Photoaging, which is different from intrinsic or chronological aging, is a skin change induced by chronic and repeated exposure to ultraviolet light (UV). Photoaging skin is characterized by sallowness, mottled pigmentation, solar lentigines, dry and rough skin, telangiectasia, loss of skin tone, leathery texture, laxity, coarse and fine wrinkles, and benign and malignant skin tumors. The dermis of photoaging skin displays solar elastosis and prominent alterations in the collagenous extracellular matrix of the connective tissue. Solar elastosis is the accumulation of massive amounts of abnormal elastic material in the dermis. Some studies using a novel transgenic mouse model expressing a human elastin promoter-reporter gene construct have revealed that an increase in human elastin promoter activity is involved in accelated synthesis of elastin-related proteins. UV irradiation induces an increase in the activity, mRNA, and protein of matrix metalloproteinases via downstream signal transduction through activation of MAP kinase pathways and may contribute to photoaging. Sunscreens are known to be capable of preventing photoaging.
NC/Nga (NC) mice kept under conventional conditions spontaneously develop atopic dermatitis (AD)-like lesions with an elevation of serum IgE levels and hyperproduction of cytokines in Th2 T cells. In this study, cytokine production by splenocytes and lymph node cells was examined by ELISpot and ELISA in mice with and without dermatitis. In the mice with dermatitis, the production of the Th2-associated cytokines IL-4, IL-5, and IL-13, the Th1-associated cytokine, IFN-γ, and IL-12 were higher than those of the mice without dermatitis. The mice showing high levels of serum IL-18 at the age of 7 weeks developed more severe dermatitis at the age of 15 weeks than those with low levels of serum IL-18. There was no correlation between serum IL-18 levels and the production of Th1 or Th2-associated cytokines. These results suggest that the NC mice with AD-like lesions are associated with not only Th2 hyperproduction but also with Th1 hyperproduction and that a high level of serum IL-18 at the age of 7 weeks is correlates well with the development of severe dermatitis.
An atheroma is a follicular or epidermal cyst. The histopathological diagnoses of 2,856 cases clinically diagnosed as atheroma were analyzed. Of the total, 2,455 cases (86.0%) were correctly diagnosed as atheroma, but the other 401 cases were incorrectly diagnosed. In the latter group, 17 cases were malignant neoplasms including basal cell carcioma, squamous cell carcinoma, metastatic carcinoma, Merkel cell carcinoma, solar keratosis, apocrine carcinoma, dermatofibrosarcoma protuberans, syringomatous carcinoma .To diagnose atheroma correctly and not miss the malignant neoplasms or other unexpected diseases, histopathological examinations should be performed routinely.
The therapy using narrowband UVB lamp has been recently introduced for the treatment of generalized vitiligo vulgaris in Europe and the United States, but there have only been a few reports about its use in Japan. We established a combination therapy using topical calcipotriol ointment plus narrowband UVB as the basis of narrowband minimal erythema dose (nMED) for a 14-year-old Japanese girl with generalized vitiligo vulgaris. Pigmented patches appeared in her vitiliginous macula only after the combination of irradiated narrowband UVB and applied calcipotriol ointment. The results we present indicate that the combination therapy of narrowband UVB and calcipotriol ointment is superior to narrowband UVB treatment only or calcipotriol ointment treatment only in some patients with vitiligo.
Various local flaps are used for the reconstruction after tumor excision from the face. However, because landmarks such as eyelid, eyebrow, nose, lip and ear that we would not like to move exist on the face, local flaps are difficult to apply to large defects. Bilobed flaps are local flaps which are used mainly for defects on the outside of the nose. We were able to reconstruct the defects of five cases using bilobed flaps after tumor excisions from the face and to obtain satisfactory results. Bilobed flaps can be applied to large defects of the face under local anesthesia with minimal invasion.
Ultraviolet-C (UVC) irradiation is commonly used to sterilize vacant sickrooms. Three inpatients and five of their family members were accidentally exposed to UVC irradiation for 30 minutes in a hospital ward in 2003. We examined five of these people 24 hours after the accident. Four persons had no signs or symptoms, but an erythematous patch a rose on the left cheek of a 31-year-old woman, and she developed congestion in her left eye. The skin lesion developed branny scales within two days. Using the same sterilizer, we then studied whether UVC could directly damage cornified cells (keratinized cells without nuclei) of the human epidermis, because UVC is known to be absorbed by DNA in the nucleus and consequently alters the cytoplasm so that cellular damage is exhibited within several days. Scanning electron microscopy revealed that, within 24 hours after irradiation, the surface of the superficial cornified cells became undulated, probably as a result of degeneration of cytoplasmic protein. The regular pattern of keratin filaments of the cornified cells became increasingly irregular after 180 hours. We hypothesized that UVC can produce certain alterations of proteins in the cytoplasm such as keratin in addition to causing DNA damage.