Yoshiaki Takegami

Bullous pemphigoid with IgG anti-LAD-1 antibodies

Bullous pemphigoid (BP) is an autoimmune subepidermal blistering disease that commonly presents with IgG autoantibodies to the NC16a domain of BP180 and/or BP230 [1]. The detection of other types of antibodies in BP patients has occasionally been reported [2, 3]. This report describes a BP patient in whom only IgG antibodies to the 120-kDa LAD-1 were detected.A 65-year-old Japanese female presented with pruritic blisters. The patient had no particular familial history; however, she had been treated [...]

Maintenance of remission with low-dose olopatadine hydrochloride for itch in well-controlled chronic urticaria

Background: The long-term follow-up of chronic urticaria (CU) is important to ensure the adequate treatment of patients. Olopatadine hydrochloride is one of the second-generation nonsedating antihistamines. Methods: This study was designed to assess the optimal dose of olopatadine to suppress symptoms of chronic urticarial itch in well-controlled patients. After CU patients were treated with 10 mg olopatadine, patients having a visual analog scale (VAS) itch score of less than 20 were randomly allocated into one of three groups: 10 mg/day (n = 35), 5 mg/day (n = 30), or no medication (n = 32). Results: The suppressive effects of both the 5 mg and 10 mg olopatadine treatments on the VAS itch score were more significant and longer lasting over a period of 4 weeks than the no-medication treatment. Both the 5-mg group and the 10-mg group showed improved urticarial symptoms and maintained their VAS itch score within normal limits compared to the no-medication group. The differences between the 5-mg and 10-mg groups were not significant. Conclusion: These results demonstrate that treatment with olopatadine at a dose of 5 mg once daily is effective and safe for the management and prevention of CU symptoms for itch in well-controlled patients.

Unusual bullous pemphigoid without infiltration of inflammatory cells in the skin lesions

Bullous pemphigoid (BP) is an inflammatory subepidermal blistering disease associated with an autoimmune response to BP180 and/or BP230. The histopathological findings demonstrate subepidermal blisters with the infiltration of eosinophils and neutrophils [1]. This report describes a Japanese patient with BP, in whom only a few inflammatory cells were observed in the skin lesions.An 84-year-old Japanese female presented with tense blisters. She had no particular family history; however, she had been [...]

Coexistence of antilaminin-332-type mucous membrane pemphigoid, lamina lucida-type linear IgA bullous dermatosis and Sjögren syndrome

1 Mikeljevic J, Highet AS. Nicorandil-induced leg ulceration without mucosal involvement. Clin Exp Dermatol 2011; 36: 372–3. 2 McKenna DJ, Donnelly J, Armstrong DKB. Nicorandilinduced leg ulceration. Br J Dermatol 2007; 156: 394–6. 3 Patel GK, Harding KG. Nicorandil ulcer: moves beyond the mucosa. Ann Royal College Surgeons England 2010; 92: 451–2. 4 Heil M, Hubiche T, Beltran C et al. Isolated cutaneous inguinal ulcerations induced by nicorandil. J Eur Acad Dermatol Venereol 2008; 22: 1139–40. 5 Yap T, Philippou P, Perry M et al. Nicorandil-induced penile ulcerations: a case series. BJU Int 2011; 107: 268– 71. Coexistence of antilaminin-332-type mucous membrane pemphigoid, lamina lucida-type linear IgA bullous dermatosis and Sj€ ogren syndrome

Synthesis and characterization of high-quality skin-cooling sheets containing thermosensitive poly(N-isopropylacrylamid)

Poly(N-isopropylacrylamide) (PNIPAAm) is the most popular thermosensitive polymer, and exhibits a low critical solution temperature of approximately 32°C. This study aimed to examine the usefulness of new cooling sheets, which are manufactured using a thermosensitive poly(N-isopropylacrylamide) (PNIPAAm) material. We prepared cooling-hydrogel sheets containing PNIPAAm (PNIPAAm sheet). We measured the skin temperature on the arms of the subjects using a thermograph and compared the usefulness of the PNIPAAm sheet and a control cooling-hydrogel sheet that did not contain the PNIPAAm mixture. Thermographic measurements obtained 40 min after the treatment with the cooling sheets showed the skin temperature of the subjects treated with the 3.% (w/w) PNIPAAm sheets to be significantly lower than that of the subjects treated with the control cooling-hydrogel sheet (p < 0.005). Compared with the control sheet, the cooling effect of the new PNIPAAm sheet also persisted for a longer duration (up to 100 min). The PNIPAAm sheets exhibited excellent cooling effects. This sheet may therefore be useful for lowering the body temperature of patients with high-grade fever, such as fever due to influenza infection.

Detection of cytomegalovirus in the gastric ulcer of a patient with drug-induced hypersensitivity syndrome.

Drug-induced hypersensitivity syndrome (DIHS)/drug reaction with eosinophilia and systemic symptoms (DRESS) is a severe adverse systemic reaction.1 DIHS is characterized by its limited number of causative drugs, late onset, clinical similarity to infectious mononucleosislike syndrome, and prolonged clinical course owing to relapse.2 Subjects with DIHS are known to show reactivation of human herpesvirus (HHV)-6, cytomegalovirus (CMV), Epstein-Barr virus, and HHV-7.3 This report describes the case of DIHS with a dramatic reactivation of CMV and a development of gastric ulcers, in which CMV was immunohistochemically detected.

Successful treatment with UVA rush hardening in a case of solar urticaria

Solar urticaria (SU) is a rare idiopathic photodermatosis. The symptoms are usually observed within ten minutes after exposure to sunlight. The action spectra are different among cases, ranging from ultraviolet B (UVB) to visible light [1]. SU is commonly treated with oral antihistamines, sunscreen, plasmapheresis and/or immunosuppressants. Phototherapy with various wavelengths of light and methods has also been performed to induce a tolerant state [2-4]. However, the symptoms of SU are frequently [...]