記述言語：日本語   出版者・発行元：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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記述言語：日本語   出版者・発行元：公益社団法人 日本皮膚科学会  

<p>2014年10月から2016年3月までの期間に抗PD-1抗体による皮膚障害を認めた7症例をまとめた．そのうち2例では複数の皮膚障害を併発した．皮膚障害の内訳は白斑，皮膚そう痒症，水疱形成，苔癬型薬疹，乾癬型薬疹であった．皮膚障害を認めた7例全ての症例で治療継続可能であった．肺癌をはじめ，今後更にPD-1抗体の適応が拡大されることが予想されるため，免疫チェックポイント阻害薬による新たな障害の出現に十分な注意が必要である．</p>

DOI： 10.14924/dermatol.126.2419

CiNii Books

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記述言語：日本語   出版者・発行元：(一社)日本皮膚アレルギー・接触皮膚炎学会  

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記述言語：日本語   出版者・発行元：(株)北隆館  

アトピー性皮膚炎(AD)患者におけるペリオスチン測定の臨床的意義を検討した。ELISA法を用いて測定した血清ペリオスチン値は健常人と比較してADで有意に上昇していた。重症ADでは軽症・中等度と比較して高値を示し、臨床症状の改善に伴い低下した。その値はTARC、好酸球数、LDHと相関した。ADの臨床系では紅皮症型ADの血清、皮膚でペリオスチンの発現が有意に高く重症型と相関した。慢性皮疹である苔癬化病変を伴う症例ではペリオスチン発現が上昇していた。ペリオスチンはAD重症化、慢性病変形成に関与していると考えられた。(著者抄録)

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記述言語：英語   出版者・発行元：WILEY-BLACKWELL  

A number of cases of psoriasis vulgaris developing bullous skin lesions have been diagnosed as either bullous pemphigoid with antibodies to the 180-kDa bullous pemphigoid antigen (BP180) non-collagenous 16a (NC16a) domain or anti-laminin-1 (p200) pemphigoid. We report a case of subepidermal bullous disease with psoriasis vulgaris, showing antibodies to both BP180 C-terminal domain and laminin-1. A 64-year-old Japanese man with psoriasis vulgaris developed exudative erythemas and tense bullae on the whole body but he did not have mucosal involvement. The blistering lesion showed subepidermal blisters histopathologically. In indirect immunofluorescence of 1mol/L NaCl-split skin, immunoglobulin (Ig)G antibodies reacted with both the epidermal and dermal side. Immunoblotting showed positive IgG with recombinant protein of BP180 C-terminal domain and 200-kDa laminin-1 in normal human dermal extract.

DOI： 10.1111/1346-8138.12801

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記述言語：英語   出版者・発行元：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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記述言語：英語   出版者・発行元：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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記述言語：日本語   出版者・発行元：Kyushu University  

Fibrous hamartoma of infancy (FHI) is a relatively rare subcutaneous soft tissue tumor in children. We report on a 1-year-old girl with a fibrous hamartoma on the right upper arm. The subcutaneous tumor was first noticed at the age of 5 months and had grown gradually. When the patient was 11 months old, hypertrichosis was noticed on the tumor surface. The tumor had a diameter of around 17 mm and was elastic hard. The surface of the mass was smooth, and its movability was good. The surgical resection was performed when the girl was 12 month old. Histopathologically, an organoid structure was apparent, consisting of mature fat tissue and complicating fibrous trabeculae, as well as an increased concentration of immature mesenchymal cells. The histological diagnosis was fibrous hamartoma of infancy (FHI). Five years and nine months after the operation, no recurrence has been noticed. We suggest that FHI should be included in a differential diagnosis of subcutaneous tumors in infants.

DOI： 10.2336/nishinihonhifu.76.92

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記述言語：日本語   出版者・発行元：(一社)日本皮膚アレルギー・接触皮膚炎学会  

J-GLOBAL

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記述言語：日本語   出版者・発行元：(公社)日本皮膚科学会  

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記述言語：日本語   出版者・発行元：(一社)日本アレルギー学会  

J-GLOBAL

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記述言語：日本語   出版者・発行元：(公社)日本皮膚科学会  

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記述言語：日本語   出版者・発行元：日本皮膚科学会大阪地方会・日本皮膚科学会京滋地方会  

44歳，男性。両側精巣腫瘍，S状結腸癌の既往がある。上腹部に激痛が生じた翌日に，顔面，体幹部に発赤を伴う小丘疹と小水疱，および口腔内水疱が出現した。Tzanck 試験は陽性であった。激烈な腹痛を伴うことから，内臓播種性水痘・帯状疱疹ウイルス (VZV) 感染症を疑い，アシクロビル (acyclovir; ACV) 750mg/day 開始したが，症状の改善は乏しく，肝機能の悪化，DICを合併した。第4病日より ACV 1,500mg/day に増量，Intravenous immunoglobulin (IVIG) 5,000mg/day（5日間）を追加し，症状は次第に改善した。経過中，血中 VZV-DNA 量が髙値であり，内臓播種性 VZV 感染症と診断した。本疾患は急速に進行し，ときに致死的である。水痘に腹部症状を伴う場合，本疾患を疑い，早期に大量の ACV や IVIG による治療をおこなうことが重要と考えた。(皮膚の科学，12: 212-218, 2013)

DOI： 10.11340/skinresearch.12.212

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記述言語：日本語   出版者・発行元：(公社)日本皮膚科学会  

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記述言語：英語   出版者・発行元：ELSEVIER IRELAND LTD  

Background: Dry skin causes pruritus and discomfort in patients with xerosis and atopic dermatitis. General treatment for skin dryness involves the topical application of an emollient. However, more effective, simpler therapies are desired. Collagen tripeptide (CTP) is a highly purified, non-antigenic, low-allergenic collagen fraction that is known to have various biological effects.
Objective: To clarify the therapeutic effects of CTP for dry skin using acetone-induced dry skin model mice.
Methods: ICR mice were treated with acetone followed by oral administration of CTP (80 or 500 mg/kg/day) for 3 days. Hyaluronic acid production induced by CTP was assessed using human dermal fibroblasts in vitro and in an acetone-induced dry skin model mice in vivo. Transepidermal water loss (TEWL) and scratching behavior were evaluated. Furthermore, the effects of CTP on intraepidermal nerve fibers and expression of semaphorin 3A (Sema3A) and nerve growth factor (NGF) were examined by immunohistochemistry and quantitative RT-PCR.
Results: CTP enhanced hyaluronic acid production in human dermal fibroblasts in vitro and in murine skin in vivo. Oral administration of CTP in acetone-induced dry skin model mice significantly decreased TEWL and suppressed scratching behavior. Intraepidermal nerve growth was dramatically inhibited in CTP-treated mice. Quantitative PCR analysis and immunohistochemical study revealed that CTP abolished the increased NGF and decreased Sema3A levels induced by acetone treatment.
Conclusion: Oral administration of CTP improves dry skin and normalizes axon-guidance factors in the epidermis in addition to reducing pruritus. CUP may be used in a new therapeutic strategy against dry skin and pruritus. (C) 2012 Japanese Society for Investigative Dermatology. Published by Elsevier Ireland Ltd. All rights reserved.

DOI： 10.1016/j.jdermsci.2012.02.004

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記述言語：日本語  

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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記述言語：日本語  

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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記述言語：日本語  

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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記述言語：日本語  

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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