Language：Japanese   Publisher：金原出版(株)  

63歳男。3ヵ月前より右大腿部に紅斑を伴う皮下結節が出現し、前医にて細菌感染を疑われ、抗菌薬投与を受けるも改善しなかった。1ヵ月前には同部位が潰瘍・膿瘍化し、右鼠径にも皮下結節が出現したため、精査加療目的で当科初診となった。初診時、右大腿部外側に紅斑を伴う硬結があり、中心に13mm大の潰瘍を伴っていた。また、右鼠径部周辺に小指頭大、弾性硬の可動性に乏しい紅色結節を認めた。当初、細菌感染症や真菌感染を考え、MINO内服やスルファジアジン銀クリーム外用を開始するも改善せず、初診20日目に入院となった。入院後は穿刺排膿を施行し、皮膚Mycobacterium abscessus感染症と診断された。MINOに加え、CAMの内服投与を開始し、右大腿部感染巣切除術および右鼠径皮下結節切除術を施行した。術後経過良好であったが、切除2週間後に右大腿創周囲に感染の再燃を認め、CAMの増量とともにアミカシン・セフメタゾールを併用し、感染巣切除術を再度行った。術後3年7ヵ月の現在、再発はみられない。

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Language：Japanese   Publisher：Japanese Dermatological Association  

<p>Molecular targeting agents are widely used to treat various inflammatory and immune diseases and tumors. Unlike the adverse reactions induced by conventional drugs, these drugs induce various new types of adverse reactions. Anti-PD-1 antibody has clearly induced survival benefits in patients with metastatic melanoma. However, immune checkpoint inhibitors sometimes induce various kinds of immune-related adverse events (irAE). It is very important for clinicians to know the prevalence, clinical types, and severity of irAE in these drugs.</p><p>We analyzed the clinical characteristics of the adverse cutaneous effects of anti-PD-1 antibody in melanoma patients. The 7 patients studied were referred to Yokohama City University Hospital between October of 2014 and March of 2016. Vitiligo, cutaneous pruritus, lichenoid eruptions, psoriasiform eruptions, and bullae on the extremities were observed. All of these patients were able to be managed without discontinuation of the drug.</p><p>Larger clinical studies of this drug would help to predict and manage the characteristics of cutaneous adverse reactions. Dermatologists should be careful to detect and treat irAE induced by the newly developed immune checkpoint inhibitors.</p>

DOI： 10.14924/dermatol.126.2419

CiNii Books

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Language：Japanese   Publisher：(一社)日本皮膚アレルギー・接触皮膚炎学会  

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Language：Japanese   Publisher：(株)北隆館  

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Language：English  

DOI： 10.1111/1346-8138.12801

Web of Science

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Language：English   Publisher：WILEY-BLACKWELL  

Background Recent findings indicate that periostin, an extracellular matrix protein induced by T helper 2 cytokines, plays a critical role in the pathogenesis of atopic dermatitis (AD).
Objectives To determine whether serum periostin level is associated with clinical phenotype in adult patients with AD.
Methods An enzyme-linked immunosorbent assay was performed to determine serum periostin levels in 257 adult patients with AD, 66 patients with psoriasis vulgaris (PV) as a disease control and 25 healthy controls. Serum periostin levels were analysed together with clinical characteristics and laboratory parameters, including thymus and activation-regulated chemokine (TARC), lactate dehydrogenase (LDH), blood eosinophil count and total IgE. Immunohistochemical analysis evaluated the expression of periostin in association with various clinical phenotypes of AD. The effect of treatment on serum periostin level was also assessed.
Results Serum periostin was significantly higher in patients with AD than in patients with PV and healthy controls. Periostin level was found to be positively correlated with disease severity, TARC level, LDH level and eosinophil count, but not with IgE level. Higher serum periostin level was observed in patients with extrinsic AD compared with patients with intrinsic AD; the positive correlation of disease severity disappeared in patients with intrinsic AD. Robust expression of periostin was detected in the dermis of patients with AD with erythroderma, lichenification and, to a lesser extent, scaly erythema. Serial measurement of serum periostin revealed decreased levels of periostin after treatment for AD.
Conclusions Periostin may play a critical role in disease severity and chronicity in the pathogenesis of AD.

DOI： 10.1111/bjd.12943

Web of Science

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PubMed

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Language：English   Publisher：WILEY-BLACKWELL  

Background Recent findings indicate that periostin, an extracellular matrix protein induced by T helper 2 cytokines, plays a critical role in the pathogenesis of atopic dermatitis (AD).
Objectives To determine whether serum periostin level is associated with clinical phenotype in adult patients with AD.
Methods An enzyme-linked immunosorbent assay was performed to determine serum periostin levels in 257 adult patients with AD, 66 patients with psoriasis vulgaris (PV) as a disease control and 25 healthy controls. Serum periostin levels were analysed together with clinical characteristics and laboratory parameters, including thymus and activation-regulated chemokine (TARC), lactate dehydrogenase (LDH), blood eosinophil count and total IgE. Immunohistochemical analysis evaluated the expression of periostin in association with various clinical phenotypes of AD. The effect of treatment on serum periostin level was also assessed.
Results Serum periostin was significantly higher in patients with AD than in patients with PV and healthy controls. Periostin level was found to be positively correlated with disease severity, TARC level, LDH level and eosinophil count, but not with IgE level. Higher serum periostin level was observed in patients with extrinsic AD compared with patients with intrinsic AD; the positive correlation of disease severity disappeared in patients with intrinsic AD. Robust expression of periostin was detected in the dermis of patients with AD with erythroderma, lichenification and, to a lesser extent, scaly erythema. Serial measurement of serum periostin revealed decreased levels of periostin after treatment for AD.
Conclusions Periostin may play a critical role in disease severity and chronicity in the pathogenesis of AD.

DOI： 10.1111/bjd.12943

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Language：Japanese   Publisher：Kyushu University  

DOI： 10.2336/nishinihonhifu.76.92

Scopus

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Language：Japanese   Publisher：(一社)日本皮膚アレルギー・接触皮膚炎学会  

J-GLOBAL

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Language：Japanese   Publisher：(公社)日本皮膚科学会  

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Language：Japanese   Publisher：(一社)日本アレルギー学会  

J-GLOBAL

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Language：Japanese   Publisher：(公社)日本皮膚科学会  

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Language：Japanese   Publisher：Meeting of Osaka Dermatological Association/Meeting of Keiji Dermatological Association  

DOI： 10.11340/skinresearch.12.212

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Language：Japanese   Publisher：(公社)日本皮膚科学会  

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Language：English  

DOI： 10.1016/j.jdermsci.2012.02.004

Web of Science

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PubMed

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Language：Japanese  

A 29-year-old woman had an "episode of urticaria at the age of 17 while exercising after eating fried cuttlefish. For years thereafter, she experienced several episodes of urticaria after eating seafood. At the age of 29, she ate grilled seafood, including cuttlefish for supper after taking loxoprofen for lumbago. One hour later, she developed generalized urticaria accompanied by nausea, abdominal pain. swelling of the lips, and dyspnea while walking
she was taken to a hospital. She was then referred to us for further examination of the etiology of her anaphylactic reactions. The level of specific IgE measured using Immuno CAP was negative for all kinds of foods, including cuttlefish. However, a skin prick test was positive for raw and cooked cuttlefish. Provocation tests were performed on admission by combining the intake of cuttlefish and aspirin under the suspicion of cuttlefish allergy enhanced by nonsteroidal anti-inflammatory drugs and exercise. As a result she developed no symptoms except for slight itching of the oral mucosa after eating 20g or 100g of cuttlefish with or: without concomitant administration of 0.5g of aspirin. Finally, generalized urticaria appeared after - challenge with cuttlefish and 1.5g of aspirin. She was diagnosed with food-dependent exercise-, induced anaphylaxis (FDEIA) caused by cuttlefish. She has not developed urticaria since she started to avoid eating cuttlefish. Our results indicated that in provocation tests for the diagnosis of FDEIA, allergic reactions could not only be induced by food intake but could also be enhanced by aspirin in a dose-dependent manner. © 2010 Japanese Society of Allergology.

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Language：Japanese  

A 75-year-old man ingested salted fish guts made of Sagittated calamari which he caught in the daytime, with alcohol and then dozed. Five hours later, he woke up due to itching over his entire body and noticed generalized urticaria and a swollen tongue, which was too large for him to close his mouth. Serum total IgE was 456IU/ml and ImmunoCAP was positive for anisakis, but negative for squid, shrimp, and ascaris. A skin prick test (SPT) was positive for anisakis extract (10mg/ml) and house dust mites, but negative for squid and shrimp. He was diagnosed with IgE-mediated allergy due to Anisakis simplex after the ingestion of salted fish guts made of Sagittated calamari, which had been parasitized by Anisakis simplex. Furthermore, we performed SPT with six extracts of purified or recombinant allergens (Ani s 1,3.4,5,6, and 8) to identify the causative allergens in this case. Only Ani s 3 (tropomyosin) was positive, indicating that Ani s 3 was the causative allergen in this case. Third stage larvae of the nematode Anisakis simplex often parasitize not only marine fish but also invertebrates, including squid. It is necessary to consider Anisakis simplex allergy for urticarial reactions that develop after the ingestion of squid. © 2010 Japanese Society of Allergology.

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PubMed

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Language：Japanese  

A 29-year-old woman had an "episode of urticaria at the age of 17 while exercising after eating fried cuttlefish. For years thereafter, she experienced several episodes of urticaria after eating seafood. At the age of 29, she ate grilled seafood, including cuttlefish for supper after taking loxoprofen for lumbago. One hour later, she developed generalized urticaria accompanied by nausea, abdominal pain. swelling of the lips, and dyspnea while walking
she was taken to a hospital. She was then referred to us for further examination of the etiology of her anaphylactic reactions. The level of specific IgE measured using Immuno CAP was negative for all kinds of foods, including cuttlefish. However, a skin prick test was positive for raw and cooked cuttlefish. Provocation tests were performed on admission by combining the intake of cuttlefish and aspirin under the suspicion of cuttlefish allergy enhanced by nonsteroidal anti-inflammatory drugs and exercise. As a result she developed no symptoms except for slight itching of the oral mucosa after eating 20g or 100g of cuttlefish with or: without concomitant administration of 0.5g of aspirin. Finally, generalized urticaria appeared after - challenge with cuttlefish and 1.5g of aspirin. She was diagnosed with food-dependent exercise-, induced anaphylaxis (FDEIA) caused by cuttlefish. She has not developed urticaria since she started to avoid eating cuttlefish. Our results indicated that in provocation tests for the diagnosis of FDEIA, allergic reactions could not only be induced by food intake but could also be enhanced by aspirin in a dose-dependent manner. © 2010 Japanese Society of Allergology.

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PubMed

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Language：Japanese  

A 75-year-old man ingested salted fish guts made of Sagittated calamari which he caught in the daytime, with alcohol and then dozed. Five hours later, he woke up due to itching over his entire body and noticed generalized urticaria and a swollen tongue, which was too large for him to close his mouth. Serum total IgE was 456IU/ml and ImmunoCAP was positive for anisakis, but negative for squid, shrimp, and ascaris. A skin prick test (SPT) was positive for anisakis extract (10mg/ml) and house dust mites, but negative for squid and shrimp. He was diagnosed with IgE-mediated allergy due to Anisakis simplex after the ingestion of salted fish guts made of Sagittated calamari, which had been parasitized by Anisakis simplex. Furthermore, we performed SPT with six extracts of purified or recombinant allergens (Ani s 1,3.4,5,6, and 8) to identify the causative allergens in this case. Only Ani s 3 (tropomyosin) was positive, indicating that Ani s 3 was the causative allergen in this case. Third stage larvae of the nematode Anisakis simplex often parasitize not only marine fish but also invertebrates, including squid. It is necessary to consider Anisakis simplex allergy for urticarial reactions that develop after the ingestion of squid. © 2010 Japanese Society of Allergology.

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PubMed

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