Wakio Torinuki

Lysosome destruction and lipoperoxide formation due to active oxygen generated from haematoporphyrin and UV irradiation.

The lysosomal enzymes, acid‐phosphatase and β‐glucuronidase, were released from rat liver lysosome when exposed to 400 nm irradiation in the presence of haematoporphyrin, and the release was prevented by adding vitamin E., diazabicyclo‐octane, bovine serum albumin, superoxide dismutase or d‐mannitol to the reaction mixture. Monochromatic irradiation with wavelengths from 380 to 410 nm caused no significant differences in the release of lysosomal enzymes, but 420 nm irradiation caused three fifths of that of 400 nm irradiation. The malondialdehyde level in rat liver homogenate increased after 400 nm irradiation in the presence of haematoporphyrin. Reduction of nitroblue‐tetrazolium was not observed when haematoporphyrin was excited by 400 nm; it was considered that superoxide anion radical (O–2) was not primarily generated.

Incidence of skin cancer in Japanese psoriatic patients treated with either methoxsalen phototherapy, Goeckerman regimen, or both therapies: A 10-year follow-up study

To determine the long-term cutaneous side effects of methoxsalen phototherapy (PUVA) and Goeckerman regimen, a total of 151 Japanese psoriatic patients treated with PUVA, Goeckerman regimen, or both therapies in our department from 1976 to 1986 were evaluated for skin cancers. Sixty-seven patients had been treated with PUVA, 43 with Goeckerman regimen, and 41 with both therapies. One patient alone (62-year-old man) developed squamous cell carcinoma on the leg with cumulative ultraviolet A (UVA) dose of only 51 joules/cm2, he had a history of treatment with superficial x-ray therapy to this area 30 years prior to PUVA. The cancer was detected after 1.4 years of PUVA treatment. However, other patients at follow-up, even those who had received a cumulative dose of UVA of more than 1000 joules/cm2, had no skin cancer after more than 2 years. This report in Japanese patients confirms that only previous exposure to other risk factors such as ionizing radiation appears to be a most important factor for skin cancer formation in PUVA-treated Japanese patients.

Increased Mast Cell Numbers in the Sclerotic Skin of Porphyria cutanea tarda

We quantitated numbers of mast cells in the sclerotic skin noted on the dorsa of the hands of 10 patients with porphyria cutanea tarda (PCT), and compared them with those of diffuse scleroderma and healthy controls. Mast cell counts in sclerodermoid skin of PCT patients were significantly greater than those in involved skin of 9 patients with diffuse scleroderma in its late stage and also greater than those in normal skin of 8 controls. When mast cell density was analyzed according to the depth of the dermis, an 84% increase was noted in the uppermost layer (0-0.2 mm in depth) and a 150% increase in the second uppermost layer (0.2-0.4 mm in depth) in the patients with PCT when compared with those in the corresponding sites of the controls. These results suggest a possible role of mast cells in the pathogenesis of sclerodermoid skin of PCT.

Incontinentia pigmenti: eosinophil chemotactic activity of the crusted scales in the vesiculobullous stage

To investigate the mechanisms underlying eosinophil infiltration into the epidermis in incontinentia pigmenti (IP), we studied the eosinophil chemotactic activity in extracts of the crusted scales from three patients with IP in the vesiculobullous stage. Eosinophil ehemotactic activity was detected in the eluates from a Sephadex G‐75 chromatography column between the vitamin B12 and phenol red markers. The chemotactic activity was heat‐stable and resistant to enzyme digestion, and recovered after ether extraction at low pH. Leukotriene B4 (LTB4) was demonstrated in the fractions with high eosinophil chemotactic activity. These findings suggest that LTB4 plays an important role in the accumulation of eosinophils within the epidermis in IP, in the vesiculobullous stage. Blood eosinophilia, however, may not be induced by the eosinophil chemotactic factors in the scales.

Leukocyte chemotactic properties of soluble horny contents in epidermal cysts

SummaryEpidermal cysts are one of the most common tumors of the skin. Although asymptomatic ordinarily, they may sometimes become severely inflamed with massive invasion of polymorphonuclear leukocytes (PMN). We studied in vitro PMN chemotactic properties of the aqueous extract prepared from the horny material of epidermal cysts obtained from three patients. A crude aqueous extract of the horny content of the cysts showed PMN chemotactic activity, which, however, was less than that of a horny layer extract prepared from normal skin.Characterization of PMN chemotactic activity using a Sephadex G-75 column showed a peak in the low molecular weight fractions eluting between the vitamin B12 and phenol red markers, which corresponds with the peak of absorbance at 280 nm. The chemotactic substances withstood boiling and trypsin or protease digestion. Although the chemotactic activity was partially ether-extractable, the presence of leukotriene B4 was not demonstrated by radioimmunoassay. In addition to their own chemotactic activity, the horny extracts of epidermal cysts showed cytotaxigenic properties in the presence of fresh serum.

Activation of complement by 405-nm light in serum from porphyria cutanea tarda

SummarySera from three patients with porphyria cutanea tarda (PCT) were examined for evidence of complement activation. The irradiation of sera in vitro with 405-nm light resulted in a dose-dependent diminution of total hemolytic complement activity and the hemolytic titers of C1, C4, C2, C3, and C5. Furthermore, such irradiated sera showed immunoelectrophoretical C3 conversion, chemotactic activity for rat polymorphonuclear leukocytes inhibited by incubation with anti-C5 antisera but not anti-C3 antisera, and C5a generation as measured by radioimmunoassay. Factor-B conversion did not occur in such irradiated sera. Using Sephadex G-75 chromatography, the irradiated sera showed a multiphasic elution profile of chemotactic activity similar to that of zymosan-activated serum. The generation of C5a even occurred in factor-B-depleted serum. These studies indicate that the irradiation of PCT serum with 405-nm light induces the activation of the complement system via the classical pathway, resulting in the development of a chemotactic factor.

Photosensitivity due to hydrochlorothiazide.

A case of photosensitivity induced by only 2 tablets of hydrochlorothiazide (Behyd‐RA tablets) is reported. The patient had sunburn‐like eruptions on the face, neck, arms and hands. The histologic picture was the same as in polymorphic light eruption. Black light irradiation could induce the same reaction clinically as well as histologically. The patient had an identical history five years previously. A rapid improvement of the lesions occurred after cessation of the hydrochlorothiazide administration and avoidance of exposure to sunlight. No photosensitive reactions have been noted since. The skin reaction of this case was due to long ultraviolet light and hydrochlorothiazide, and possibly photoallergic in nature.

Mucha‐Habermann Disease in a Child: Possible Association with Measles Vaccination

A 2.5‐year‐old boy presented with skin lesions consistent with Mucha‐Habermann disease, which appeared about 5 days after an injection of freeze‐dried live attenuated measles vaccine. He responded to both oral and topical corticosteroid therapy. To my knowledge, this represents the first such association of Mucha‐Habermann disease with virus vaccination.

Erythropoietic Protoporphyria Showing Solar Purpura

An 11-year-old girl with erythropoietic protoporphyria is described. She was admitted to our hospital complaining of swelling and purpura on her arms resulting from overexposure to solar radiation. An elevated level of protoporphyrin in the red blood cells and feces was detected by thin-layer chromatography and fluorescent scanning analysis.

Plasma Concentrations of Complement-Modulating Proteins (C1 Inhibitor, C4 Binding Protein, Factor H and Factor I) in Inflammatory Dermatoses with Special Reference to Psoriasis

By using single radial immunodiffusion, plasma levels of four complement-modulating proteins, i.e. C1 inhibitor (C1INH), C4-binding protein (C4bp), factor H and factor I were measured in 42 psoriatic patients and in 60 patients with other inflammatory skin diseases in comparison with 27 normal controls. In psoriatic patients and those with related pustular dermatoses, the levels of C4bp, factor H and factor I were significantly increased. They correlated well with both extent of skin changes and disease activity. In contrast, in nonpsoriatic inflammatory dermatoses only factor H values were significantly increased in toxic erythema and factor I in atopic dermatitis. These results offer additional support for the hypothesis that the complement system is involved in psoriasis and related sterile pustular dermatoses.