摘要:

AbstractThe follicular skin lesions of a patient with eosinophilic pustular folliculitis were investigated by electron microscopy. Pustules in the outer root sheath contained acantholytic keratinocytes with numerous microvilli and features of desmosomal cleavage. The infiltrating eosinophils and neutrophils exhibited autolytic or degenerative changes rather than degranulation. The aggregated tubulo‐vesicular structures were associated with the debris of autolytic eosinophils. Multiple, tiny, bubble‐like structures enclosed within a membrane were frequently seen in the intercellular space. The intercellular space of the outer root sheath was widened with decreased desmosomal adhesion between the keratinocytes, but no intracellular edema was detectable. The infiltrating lymphocytes, predominantly T‐cells with convoluted nuclei, extended cytoplasmic processes to adjacent keratinocytes. Apposition of T‐lymphocytes and Langerhans cells was noted. Some keratinocytes in the outer root sheath contained large, sebaceous lipid droplets. No obvious virus particles or other pathogenic agents were detected. It is possible mat T‐lymphocytes and other immunosurveillance cells are involved in the pathomechanism of eosinophilic pustular fol

ISSN:0385-2407    

DOI:10.1111/j.1346-8138.1992.tb03208.x

年代:1992

数据来源: WILEY

摘要:

AbstractEosinophil cationic protein (ECP), one of the eosinophil granule proteins, is released during allergic reactions. We investigated the possibility of correlations among the serum levels of ECP, clinical activity, and eosinophil number in patients with atopic dermatitis (AD). Forty‐four patients with AD and 25 normal, non‐atopic subjects were studied. ECP was quantitated by a double antibody radioimmunoassay. The levels of serum ECP correlate with the grading of severity of clinical evaluations in AD. The patients with severe and moderate AD had significantly higher ECP concentrations than normal controls (p<0.001); mild AD had levels identical with those of control groups. A positive correlation was observed between the number of peripheral blood eosinophils and serum ECP levels in the severe cases (r=0.67, p<0.05). Furthermore, these ECP levels significantly decreased in response to either improvement of clinical severity of AD or decreased numbers of blood hypodense eosinophils in anti‐allergic drug‐treated patients. No coefficient of correlation was observed between serum ECP and IgE levels. These findings indicate that eosinophils may release their granular contents, including ECP, into the peripheral circulation and/or inflammatory skin lesions and subsequently provoke a clinical exacerbation by stimulating allergic re

ISSN:0385-2407    

DOI:10.1111/j.1346-8138.1992.tb03209.x

年代:1992

数据来源: WILEY

摘要:

AbstractTo clarify the differences in epidermal keratinocyte proliferative activity and in postnatal developmental changes of this activity between the hair discs and the interfollicular epidermis, the incorporation of3H‐thymidine into the nuclei of the basal cells was measured by autoradiography, and the percentages of basal cells thus labelled were calculated. This percentage was higher in hair discs than in interfollicular epidermis at all stages examined. The percentage of labelled basal cells in the hair discs was 10% up to 15 days after birth, decreasing to about 6% from 20 days postnatally. These results suggest that the degree of cell proliferation in the hair disc epidermis differs from that in the surrounding epidermis and that changes in proliferative activity during the postnatal developmental stages are well correlated with the morphogenesis of the hair disc

ISSN:0385-2407    

DOI:10.1111/j.1346-8138.1992.tb03210.x

年代:1992

数据来源: WILEY

摘要:

AbstractLight and electron‐microscopic studies were performed on the vitiligo and adjacent, normal appearing skin from 97 patients with actively spreading vitiligo and 19 patients with stable vitiligo. The vitiliginous skin revealed complete loss of pigment and melanocytes. In addition to degenerative changes in melanocytes, vacuolar changes of basal cells, epidermal infiltration of lymphocytes, dermal infiltration of lymphocytes, and melanophages in the upper dermis were also seen in the normal appearing skin adjacent to vitiliginous skin. These epidermal and dermal changes are more prominent in the skin of actively spreading vitiligo than in stable vitiligo. These findings suggest that the adjacent, normal appearing skin of actively spreading vitiligo shows some characteristic histopathologic findings, especially in the epidermis, indicating that cellular immunity could be involved in the pathogenesis of vitilig

ISSN:0385-2407    

DOI:10.1111/j.1346-8138.1992.tb03211.x

年代:1992

数据来源: WILEY

摘要:

AbstractWe encountered three Japanese families with neonatal lupus erythematosus. None of the three fathers showed any signs of collagen disease. The three mothers were found to suffer from Sjögren's syndrome; they all tested positive for anti‐SSA and SSB antibodies and had lymphocyte infiltration into the small salivary gland. In two families, one child had neonatal lupus erythematosus while a sibling was normal; in the third family, both children had neonatal lupus erythematosus. Thus, a mother with positive anti‐SSA and SSB antibodies can give birth to one infant with and one infant without or have two infants with neonatal lupus erythematosus. We conducted HLA typing of all 12 members of the three families in order to clarify the immunologic factors involved. We found no increased frequency of any HLA phenotype in the three mothers and their four children with neonatal lupus erythematosus; however, HLA‐DR4 was present in three of the children with neonatal lupus erythem

ISSN:0385-2407    

DOI:10.1111/j.1346-8138.1992.tb03212.x

年代:1992

数据来源: WILEY

摘要:

AbstractTwo cases of tsutsugamushi disease misdiagnosed initially as drug eruption were reported. Clinical symptoms of both cases disappeared dramatically after starting minocycline. Statistical examinations were performed on 29 cases of tsutsugamushi disease, including those observed in Mie Prefecture since 1982. Half of them were seen in the last 2 years. The onset was predominantly recorded in November (59%). Presumptive sites of infection were forests (63%) and fields (21%). No patients were infected along river‐bank

ISSN:0385-2407    

DOI:10.1111/j.1346-8138.1992.tb03213.x

年代:1992

数据来源: WILEY

摘要:

AbstractWe herein report a case of a rare variety of the acute eruptive form of lichen planus. The patient was a 51‐year‐old male who developed an intensely pruritic eruption on the lower legs which spread rapidly to all four extremities and trunk within a few months. The papulosquamous lesions were more than ten thousand in number. Topical steroid, cyclosporine, and systemic griseofulvin treatments were ineffective. However, there was a dramatic response to oral etretin

ISSN:0385-2407    

DOI:10.1111/j.1346-8138.1992.tb03214.x

年代:1992

数据来源: WILEY

摘要:

AbstractAlthough the usual size of senile sebaceous hyperplasia is 2 to 3 mm in diameter, we report one “giant” nodular case on the face. The patient is a 75‐year‐old Japanese man with a dome‐shaped, skin‐colored nodule on his right cheek. The lesion was 10 mm in diameter and had multiple small umbilications on its surface. He also had several small, yellow‐colored, asymptomatic papules with central umbilication on his cheeks. Histologically, the giant nodule and the papule on the right cheek showed the same architectural pattern, a sharply demarcated hyperplasia of grouped mature sebaceous glands with a sebaceous converging duct, whose opening to the surface epithelium corresponded to the clinical umbilication. The reason for the giant growth of this senile sebaceous hyperplasia in our case is obscure; the patient had not been stressed by inductive agents or factors such as systemic corticosteroid and hemodialysis except for electrocoagulation on the lesion. In spite of the extraordinarily large size of the nodule, the conservative proliferating pattern seemed to show the benign hyperplastic character of senile sebaceou

ISSN:0385-2407    

DOI:10.1111/j.1346-8138.1992.tb03215.x

年代:1992

数据来源: WILEY

摘要:

AbstractWe report a case of angiosarcoma with some peculiar clinical features developing on the left thigh of a 63‐year‐old man. The early primary lesion was erythematous with necrotic areas. The initial biopsy specimen of the lesion indicated a benign angioproliferative process. However, the necrotic area enlarged rapidly, ulcerated with severe pain, and thus was widely excised. The excised specimen had a malignant histologic appearance, particularly in the fascia, and was diagnosed as angiosarcoma. Following local recurrence, the lesion was complicated by thrombosis of the femoral artery at the affected site. A similar cutaneous lesion subsequently arose on the right lower leg, and thrombosis developed in the right femoral artery. Both legs had to be amputated. There were no distant metasta

ISSN:0385-2407    

DOI:10.1111/j.1346-8138.1992.tb03216.x

年代:1992

数据来源: WILEY

摘要:

AbstractA female patient with acanthosis nigricans, insulin resistant diabetes, and generalized lipoatrophy is reported. The patient developed skin pigmentation and acanthosis nigricans around the age of 34. Arthralgia, muscle weakness, and peripheral neuropathy were also present when she first visited us at 36 years of age. Dermatomyositis, systemic sclerosis, and internal malignancy were ruled out, and the diagnosis of acanthosis nigricans and insulin resistant diabetes was made. Her diabetes gradually worsened and, since the age of 39, she has been treated with an oral anti‐diabetic drug. Around the age of 47, generalized lipoatrophy became prominent Insulin receptor studies ruled out insulin resistant diabetes type A and B. At this point, we diagnosed this patient as having lipoatrophic diabetes, which is a syndrome characterized by insulin resistant diabetes, acanthosis nigricans, generalized lipoatrophy, and other metabolic disturbances. The control of her diabetes has been poor, and diabetic neuropathy and lipoatrophy‐induced painful skin lesions such as clavus and tylosis have been persistent The present case indicates the importance of careful skin examinations in the diagnosis of this syndr

ISSN:0385-2407    

DOI:10.1111/j.1346-8138.1992.tb03217.x

年代:1992

数据来源: WILEY