gene expression in rat skin during wound healing

Lysyl oxidase (LOX) initiates the crosslinking of the lysine-derived aldehyde and plays an essential role in maturation of collagen, for example in wound healing. Although the activity of this enzyme has been examined in various disorders, and a further intriguing aspect of the relationship between LOX and tumorigenesis has recently emerged, its gene expression pattern in tissues is still unknown. We examined LOX gene expression during wound healing in rat skin. In addition, type III collagen gene expression was studied to determine the formation of fibrils. The LOX mRNA level reached a peak by day 3 after injury, which was earlier than that of type III collagen, and continued at a high level until day 22. The type III collagen mRNA level began to rise from day 3 and had increased intensely by day 22. In situ hybridization revealed grains corresponding to LOX mRNA in the fibroblasts of the granulomatous tissue. These results suggest that LOX is produced before collagen synthesis in preparation for crosslinking in the early phase of wound healing.

Topical Antibiotic Treatment of Impetigo with Tetracycline

Forty‐nine children aged 0.2–13 years with bullous and eroded lesions, from which Staphylococcus aureus was isolated, were diagnosed with impetigo and entered into a randomized, open‐labeled trial of topical oxytetracycline hydrochloride (tetracycline) compared with a combination of topical tetracycline and oral antibiotics. After one week of topical tetracycline treatment, 22 of the 28 patients were clinically cured, and the remaining six patients had improved. In the other treatment group, 14 patients of 21 were clinically cured and 7 patients improved by the combination of topical tetracycline and oral antibiotics. There were no significant differences between the two groups. Therefore, the present study suggests that topical tetracycline treatment is effective for the treatment of impetigo.

Pyoderma gangrenosum with myelodysplastic syndrome treated with analogous bone marrow transplantation.

Sir, Pyoderma gangrenosum (PG) is a neutrophilic dermatosis characterized by necrotizing suppurative inflammation. PG is often associated with myelodysplastic syndrome (MDS). Its pathogenesis is unknown, but immune dysfunction associated with neutrophil hyperactivity has most often been proposed. In general, patients are treated with systemic steroids or immunosuppressive agents (1). Cases of PG in a patient with MDS treated with systemic steroids or immunosuppressive agents have rarely been documented. The pathogenesis of the association of PG and MDS is controversial. We describe here an 18year-old man with multiple PG ulcers. Treatment with analogous bone marrow transplantation (BMT) achieved complete relief.

Detection of human T-cell lymphotropic virus type-1 proviral DNA in the saliva of an adult T-cell leukaemia/lymphoma patient using the polymerase chain reaction

We report a case of adult T‐cell leukaemia/lymphoma (ATLL), in whom the polymerase chain reaction (PCR) on genomic DNA from saliva demonstrated the monoclonal integration of human T‐cell lymphotropic virus type‐1 (HTLV‐1) proviral DNA in lymphocytes in the saliva. These results provided evidence of the possibility of saliva‐borne transmission of HTLV‐1.

Effects of Butylated Hydroxyanisole on Ornithine Decarboxylase Activity Induced by Ultraviolet‐B and PUVA in Mouse Skin

The effects of butylated hydroxyanisole (BHA), a representative phenolic antioxidant, on the activity of ornithine decarboxylase (ODC, an indicator of tumor promotion and epidermal hyperproliferation) induced by ultraviolet‐B (UVB) or PUVA in mouse skin were investigated. By topical application of BHA (55 μmol), PUVA‐induced ODC activity was suppressed by about 60% at both 12 h and 24 h after treatment. In contrast, BHA failed to suppress UVB‐induced ODC activity in mouse skin. These results suggest that the induction of ODC activity by UVB or PUVA is mediated by different pathways.

Ectopic extramammary Paget's disease on the head: case report and literature review

Extramammary Paget’s disease (EMPD), first described by Crocker in 1889, is a form of intraepidermal adenocarcinoma that generally occurs in areas with a high density of apocrine glands. It presents as a scaly, erythematous lesion simulating inflammatory conditions, tumors, and infections. Isolated cases that occur in locations where there are usually no apocrine glands are called ectopic EMPD. We report a case of EMPD in the occipital region of the head, which is the fourth case of ectopic EMPD affecting the head. Immunohistochemically, we discuss previously reported cases of ectopic EMPD involving the head.

Ciliated Cyst of the Vulva: Oestrogen and Progesterone Receptors

Sir, Cases of cutaneous cysts lined by ciliated epithelium have rarely been documented, and only a few cases of such cysts in the vulvar vestibulae have been reported (1–3). The origin of the cysts is controversial because the location is so anatomically specific. In this report, we describe a 14-year-old girl with a ciliated cyst of the vulva (CCV), the lining cells of which were positive for oestrogen and progesterone receptors, and discuss the pathogenesis of ciliated epithelium.

Effects of Ultraviolet‐B and PUVA on Ornithine Decarboxylase Activity, DNA Synthesis, and Protein Kinase C Activity in Mouse Skin

Ultraviolet‐B and PUVA share several biological events with phorbol ester tumor promoters. The effects of ultraviolet‐B irradiation and topical PUVA treatment on ornithine decarboxylase activity, DNA synthesis, and protein kinase C activity, which are known to be induced or activated by phorbol ester tumor promoter, were investigated in hairless mouse skin. Ornithine decarboxylase activity was remarkably enhanced by ultraviolet‐B and PUVA. Although PUVA did not affect DNA synthesis significantly, ultraviolet‐B stimulated epidermal DNA synthesis approximately 5‐fold over control values at 48 h. However, unexpectedly, neither cytosolic nor membrane‐bound protein kinase C activity showed any change during the 2 h after either treatment. These results suggest that the protein kinase C system is not involved in the initial signal transduction system of ultraviolet‐B or PUVA, unlike the case with phorbol ester tumor promoter.

Secondary reconstruction for dermatofibrosarcoma protuberans in the scalp

隆起性皮膚線維肉腫 (以下DFSP) は, 若年～中年の体幹・四肢に好発する腫瘍である。腫瘍の境界は, 比較的明瞭に見えるが, 皮下組織さらに筋膜や筋組織への浸潤がしばしばみられる。治療は, 広範囲切除が一般的であるが, 不十分な切除ではしばしば局所再発することが知られている。特に頭部における再発は非常に高率である。近年, Mohs micrographic surgery (以下MMS) が推奨されてきている。自験例は23歳男性の頭部に生じた約4cmのDFSPで, 2cmの切除幅で骨膜を含めて切除し, 人工真皮を貼附した。術後, 腫瘍の残存がないことを確認し, 二期的に植皮術を行った。DFSPの治療は, MMSが最も有効な方法と考えたが, 設備や人的な面で制約があり, 自験例では, 二期的手術を行わざるを得なかった。今後はMMSを含めさらに手術方法の検討が必要と考える。

Pedunculated dermatofibrosarcoma protuberans (DFSP) on the lower abdomen

56歳女性。初診の約8ヵ月前に, 下腹部に小結節が生じ, 次第に拡大した。当科初診時, 下腹部に基部が直径約3cmで, 高さが10cmの有茎性の腫瘤を認めた。中間部に切れ込みを有し, 末端部が腫大していた。下床では周辺への浸潤性増殖も認められた。隆起部表面は, 赤褐色を呈しており, 周辺の浸潤増殖部には色素沈着が観察された。病理組織学的には紡錘形の線維芽細胞様細胞がstoriform patternを呈して増殖していた。免疫組織化学染色にて腫瘍細胞はCD34が陽性であった。治療として, 肉眼的腫瘍辺縁から3cm離して皮切を加え, 一部は筋膜も含めて, 一塊として切除した。切除から1年を経過し, 再発を認めない。自験事は特徴的な隆起性病変ではなく, 特異な有茎性の臨床像を示した。同様の症例を検索したが, 多くが高齢者で, 比較的伸展に富む部位に発生していた。有茎性の臨床像を呈した理由の一つかと考えた。