Taketsugu Tadokoro

Expression of estrogen receptor β in normal skin, melanocytic nevi and malignant melanomas

Sex hormones are known to be associated with increases of melanocytes and melanin production in human skin. However, the expression of estrogen receptor (ERα) in melanocytic lesions has been controversial. In 1996, a new subset of estrogen receptor was cloned, and named estrogen receptor β (ERβ). We used immunohistochemical staining to characterize the expression of ERα and ERβ in normal skin and in melanocytic lesions. Normal sebaceous glands and hair follicles were positive for ERα and ERβ. Other adnexal structures and constituents in the skin were positive for ERβ, but not for ERα. Melanocytic nevi and malignant melanomas were negative for ERα, but both were positive for ERβ. The ubiquitous expression of ERβ may play a fundamental role in various normal skin cells and melanocytic tumors.

Perineural and Neural Involvement in Skin Cancers

BACKGROUND Malignant skin tumors rarely spread along nerves. Complete resection of involved nerves is often unsuccessful. OBJECTIVE In the treatment of tumors with perineural invasion, surgeons should accurately estimate the extent of distant spread. METHODS We report six cases of skin cancers, including two basal cell carcinomas, two squamous cell carcinomas, and two neurotropic malignant melanomas, that invaded nerve or perineural spaces. RESULTS In three of the cases, the tumors developed on the face and involved the infraorbital nerves or its branches. Two patients suffered from tumors on aid burn scars of lower legs. Branches of posttibal nerves were involved in both cases. In the last case, tumor invasion of a branch of the greater occipital nerve was detected. CONCLUSION The extent of surgical excision should include the area of skin supplied by the affected nerve, which must be resected in continuity.

Minoxidil increases 17β-hydroxysteroid dehydrogenase and 5α-reductase activity of cultured human dermal papilla cells from balding scalp

Minoxidil is known to induce hair growth in male pattern baldness, for which development androgen plays a central role. We studied the effect of minoxidil on testosterone metabolism by cultured dermal papilla cells from balding or nonbalding scalp and dermal fibroblasts. In all three groups, 17β-hydroxysteroid dehydrogenase activity was much higher than 5α-reductase activity. Minoxidil increased 17β-hydroxysteroid dehydrogenase activity by nearly 40% (P<0.001) in dermal papilla cells of balding scalp, whereas the effect was less marked in dermal papilla cells from nonbalding scalp and dermal fibroblasts. 5α-Reductase activity was also slightly increased by minoxidil in dermal papilla cells from balding scalp. Again, the effect on 5α-reductase activity was insignificant in the other two groups of cells. Whether such modification of testosterone metabolism in dermal papilla cells of balding scalp by minoxidil is related to its therapeutic effect remains unknown.

Double involvement of extramammary Paget's disease in the genitalia and axilla.

We here reported a case of an 82‐year‐old man with double involvement of extramammary Pagets disease in the genitalia and axilla. Physical examination revealed erythema and reddish tumors on the pubic area and scrotum and irregular‐shaped erythema on the left axilla. The skin biopsy sample from the genital area showed Pagets cells in the epidermis and upper dermis. The specimen from the left axilla showed Pagets cells scattered in the epidermis but not in the dermis.

Melkersson-Rosenthal syndrome caused by saprodontia: a case report.

A 24‐year‐old female patient with Melkersson‐Rosenthal syndrome (MRS) in association with saprodontia is reported. She presented with lower labial swelling and left facial edema. Histological examination of the involved oral mucosa showed a noncaseating epithelioid granuloma. Results from the laboratory and imaging examinations were normal or negative. Her orofacial swelling disappeared after treatment of the saprodontia of the left first molar.

Frontonasal Flap for Reconstruction of Complete Alar Defects

background It is difficult to reconstruct a satisfactory ala. Axial frontonasal flap has been common in reconstruction of nasal tip. We modified this flap to reconstruct nasal ala. objective A modified axial frontonasal flap was applied for reconstruction of complete unilateral alar defects in two patients. methods Skin from an intact nasal tip covered the alar defect. The resulting defect in the nasal tip was covered with dorsal skin from the nose. Extended mucosa or a hinged nasolabial flap was used to line the mucosal side of the reconstructed ala. results The outcome judged by shape, and texture, was satisfactory. This technique can be employed under field block. conclusion The modified frontonasal flap is one of the ideal techniques to reconstruct an entire nasal ala.

Extended V-Y flap: patient reports and reconsideration.

The extended V-Y flap, a modified V-Y advancement flap, is very useful in closing relatively large defects on the face. Its extension limb is hinged down as a transposition flap on the end of the V-Y advancement flap to close the most distal portion of the defect. We applied this flap in closing a defect following excision of skin tumors on the face with excellent cosmetic results in 11 patients. However, this flap tended to make a distortion at the base of the flap in the primary closure site. By drawing figures, we concluded that the distortion was due to the characteristic of this technique as a V-Y advancement-rotation flap or V-Y advancement flap with rotation.

Whitening efficacy of plant extracts including orchid extracts on Japanese female skin with melasma and lentigo senilis

The purpose of this study was to assess the in vivo efficacy of a cosmetic formulation containing plant extracts including orchid extracts, compared to 3% vitamin C derivative formulated with the same excipient, in Japanese female adult volunteers with melasma and/or lentigo senilis. The ethics committee of Osaka National Hospital approved the protocol of the study. Before recruitment, selection and inclusion of a volunteer in this study, signed informed consent was obtained from each volunteer after she was given clear and precise information on the study, enabling her to appreciate the aim of the study and the consequences of her consent. Forty‐eight female volunteers aged 30–60 years applied the plant extracts and vitamin C derivative to one side of the face. After repeated application for 8 weeks, efficacy was evaluated clinically by colorimetric measurements and subjectively using a questionnaire. After 8 weeks of treatment, both the clinical evaluations by a dermatologist and the questionnaire surveys by volunteers indicated that the cosmetic formulation containing plant extracts was significantly effective in improving the size, brightness, color intensity, clarity, visibility and global appearance of the pigmented spots, and also the luminosity complexion and skin clarity of the face. The good agreement between the results of clinical evaluations and those of questionnaire surveys showed that the orchid‐rich plant extracts possess efficacy similar to vitamin C derivative in whitening the skin as well as melasma and lentigo senilis on the face of Japanese women.

Growth stimulation of normal melanocytes and nevocellular nevus cells by gastrin releasing peptide (GRP)

In order to know the possible effects of gastrin releasing peptide (GRP) on nevus cells and melanocytes, we studied the effect of GRP on the proliferation of cultured human nevus cells and normal melanocytes. MTS assay showed that GRP stimulated the growth of viable melanocytes at 1000 ng/ml. GRP also stimulated the growth of nevus cells in a dose dependent manner and maximum stimulation was obtained at 100 ng/ml of GRP. GRP was less effective for growth stimulation of normal melanocytes than nevus cells. The cytoplasm of nevus cells were positively stained by polyclonal anti-GRP antibody. We also detected the expression of GRP and GRP receptor mRNAs in these cells by RT-PCR. These results suggest that GRP acts as an autocrine growth factor for nevus cells and normal melanocytes.

Free composite graft for lip reconstruction after tumor excision

This paper represents 10 patients for whom lip defects following excision of malignant tumors were reconstructed by the free composite graft technique using the opposite side of the lip. Usually, for upper lip reconstruction, a switch flap or Zisser-Madden method is commonly used. For lower lip reconstruction, the methods of the double cross-lip flaps or the rotation flap are most frequently used. However, we recommend the free composite graft technique for selective patients, since this method is simpler than the other techniques and the results are excellent both cosmetically and functionally.