Natsuko Ishida

A pilot study to assess the efficacy of photodynamic therapy for Japanese patients with actinic keratosis in relation to lesion size and histological severity

Background/purpose: Topical 5‐aminolevulinic acid (ALA)‐based photodynamic therapy (PDT) is effective for actinic keratosis (AK); few studies have examined Oriental patients. The aim of this study is to assess the efficacy of PDT for the treatment of Japanese AK patients classified by lesion size and histological severity.

Disseminated mucocutaneous herpes simplex virus infection in an immunocompetent woman.

Disseminated mucocutaneous herpes simplex virus (HSV) infection in an immunocompetent person is quite rare. A 19-year-old healthy Japanese woman presented with painful, umbilicated vesicles and pustules on her genital region, both nipples and on the forearm 10 days after the last sexual contact with her partner who had cold sore at that time. Tzanck test and biopsy confirmed the diagnosis of disseminated mucocutaneous HSV infection. She did not have any visceral HSV disease. Skin lesions improved after treatment with acyclovir and erythromycin for seven days. We propose that like herpes gladiatorum, HSV dissemination in this case was acquired by close body contact.

Etretinate enhances the susceptibility of human skin squamous cell carcinoma cells to 5-aminolaevulic acid-based photodynamic therapy

Background.  Photodynamic therapy (PDT) with 5‐aminolaevulinic acid (5‐ALA) is a noninvasive and effective treatment for superficial skin cancers. Etretinate, a derivate of vitamin A, with the chemical formula ethyl(2E,4E,6E,8E)‐9‐(4‐methoxy‐2,3,6‐trimethylphenyl)‐3,7‐dimethyl‐2,4,6,8‐nona‐tetraenoate, has been reported to have antitumour effects and to regulate the proliferation and differentiation of skin cancers.

Reduction in QSART and vasoactive intestinal polypeptide expression in the skin of Parkinson's disease patients and its relation to dyshidrosis.

Background:  With regards to dyshidrosis in Parkinson’s disease (PD), there is no established and consistent view on the occurrence sites, frequency and etiology, although there have been several reports on hypohidrosis of the limbs and sudoresis on the face/cervical region.

Thioredoxin upregulation by 5-aminolaevulinic acid-based photodynamic therapy in human skin squamous cell carcinoma cell line

Background/purpose: 5‐aminolaevulinic acid‐based photodynamic therapy (ALA‐PDT) is widely performed in the clinical setting for superficial skin cancers, giving favorable results, but residual tumor and recurrence occur occasionally. Thioredoxin is a common antioxidant that suppresses apoptosis and facilitates cell growth. We investigated the expression of thioredoxin following ALA‐PDT in human skin squamous cell carcinoma cell line, HSC‐5.

Herpes zoster of the nipple: rapid DNA-based diagnosis by the loop-mediated isothermal amplification method

A 28-year-old Japanese man presented with grouped erosions and vesicles on an erythematous base affecting the right areola and the surrounding skin. A Tzanck smear from the vesicle revealed giant cells. An initial clinical diagnosis of mammary herpes simplex was considered but to explore the differential diagnosis, viral DNA was amplified by the loop-mediated isothermal amplification (LAMP) method. DNA replication was observed only in varicella zoster virus LAMP mixture, and this confirmed a diagnosis of herpes zoster. The patient was treated with 3000 mg of daily oral valacyclovir for seven days. After antiviral treatment, the lesion had healed and the pain had resolved completely.

Quantitative analysis of shedding of Epstein–Barr virus in saliva from patients with connective tissue diseases: a pilot study

Emergency contraceptive update Editor, Emergency contraception (EC) is particularly important for patients who have unprotected sexual intercourse or who experience an oral contraceptive ‘‘lapse’’ while taking a known teratogenic drug, such as isotretinoin or methotrexate. In a previous review paper, it was noted that the only US Food and Drug Administration (FDA)-approved emergency oral contraceptive (Plan B ; Teva Pharmaceuticals USA, North Wales, PA, USA) consisted of two 0.75mg levonorgestrel tablets to be taken at 12-hour intervals and within 72 hours of unprotected intercourse. This agent has largely been supplanted by two versions of a more convenient, single-dose 1.5-mg levonorgestrel tablet to be ingested within 72 hours of sexual exposure (Next Choice [Watson Pharmaceuticals, Inc., Corona, CA, USA] and Plan B One-Step [TEVA Pharmaceuticals USA]). As of December 1, 2010, another emergency contraceptive, Ella (Watson Pharmaceuticals, Inc.), has become available in the USA. This new agent consists of a single 30-mg dose of ulipristal acetate, a selective progesterone receptor modulator which delays or inhibits ovulation. This recently released drug is available only on prescription, not over-the-counter as is the case with the levonorgestrel-based drugs. However, it is comparably priced and demonstrates no significant adverse events. Perhaps more importantly, the newer drug has several advantages. Firstly, this EC agent affords pregnancy rates that are 65% and 42% lower in the first 24 and 72 hours after unprotected intercourse, respectively, compared with the older agents. Secondly, the newer drug retains considerable efficacy (and is approved for use) even when taken up to five days following sexual intercourse, compared with the markedly reduced efficacy of the levonorgestrel-based medications at this time-point. It is important for dermatologists to be aware of the expanding alternatives for EC that are available to patients who use medication that is considered to be highly risky should an unexpected or undesired pregnancy occur.

Painless thyroiditis in drug-induced hypersensitivity syndrome with prolonged reactivation of herpesviruses

Drug-induced hypersensitivity syndromze (DIHS) is a rare disease with a severe drug eruption usually characterized by fever, rash, and eosinophilia associated with reactivation of human herpes simplex virus 6 (HHV-6). Multiple organ failures and autoimmune diseases sometimes appear during the course of DIHS. Herein we report a case of carbamazepine-induced DIHS with prolonged reactivation of HHV-6 and human cytomegalovirus (CMV) causing painless thyroiditis after one year. A 51-year-old Japanese man started carbamazepine therapy for manic-depressive psychosis in March 2008. Four weeks after starting carbamazepine, he developed a fever (39 C) and widespread rash. The diagnosis of toxic eruption was made and he was treated with antibiotics in a local hospital. However, his condition deteriorated and he was referred to our hospital because of general malaise, high fever, liver disorder, and skin rash over his entire body. Physical examination revealed a maculopapular erythematous rash involving most of his body (Fig. 1a–c). He also had facial edema with small pustules (Fig. 1d) and lymphadenopathy involving bilateral cervical nodes. The mucous membrane was intact. Nikolsky’s sign was negative. Laboratory data were significant for a white blood cell count of 9200/ll with 5% atypical lymphoid cells. Aspartate aminotransferase and alanine aminotransferase were elevated at 69 and 159 U/l. Elevated antibody titer against HHV-6, HHV-7, and CMV were observed (Fig. 2). A skin biopsy specimen from the abdomen revealed interface alterations with vacuolar degeneration of the basal cells with infiltration of lymphocytes in the upper dermis (Fig. 1e). The patient was diagnosed as

Heating increases protoporphyrin IX production in normal skin after delivery of 5-aminolevulinic acid by iontophoresis.

Heating increases protoporphyrin IX production in normal skin after delivery of 5-aminolevulinic acid by iontophoresis Natsuko Ishida, Daisuke Watanabe, Kimihiko Mizutani, Makio Akimoto, Aki Nakano, Yoichi Akita, Yasuhiko Tamada & Yoshinari Matsumoto Department of Dermatology, Aichi Medical University School of Medicine, Aichi, Japan, and Department of engineering, Kanto Gakuin University, Yokohama, Japan

Herpetic folliculitis in seborrheic keratosis of the head

ejd.2011.1477 Auteur(s) : Yumi Kinoshita, Hiromichi Takama, Natsuko Ishida, Yoichi Akita, Yasuhiko Tamada, Daisuke Watanabe dwatanab@aichi-med-u.ac.jp Department of Dermatology, Aichi medical University, Nagakute, Aichi, 480-1195, Japan Herpetic folliculitis is a rare manifestation of herpesvirus infection of the follicular epithelium and is often misdiagnosed or retrospectively diagnosed by histopathological examination [1]. Seborrheic keratosis is one of the most common non-cancerous skin growths [...]