Anti-CD8 monoclonal antibody (DAKO clone C8/144B) cross reacts with keratin 15 (K15) and serves as a specific marker for the bulge area of the outer root sheath, in which hair stem cells reside. Using this antibody, we investigated the immunoreactivity of K15 in a group of cutaneous tumors known or alleged to be of follicular differentiation. Some neoplastic cells of follicular tumors such as basal cell carcinomas, trichoepitheliomas, trichoblastomas, and steatocystoma multiplex were shown to be positive for anti-CD 8 monoclonal antibody. Immunoreactivity of a specific marker for the bulge area in follicular tumors suggests that the hair stem cells play a role in the pathogenic mechanisms of these tumors.
We studied the production of type I collagen and glycosaminoglycans by human dermal fibroblasts derived from young and old individuals after UVA irradiation. In these experiments, we introduced a new three-dimensional culture system supplemented with L-ascorbic acid 2-phosphate. In fibroblasts from old individuals (n=3), the amount of collagens in the cell layer was significantly decreased and matrix metallproteinase-1 (MMP-1) activity in the supernatant was significantly elevated after UVA irradiation, while the amounts of glycosaminoglycans in the cell layer and stromelysin-1 (MMP-3) activity showed no significant changes. In contrast, there were no significant changes after UVA irradiation of fibroblasts from young individuals (n=3). These results suggest that the donor age of dermal fibroblasts may be crucial to investigating the metabolism of type I collagen after UVA irradiation.
A statistical analysis of 111 cases of squamous cell carcinoma treated at the Department of Dermatology, Asahikawa Medical College, during the past 25 years (1976–2000) is reported. The patients comprised 65 men and 46 women with a sex ratio of 1 : 0.7. The incidence tended to increase in those over 60 years of age, and the face (53 cases (47.7%)) followed by the lower legs (14 cases (12.6%)). Pre-cancerous lesions were documented in 57 cases, including 27 senile keratoses and 12 burn scars. Surgical operation alone was used in 77 cases, and surgical operation combined with chemotherapy was performed 21 cases. Local recurrence with distant metastasis was observed in 22 cases ; 13 patients were killed by the disease. The five-year survival rates in terms of TNM classification were as follos: stage I, 100%; stage II, 79.3%; stage III, 34.4%; stage IV, 0%. Prognosis became poorer as TNM classification and level classification advanced. Pre-cancerous lesions of scars and male gender were other factors of a worse prognosis.
Apocrine cystadenoma (AC) usually affects the facial region. Here in we report two cases of AC occurring on the foot and toe. They were 74-and 54-year-old males. The former developed a 15×17×10 mm sized, blue-brown nodule on the left forth toe, and the latter developed a 45×36×25 mm sized, dark brown cystic nodule on the left dorsal foot. Microscopically, the two cases exhibited unilocular cysts in the dermis. The cyst wall was lined by two or more layers of columnar cells, part of which shoued papillary projection into the lumen ; furthermore, these cyst walls showed distinct decapitaion secretion. An immunohistochemical study, using anti-cytokeratin antibodies, which characterize distinct parts of the sweat gland, showed the Case 1 had differentiated to the secretory portion of the sweat glands and that Case 2 had differentiated to the secretory and excretory ductal portions of the sweat glands. In addition, both cases were positive for S-100 protein, lysozyme and HMFG1. GCDFP-15, which is not reportedly a marker for apocrin differentiation, was positive only in Case 1. Based on the above observations, we concluded that our two cases had differentiated to apocrine glands.
We describe herein two cases of mucous cyst with infiltration of mucoprotein-containing histiocytes. One patient had a mucous cyst of the lower lip, and the other had a digital mucous cyst of the thumb. These patients were treated by surgical excision after local triamcinolone acetonide injections were administered. Histologic features of the surgical specimen from the mucous cyst of the lower lip showed solid regions of various sizes that were composed of cells with abundant granular basophilic cytoplasm, round nuclei were observed in the submucosa and muscle tissues. The surgical specimen from the digital mucous cyst also showed infiltration of the same type of cells in the upper dermis. The cells were positive with mucicarmine and Alcian blue at pH 2.5. Metachromasia was demonstrated by toluidine blue stain. Immunohistologically, CD68 and lysozyme stains were postitve in the majourity of the infiltrating cells. These histological findings show the pattern expected in mucoprotein-containing macrophages, and these cases suggest that local triamcinolone acetonide injection for mucous cyst may induce a mucoprotein-phagocytic reaction.
We report two cases of secondary syphilis in HIV-infected homosexual men. A 29-year-old men with HIV seropositivity developed multiple, large, annular, growing lesions on his face, limbs and trunk. A loss of the left wing of his nose, scaly erythema on his scrotum, and multiple ulcers on his penis were also observed. The second case, 34-year-old man with HIV-seropositvity developed multiple rupioid lesions with ulceration on his limbs and trunk. Necrosis of the soft palate and a shift of uvula palatina were observed. Histopathologically, specimens from both cases revealed high-density cellular infiltration, mainly consisting of lymphocytes and plasma cells in the dermis. Warthin-Starry stain for spirochetes were negative. Even with treatment of a penicillin series, both patients suffered a loss of the wing of the nose or the soft palate the annular skin lesions of both cases healed without any scar. Both cases were diagnosed as aggressive forms of secondary syphilis, so called ‘malignant syphilis’. In addition, we compared the incidence of symptomatic syphilis among a group of HIV positive persons with that among HIV negative persons who attended the dermatology clinic at Tokyo Metropolitan Komagome hospital during the last ten years. The results showed that the HIV positive group had a greater variety of eruptions and chance of re-infection and recrudescence than the HIV negative group did.