It has been reported that histamine induces CD86 expression and chemokine production in human immature monocyte-derive dendritic cells (MoDCs); this can be blocked by both H1 and H2 receptor antagonists. In our previous paper, we reported that, using this phenomenon, the efficacy of different H1-type antihistamines such as cetirizine, diphenhydramine, ketotifen, olopatadine, and emedastine could be evaluated. In this study, we examined the suppressive effects of four other H1-type antihistamines, epinastine, azelastine, bepotastine, and fexofenadine, on the histamine-induced CD86 and IL-8 production by MoDCs from four different healthy individuals. All the antihistamines we examined suppressed the increase in CD86+ cells and in IL-8 production after histamine stimulation in a dose-dependent fashion. We did not examine the suppressive effect of fexofenadine on histamine-induced IL-8 production. The suppressive effect of these antihistamines on the CD 86 augmentation or IL-8production varied by on the individual. This study suggests that the evaluation of antihistamines using MoDCs can be a useful method for the screening of effective antihistamines, for the comparison of the efficacy of antihistamines, and for predicting the efficacy of antihistamines on an individual basis.
Ulcer in summer of livedo reticularis with summer ulceration (LRSU) occurring every year is very painful and intractable. Such ulcer prevention is very important for improving the QOL of patients with LRSU. As a trial, we encouraged patients to drink Kanpo-tea® all year around. It is a health tea to improve blood circulation, that is mainly composed of Miyako Bidens pilosa L (MMBP). Fourteen cases with LRSU were treated for 5 years, and a preventative effect was observed in an average of 87% cases per year. The validated composition of Kanpo-tea® to prevent ulceration is still unknown, but our data suggest that Kanpo-tea® is a very useful health food for improving the QOL of patients with LRSU.
The patient was a 72-year-old man in whom an erythema had developed on the left breast and the suprapubic region several years before the initial examination ; it then gradually expanded. At the initial examination, an irregularly shaped, well-demarcated erythema with nodules was observed on the left breast and the suprapubic region. Histopathologically, the breast and suprapubic lesions showed intraepithelial growth of Paget’s cells with a marked tendency toward tubule formation. The suprapubic lesion showed a diffuse invasion of tumor cells in not only in the epithelium but also in the dermis and subcutaneous tissue, consistent with a state of Paget’s carcinoma. The patient also suffered from prostate cancer, and the Paget cells were immunohistologically positive for prostate specific antigen（PSA）. However, the pubis lesion was diagnosed as multicentrically arising ectopic extramammary Paget’s disease complicated by prostate cancer, instead of metastatic prostate cancer to the skin. Because it has recently been reported that tumor cells can be immunohistologically positive for PSA in ectopic extramammary Paget’s disease, the expression of PSA in this pathological condition is discussed.
Case 1: A 55-year-old female presented with a four-month history of infiltrated erythemas on the lower legs and a fever of 38°C. The lesions progressed in size and evolved into painful ulcers. She was admitted to hospital in January of 2003. A weight loss of approximately 5 kg was observed within the three months before admission. Case 2: A 70-year-old female presented with a three-month history of edema and pain in the lower legs. Because the lesions subsequently evolved into multiple ulcers, she was admitted to hospital in September of 2001. A weight loss of approximately 6 kg was observed within the two months before admission. In both cases, histological examination of the lesional skin revealed a dense polymorphonuclear infiltration of subcutaneous small vessels with nuclear dusts, permitting pathologic diagnosis of leukocytoclastic vasculitis. Clinical and laboratory evaluation revealed subjective sicca symptoms, pronounced lymphocytic infiltration of the minor salivary glands, and positive anti-Ro/SS-A antibodies. These findings fulfilled the diagnostic criteria of primary Sjören’s syndrome. Treatment with oral prednisolone produced a favorable clinical response. We suggest that clinical and laboratory evaluations are necessary in cases with leg ulcers and polyarteritis nodosa-like vasculitis to rule out the coexistence of primary Sjören’s syndrome, although it is infrequent.
Morpheic basal cell carcinoma was observed in the nasal region of an 88-year-old male. It was virtually impossible to determine the tumor area clinically. Therefore, a photodynamic diagnosis (PDD) was undertaken. Following coating of the area with photosensitive 5-aminolevulinic acid, red fluorescence was emitted under ultraviolet A irradiation. Strong red fluorescence was observed in the tumor region. Resection was made 2 mm from that site, and pathological investigation revealed total removal of the tumor with no tumor cells in the resection stump. Therefore, PDD can be useful for determining the tumor area in cases of morpheic basal cell carcinoma in which the treatment locus is difficult to pinpoint.