Tsutomu Muramatsu

Expression of desmoglein I and plakoglobin in skin carcinomas

Reduction or absence of cell‐cell adhesion molecules has been reported in various carinomas and the abnormal expression of these molecules contributes to the invasive and metastatic behavior of malignant tumor cells. In epidermal keratinocytes, the main cell‐cell adhesion systems are adherens junctions and desmosomes. Previous studies have shown that, in skin carcinomas, the decreased expression of E‐cadherin, major constitutional glycoprotein of adherens junctions, is associated with the invasive and metastatic ability of the tumor cells. In the present study, we examined the expression of desmoglein I and plakoglobin, the constitutional components of desmosomes, in various skin carcinomas such as basal cell carcinoma (BCC), squamous cell carcinoma (SCC), extramammary Pagets disease and Bowens disease by an immunofluorescence method. In normal human skin, desmoglein I and plakoglobin were strongly expressed in the intercellular space of the epidermis except for the basal cell layer. In BCC and SCC, the expression of desmoglein I and plakoglobin was markedly reduced or absent in tumor cells. In carcinoma in situ of Pagets disease, compared with the normal epidermal cells surrounding tumor cell nests, the expression of these molecules was reduced in tumor cells. In Pagets disease with dermal infiltration of tumor cells, the expression of these molecules was almost absent throughout the epidermis. In Bowens disease, the expression of desmoglein I was reduced in the clumping cells and dyskeratotic cells. These results suggest that the expression of desmosomal cadherin is reduced or absent in human skin carcinomas, and that reduction of these molecules may also contribute to the invasiveness and metastasis of skin carcinomas.

8-Methoxypsoralen plus UVA induces the 72-kDa heat shock protein in organ-cultured normal human skin

Abstract The proteins induced by heat and other stressors, called heat shock proteins (HSP) or stress proteins, are considered to play a general role in protection from cellular injury. Exposure to UVA (320400 nm) following application of 8‐methoxypsoralen (8‐MOP), termed PUVA is commonly used in the field of dermatology. In order to understand the induction of HSP in PUVA‐treated human skin, indirect immunofluorescence using a monoclonal antibody specific for the 72 kDa HSP (HSP 72) was carried out in organ‐cultured normal human skin that was treated with PUVA. When the organ‐cultured skin was treated at 37°C for 1 h with 8‐MOP at a final concentration of 10 or 100 μg/mL and exposed to UVA (51.3 kJ/m2), nuclear immunofluorcscence of HSP 72 was detected in the epidermal cells 12 h after UVA irradiation. In contrast, the induction of HSP 72 was not detected either by UVA irradiation or 8‐MOP treatment. These results suggest that PUVA treatment is one of the stressors for human skin, and DNA damage caused by PUVA induces HSP 72.

Induction and repair of UVB-induced cyclobutane pyrimidine dimers and (6-4) photoproducts in organ-cultured normal human skin

SummaryTo examine the induction and repair of UV-induced DNA damage, indirect immunofluorescence was performed on UVB-irradiated organ-cultured normal human skin using monoclonal antibodies specific for either cyclobutane pyrimidine dimers or (6-4) photoproducts. Nuclear immunofluorescence of cyclobutane pyrimidine dimers and (6-4) photoproducts were observed in a dosedependent manner after UVB irradiation. The intensity of nuclear immunofluorescence of the upper epidermal layers was stronger and clearer than that of the lower epidermal layers. DNA repair time-course studies showed that both types of DNA damage could be repaired within 24 h after UVB irradiation.

Cutaneous Bronchogenic Cyst

A 22-year-old man had a small asymptomatic papule on his left neck that had been present since early childhood. There was no history of trauma or infection to the affected site prior to onset. On close examination, a !-mm papule was present on his left neck (Fig. !). General physical examination revealed no other abnormalities. This skin lesion was excised under local anesthesia. At operation, small amounts of clear mucoid fluid were expressed from the cyst by lateral compression, however, there was no evidence of extension or connections to other structures or to deep tissues. The postoperative course was uneventful. Microscopic examination revealed a cyst lined by ciliated pseudostratified columnar epithelium intermingled with goblet cells in the upper-to-mid dermis (Fig. 2). The cytoplasm of these goblet cells stained positively with diastase resistant PAS and alcian blue (at pH 2.5) (Fig. 3). In the connective tissues surrounding the cyst, groups of seromucous glands were observed, but, smooth muscles, cartilages, and thyroid tissues could not be identified. Based on these histologic features, a diagnosis of cutaneous bronchogenic cyst of the neck was made.

Expression of E‐Cadherin in Skin Carcinomas

In this study, we investigated the expression of E‐cadherin in 31 cases of human skin carcinoma including basal cell carcinoma (BCC), squamous cell carcinoma (SCC), Pagets disease, Bowens disease (invasive type), and trichilemmal carcinoma, by immunohistochemical staining using a monoclonal antibody specific for E‐cadherin. Similar to the E‐cadherin expression in normal epidermis, E‐cadherin was strongly expressed in all samples of BCC on the cell borders, whereas marked decrease or loss of E‐cadherin expression was found in the tumor cells of SCC, Pagets disease, and Bowens disease (invasive type). On the other hand, E‐cadherin expression of trichilemmal carcinoma was slightly reduced. Considering the clinical and histological features of these skin carcinoma, the reduction of E‐cadherin expression is considered to be associated with the invasion and metastasis of human skin carcinoma.

Age‐related decrease in the inductability of heat shock protein 72 in normal human skin

In order to know the effect of chronological ageing on the induction of heat shock protein (HSP) in normal human skill, the 72‐kDa HSP (HSP72) was examined in organ‐cultured samples of normal human skin which were obtained from 30 individuals (age range 17–86 years. The skin explants were first incubated al 37°C for 24 h. and then heat‐treated at 45°C for 1 h. After heat treatment, the skin explants were incubated al 37°C for 1 or 3h. Immunohistological analysis, using a monoclonal antibody specific for the HSP72. revealed that although the time course of the heat‐induced HSP72 expression was similar in the young and aged groups, a lower level of induction of HSP72 was observed in the aged group. This result indicates that there is an age‐related dysfunction of the heat shock response in normal human skin.

Lichen planus pemphigoides‐like lesions induced by cinnarizine

A 72‐year‐old woman developed a lichen planus pemphigoides‐like eruption following the administration of cinnarizine. The eruption recurred on challenge with the drug. Direct immunofluorescence studies of the lesions demonstrated deposition of IgG, IgM and C3 on colloid bodies and fibrin at the epidermal basement membrane zone. Circulating IgG antibasement membrane zone antibodies were detected at high titres, with no complement‐ fixing activities. To our knowledge, this is the first report of immunologically defined lichen planus pemphigoides induced by a drug.

Trichilemmal carcinoma developing in a burn scar: a report of two cases.

Two cases of trichilemmal carcinoma (TLC) developing in burn scars are reported. In Case 1, a 73‐year‐old man developed a TLC on his left lower leg five years after a burn. In Case 2, a 43‐year‐old man developed a cauliflower‐like mass on his head 42 years after a burn. Histologically, tumor cells showed a lobular proliferation in continuity with the epidermis. Tumor nests were mostly composed of large atypical cells with clear cytoplasms containing PAS‐positive, diastase sensitive materials. Some of the nests showed trichilemmal‐type keratinization. These cases were treated only with surgical excision, and there has been no evidence since of local recurrence or metastasis.

Earlobe Reconstruction Using a Subcutaneous Island Pedicle Flap after Resection of “Earlobe Keloid”

background. A large keloid of the earlobe is a difficult case in which to obtain a satisfying result by nonsurgical therapies. In this case, surgical resection of keloids should be considered as a first step in therapy. However, it is difficult to reconstruct the earlobe cosmetically after resection of the lesion. objective. To discuss the usefulness of the subcutaneous island pedicle flap in earlobe keloid surgery. methods. Five earlobe keloids in five patients (four females and one male) were resected and reconstructed by subcutaneous island pedicle flap. results. In all patients, there were no keloid recurrences and no adjuvant therapies used during the follow‐up periods, which ranged from 10 to 26 months. The reconstructed earlobes were almost symmetrical. conclusion. In the selected cases, use of the subcutaneous island pedicle flap is a viable method to be considered for reconstruction after resection of earlobe keloids.

Reconstruction of full-thickness lower eyelid defects using a blepharoplasty technique with a hard palate mucosal graft

The authors report a method of reconstruction of a full-thickness lower eyelid defect using a blepharoplasty technique utilizing excess skin of the lower eyelid with a hard palate mucosal graft. In all patients the hard palate mucosa took well, and good functional and aesthetic results were obtained. The most suitable indication of this technique might be for the defect occurring horizontally (for which direct closure is difficult to apply) and located in the lateral side of the lower eyelid (when a large amount of excess skin can be utilized). The authors conclude that although the shape and size of the defect to which this method can be applied is restricted, this is a useful option in the reconstructive methods of a full-thickness lower eyelid defect.