We reviewed the etiology and molecular mechanisms of photoaging, emphasizing the dominant role of ultraviolet-B in solar light. An epidemiological study demonstrated the close relationship between skin photo-type and wrinkle formation. In addition, we described the possible roles of prevention by an antioxidant protein of metallothionein and NF-κB decoy oligonucleotides in photocarcinogenesis. They have different action modes in keratinocyte apoptosis. Finally, we discussed the necessity of photoaging itself, including deep wrinkles and pigmented spots in exposed areas, for sun-protection.
We retrospectively studied the clinical features and treatments of AIDS-related Kaposi’s sarcoma (KS) patients seen at Tokyo Metropolitan Komagome Hospital. Between 1997 and 2002, 640 HIV infected patients were treated. Of these, 29 developed KS. All the patients were male, the mean age was 45 years and the mean initial CD4+cell count was 107.0/μl. Thirteen patients were treated with highly active antiretroviral therapy (HAART) alone, 7 with HAART and radiotherapy, 2 with HAART and chemotherapy, and one with HAART, radiotherapy and chemotherapy, respectively. Four patients had no treatments. Of the 27 patients, 18 had complete remission, 2 had partial remission, but the others died. HAART, associated or not with another therapy, induced complete remission in 73.9% of the patients. Two patients who had no response to HAART received liposomal doxorubicin and achieved partial remission. The 18 month survival rate after the diagnosis of KS was 19.0% in 1985–1996 and 74.1% in 1997–2002. These data show that HAART should be the first attempted therapy in patients with newly diagnosed AIDS-related KS. In the treatment of patients with advanced AIDS-KS, liposomal doxorubicin is considered an effective therapy.
We examined 67 patients with human parvovirus (HPV) B19 infection to determine their clinical features, complications, and risk of contracting HPVB19 infection during pregnancy. The examination was performed between January of 1999 and December of 2003 at Nippon Medical School Hospital. The patients included 15 males and 52 females. The range of age was from 0 to 60, and the majority of patients were children under 10 and thirty-year-old women. Most of the patients with HPVB19 infection were diagnosed in 2001 and in June. The eruptions were of various types: well-defined erythema on the face and extremities, punctate erythema on the body and extremities, and petechiasis on lower legs. The petechiasis on the lower legs was found in three of 29 children, but not in any adult patients. In this study, 35 cases were women, and 14 of them were pregnant. Intraurterine fetal death occurred in one of them (7.1%). We suggested that it is necessary to carefully follow up patients who are infected with HPVB19 during pregnancy.
We investigated lichen planus (LP) cases diagnosed histologically and treated in the Dermatology Clinic of Niigata Medical University Hospital between 1993 and 2002. Twelve (15.4%) of 78 LP cases were serologically positive for anti-hepatitis C virus antibody. Sixty-four of 78 LP cases had oral LP. Patch tests for dental metals were performed in 40 cases of oral LP; 22 (55%) demonstrated positive results, and 15 of the 22 cases were found to have the patch test-positive dental metals in their dental materials by metal analysis. Nine of the 15 cases underwent removal of dental materials containing these positive metals, and 7 (77.8%) of the 9 cases showed favorable clinical effects. Furthermore, improvement of oral LP was also observed in 6 cases who underwent removal of dental metals adjacent to the oral mucosal lesions, when elemental analysis could not be performed. In conclusion, contact metal allergy and/or local irritation may be an important causative factor or aggravative factor for oral LP.
We describe two cases of glomus tumor that developed in a mother and a daughter. Although many authors have reported that multiple glomus tumors often occur in genetically related individuals, only one case has been reported for solitary glomus tumors. The etiology of solitary glomus tumors is unknown, so we thought these cases were valuable enough to report.
We reported a case of extramammary Paget’s disease associated with brain metastases. The patient, a 59-year-old woman, visited our hospital because of left inguinal lymphadenopathy and purpuric edema of left thigh. She had a brownish plaque in the right inguinal region. She was diagnosed with genital Paget’s disease by skin biopsy. The specimen revealed many Paget cells in the epidermis of the right inguinal region and lymph duct ectasis due to an aggregation of Paget cells in the left thigh. Metastatic lesions were found throughout the lymph nodes and the brain. The frequency of brain metastases due to extramammary Paget’s disease is low (3%). Gamma knife radiosurgery (GKS) was used as the initial treatment for the metastatic brain tumors. Fourteen tumors were detected on MR imaging at the time of GKS, and all of them were treated. Although most of treated lesions disappeared (10/14) or decreased in size (3/14) on follow up imaging, numerous other metastatic brain tumors newly developed, and she received whole brain radiotherapy. We conclude that GKS is worth considering in patients with brain metastasis of extramammary Paget’s disease.