1
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Minagawa A, Koga H, Matsunaga K, Hamada A, Okuyama R. Difference in computer-assistance effects on human doctor accuracy in diagnosing acral and non-acral pigmented skin tumors. J Dermatol 2024; 51:735-737. [PMID: 38634738 DOI: 10.1111/1346-8138.17240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 03/12/2024] [Accepted: 04/04/2024] [Indexed: 04/19/2024]
Affiliation(s)
- Akane Minagawa
- Department of Dermatology, Shinshu University School of Medicine, Nagano, Japan
| | - Hiroshi Koga
- Department of Dermatology, Shinshu University School of Medicine, Nagano, Japan
| | | | | | - Ryuhei Okuyama
- Department of Dermatology, Shinshu University School of Medicine, Nagano, Japan
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2
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Matsuo M, Niwa H, Koga H, Ishii N, Nakamura N, Iwata H. A case of paraneoplastic pemphigus associated with follicular lymphoma positive only for anti-desmoglein 3 antibody. J Dermatol 2024; 51:e164-e165. [PMID: 38111329 DOI: 10.1111/1346-8138.17059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 10/18/2023] [Accepted: 11/11/2023] [Indexed: 12/20/2023]
Affiliation(s)
- Maho Matsuo
- Department of Dermatology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Hirofumi Niwa
- Department of Dermatology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Hiroshi Koga
- Department of Dermatology, Kurume University School of Medicine, Fukuoka, Japan
| | - Norito Ishii
- Department of Dermatology, Kurume University School of Medicine, Fukuoka, Japan
| | - Nobuhiko Nakamura
- Department of Hematology and Infectious Disease, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Hiroaki Iwata
- Department of Dermatology, Gifu University Graduate School of Medicine, Gifu, Japan
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3
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Sugiura R, Hashimoto T, Ishizuka Y, Okuzawa M, Okuno S, Koga H, Ishii N, Satoh T. Matrix metalloproteinase-9 and neutrophil elastase from infiltrating neutrophils with neutrophil extracellular DNA traps in linear IgA bullous dermatosis: A case report. J Dermatol 2024. [PMID: 38650312 DOI: 10.1111/1346-8138.17244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 04/02/2024] [Accepted: 04/08/2024] [Indexed: 04/25/2024]
Affiliation(s)
- Riichiro Sugiura
- Department of Dermatology, National Defense Medical College, Tokorozawa, Japan
| | - Takashi Hashimoto
- Department of Dermatology, National Defense Medical College, Tokorozawa, Japan
| | - Yukiko Ishizuka
- Department of Dermatology, National Defense Medical College, Tokorozawa, Japan
| | - Manami Okuzawa
- Department of Dermatology, National Defense Medical College, Tokorozawa, Japan
| | - Satoshi Okuno
- Department of Dermatology, National Defense Medical College, Tokorozawa, Japan
| | - Hiroshi Koga
- Department of Dermatology, Kurume University School of Medicine, Kurume, Japan
| | - Norito Ishii
- Department of Dermatology, Kurume University School of Medicine, Kurume, Japan
| | - Takahiro Satoh
- Department of Dermatology, National Defense Medical College, Tokorozawa, Japan
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4
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Hoashi T, Ishikawa M, Uehara J, Oashi K, Maeda S, Kato J, Saruta H, Shichinohe R, Ohashi R, Nakamura Y, Koga H, Sugaya M. Japanese Dermatological Association guidelines: Outlines of Japanese clinical guidelines for basal cell carcinoma 2021. J Dermatol 2024; 51:e90-e105. [PMID: 38264942 DOI: 10.1111/1346-8138.16944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 08/12/2023] [Accepted: 08/15/2023] [Indexed: 01/25/2024]
Abstract
To summarize the current therapies for skin cancers, the Japanese Skin Cancer Society issued the first guidelines for skin cancers, including melanoma, squamous cell carcinoma, basal cell carcinoma (BCC), and extramammary Paget's disease, in 2007. These guidelines were revised in 2015. Herein, we present the English version of the 2021 edition of the Japanese clinical guidelines for BCC. In the latest edition, all procedures were performed according to the Grading of Recommendations, Assessment, Development and Evaluation systems. The clinical questions that could not be answered were selected for further analysis. A comprehensive literature search, systematic review, and recommendations for each clinical question were determined by a multidisciplinary expert panel comprising dermatologists, a plastic and reconstructive surgeon, and a pathologist. Surgical resection is the gold-standard therapy of BCC. Radiotherapy or topical treatments, other than surgical resection, have been used in some cases. Patients with unresectable or metastatic BCC require systemic therapy. Novel agents, such as immune response modifiers or hedgehog pathway inhibitors, are emerging worldwide for the treatment of BCC. Based on these viewpoints, four relevant clinical questions regarding, surgical resection, radiotherapy, topical treatment, and systemic therapy, were raised in this report that aims to help clinicians select suitable therapies for their patients.
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Affiliation(s)
| | - Masashi Ishikawa
- Department of Dermatology, Saitama Cancer Center, Saitama, Japan
| | - Jiro Uehara
- Department of Dermatologic Oncology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Kohei Oashi
- Department of Dermatology, Saitama Cancer Center, Saitama, Japan
| | - Shintaro Maeda
- Department of Dermatology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| | - Junji Kato
- Department of Dermatology, Sapporo Medical University, Sapporo, Japan
| | - Hiroshi Saruta
- Department of Dermatology, Kurume University School of Medicine, Fukuoka, Japan
| | - Ryuji Shichinohe
- Department of Plastic and Reconstructive Surgery, Teine Keijinkai Hospital, Sapporo, Japan
| | - Ryuji Ohashi
- Department of Integrated Diagnostic Pathology, Nippon Medical School, Tokyo, Japan
| | - Yoshio Nakamura
- Department of Dermatology, Keio University School of Medicine, Tokyo, Japan
| | - Hiroshi Koga
- Department of Dermatology, Shinshu University, Matsumoto, Japan
| | - Makoto Sugaya
- Department of Dermatology, International University of Health and Welfare, Narita, Japan
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5
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Koga H, Teye K, Hamada T, Katsumi T, Takei S, Hayashi R, Nakama T. A case of intermediate recessive dystrophic epidermolysis bullosa with a novel COL7A1 mutation. J Dermatol 2024. [PMID: 38321622 DOI: 10.1111/1346-8138.17137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Revised: 01/13/2024] [Accepted: 01/20/2024] [Indexed: 02/08/2024]
Affiliation(s)
- Hiroshi Koga
- Department of Dermatology, Kurume University School of Medicine, Fukuoka, Japan
| | - Kwesi Teye
- Kurume University Institute of Cutaneous Cell Biology, Fukuoka, Japan
| | - Takahiro Hamada
- Department of Dermatology, Kurume University School of Medicine, Fukuoka, Japan
| | - Tatsuya Katsumi
- Division of Dermatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Shingo Takei
- Division of Dermatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Ryota Hayashi
- Division of Dermatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Takekuni Nakama
- Department of Dermatology, Kurume University School of Medicine, Fukuoka, Japan
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6
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Yokomizo S, Miyake T, Kawakami Y, Ohashi K, Koga H, Ishii N, Morizane S. Cutaneous toxicity with subepidermal blisters and dyskeratosis following administration of pemetrexed in a patient with nivolumab-induced psoriasis and linear IgA bullous dermatosis. J Dermatol 2024; 51:e57-e58. [PMID: 37735962 DOI: 10.1111/1346-8138.16974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 09/04/2023] [Accepted: 09/06/2023] [Indexed: 09/23/2023]
Affiliation(s)
- Sayuri Yokomizo
- Department of Dermatology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Okayama, Japan
| | - Tomoko Miyake
- Department of Dermatology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Okayama, Japan
| | - Yoshio Kawakami
- Department of Dermatology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Okayama, Japan
| | - Kadoaki Ohashi
- Department of Allergy and Respiratory Medicine, Okayama University Hospital, Okayama, Japan
| | - Hiroshi Koga
- Department of Dermatology, Kurume University School of Medicine, Fukuoka, Japan
| | - Norito Ishii
- Department of Dermatology, Kurume University School of Medicine, Fukuoka, Japan
| | - Shin Morizane
- Department of Dermatology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Okayama, Japan
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7
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Koshida A, Nishijima C, Koga H, Ishii N, Inaoki M. Subepidermal blistering disease presenting with anti-p200 and anti-type VII collagen autoantibodies. Eur J Dermatol 2024; 34:102-103. [PMID: 38557472 DOI: 10.1684/ejd.2024.4635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Affiliation(s)
- Anna Koshida
- Department of Dermatology, National Hospital Organization Kanazawa Medical Center, 1-1 Shimoishibiki-machi, Kanazawa, Ishikawa 920-8650, Japan
| | - Chihiro Nishijima
- Department of Dermatology, National Hospital Organization Kanazawa Medical Center, 1-1 Shimoishibiki-machi, Kanazawa, Ishikawa 920-8650, Japan
| | - Hiroshi Koga
- Department of Dermatology, Kurume University School of Medicine, Kurume, Japan
| | - Norito Ishii
- Department of Dermatology, Kurume University School of Medicine, Kurume, Japan
| | - Makoto Inaoki
- Department of Dermatology, National Hospital Organization Kanazawa Medical Center, 1-1 Shimoishibiki-machi, Kanazawa, Ishikawa 920-8650, Japan
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8
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Takeichi T, Hamada T, Yamamoto M, Ito Y, Kawaguchi A, Kobashi H, Yoshikawa T, Koga H, Ishii N, Nakama T, Muro Y, Ogi T, Akiyama M. Patients with keratinization disorders due to ABCA12 variants showing pityriasis rubra pilaris phenotypes. J Dermatol 2024; 51:101-105. [PMID: 37752865 DOI: 10.1111/1346-8138.16967] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 08/17/2023] [Accepted: 09/01/2023] [Indexed: 09/28/2023]
Abstract
Pathogenic variants in ABCA12 are important causative genetic defects for autosomal recessive congenital ichthyoses (ARCI), which include congenital ichthyosiform erythroderma (CIE), harlequin ichthyosis, and lamellar ichthyosis. In addition, pathogenic variants in ABCA12 are known to cause a localized nevoid form of CIE due to recessive mosaicism. We previously reported siblings who carried an ABCA12 variant but did not show a "congenital" phenotype. They were considered to have pityriasis rubra pilaris (PRP). Here, we present a further patient with ABCA12 variants whose phenotype was not congenital ichthyosis, in an independent family. Notably, these three patients had geographic unaffected areas. Such areas are not usually found in patients with ARCI who have ABCA12 variants, suggesting mild phenotypes for these patients. Interestingly, the histological features of the ichthyotic lesions in these patients resembled those of PRP. All three patients had homozygous pathogenic missense variants in ABCA12. Our findings expand the phenotypic spectrum of patients with ABCA12 variants.
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Affiliation(s)
- Takuya Takeichi
- Department of Dermatology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Takahiro Hamada
- Department of Dermatology, Kurume University School of Medicine, Kurume, Japan
| | - Mayuko Yamamoto
- Department of Dermatology, Kochi Medical School, Kochi University, Nankoku, Japan
| | - Yasutoshi Ito
- Department of Dermatology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Aya Kawaguchi
- Department of Dermatology, Kurume University School of Medicine, Kurume, Japan
| | - Haruka Kobashi
- Department of Dermatology, Kochi Medical School, Kochi University, Nankoku, Japan
| | - Takenori Yoshikawa
- Department of Dermatology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hiroshi Koga
- Department of Dermatology, Kurume University School of Medicine, Kurume, Japan
- Kurume University Institute of Cutaneous Cell Biology, Kurume, Japan
| | - Norito Ishii
- Department of Dermatology, Kurume University School of Medicine, Kurume, Japan
- Kurume University Institute of Cutaneous Cell Biology, Kurume, Japan
| | - Takekuni Nakama
- Department of Dermatology, Kurume University School of Medicine, Kurume, Japan
- Kurume University Institute of Cutaneous Cell Biology, Kurume, Japan
| | - Yoshinao Muro
- Department of Dermatology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Tomoo Ogi
- Department of Genetics, Research Institute of Environmental Medicine (RIeM), Nagoya University, Nagoya, Japan
- Department of Human Genetics and Molecular Biology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Masashi Akiyama
- Department of Dermatology, Nagoya University Graduate School of Medicine, Nagoya, Japan
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9
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Yamamoto S, Koga H, Tsutsumi M, Ishii N, Nakama T. Bullous pemphigoid associated with prodromal-phase by repeated COVID-19 vaccinations. J Dermatol 2024; 51:e6-e7. [PMID: 37698074 DOI: 10.1111/1346-8138.16940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 08/01/2023] [Accepted: 08/15/2023] [Indexed: 09/13/2023]
Affiliation(s)
- Sayumi Yamamoto
- Department of Dermatology, Kurume University School of Medicine, Fukuoka, Japan
| | - Hiroshi Koga
- Department of Dermatology, Kurume University School of Medicine, Fukuoka, Japan
| | - Masahiro Tsutsumi
- Department of Dermatology, Kurume University School of Medicine, Fukuoka, Japan
| | - Norito Ishii
- Department of Dermatology, Kurume University School of Medicine, Fukuoka, Japan
| | - Takekuni Nakama
- Department of Dermatology, Kurume University School of Medicine, Fukuoka, Japan
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10
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Yamamoto M, Kokubu H, Yamamoto B, Koga H, Ishii N, Fujimoto N. Dipeptidyl peptidase-4 inhibitor-related pemphigus herpetiformis with antibodies against desmocollin 3. J Dermatol 2024; 51:e16-e18. [PMID: 37680081 DOI: 10.1111/1346-8138.16956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 08/07/2023] [Accepted: 08/23/2023] [Indexed: 09/09/2023]
Affiliation(s)
- Mayuka Yamamoto
- Department of Dermatology, Shiga University of Medical Science, Otsu, Japan
| | - Hiraku Kokubu
- Department of Dermatology, Shiga University of Medical Science, Otsu, Japan
| | - Bunpei Yamamoto
- Department of Dermatology, Shiga University of Medical Science, Otsu, Japan
| | - Hiroshi Koga
- Department of Dermatology, Kurume University School of Medicine, Fukuoka, Japan
| | - Norito Ishii
- Department of Dermatology, Kurume University School of Medicine, Fukuoka, Japan
| | - Noriki Fujimoto
- Department of Dermatology, Shiga University of Medical Science, Otsu, Japan
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11
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Muto I, Koga H, Doi R, Katayama E, Nakama K, Nakama T. Efficacy of Nivolumab and Ipilimumab Combined Therapy as a First-Line Therapy for Patients with Advanced Melanoma and the Urgent Need for an Effective Second-Line Therapy for Patients with Wild-Type BRAF in Japan: A Single Center Retrospective Study. Kurume Med J 2023; 69:75-80. [PMID: 37793888 DOI: 10.2739/kurumemedj.ms6912008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023]
Abstract
Therapeutic advantages of immune checkpoint inhibitors, anti-programmed death-1 (PD-1), and anticytotoxic T-lymphocyte-associated antigen 4 (CTLA-4) in melanoma have been reported recently. In this study, we conducted a retrospective study to evaluate the clinical efficacy and safety of the combined use of nivolumab and ipilimumab as a first-line therapy for Japanese patients with advanced melanoma. Moreover, we examined the effects of second-line treatment. Seven patients were enrolled in this study. The median progression-free survival (PFS) and median overall survival (OS) were 7 months (95%CI, 1.868-12.132) and 12 months (95%CI, 0.000- 27.397), respectively. The objective response rate (ORR) and the disease control rate (DCR) were 42.9 % and 85.7 %. Three patients chose pembrolizumab monotherapy as second-line therapy after the combination therapy due to their BRAF wild-type status, which resulted in progressive disease. ORR and DCR were 0% and 33.3%, respectively, with pembrolizumab. Grade 3 or 4 immune-related adverse events occurred in 71.4% of the patients treated with the combined-therapy. All irAEs were treated with corticosteroid or hormone replacement therapy. Although this single center retrospective study had some limitations, it demonstrated good efficacy for the combined use of nivolumab and ipilimumab as a first-line therapy for Japanese patients with advanced melanoma. Moreover, poor efficacy was observed for the second-line therapy after the combined therapy. These findings suggest that a novel second-line therapy is required for patients with advanced melanoma in Japan, particularly for patients with wildtype BRAF.
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Affiliation(s)
- Ikko Muto
- Department of Dermatology, Kurume University School of Medicine
| | - Hiroshi Koga
- Department of Dermatology, Kurume University School of Medicine
| | - Reiichi Doi
- Department of Dermatology, Kurume University School of Medicine
| | - Eri Katayama
- Department of Dermatology, Kurume University School of Medicine
| | - Kenta Nakama
- Department of Dermatology, Kurume University School of Medicine
| | - Takekuni Nakama
- Department of Dermatology, Kurume University School of Medicine
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12
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Yamamoto K, Kaku Y, Koga H. Case Report: RNF213 variant and choroidal anastomosis as potential risk factors for early stroke in moyamoya syndrome associated with Down syndrome. Front Pediatr 2023; 11:1289554. [PMID: 38027262 PMCID: PMC10652563 DOI: 10.3389/fped.2023.1289554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 10/20/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Recent studies have suggested associations between RNF213 variants and the formation of periventricular anastomosis among patients with moyamoya disease, leading to early onset of cerebral hemorrhage and rebleeding. Case description We report herein the case of a boy with Down syndrome and moyamoya syndrome. Exome sequencing identified a heterozygous RNF213 R4810K variant. After ischemic stroke occurred at 9 years old, indirect surgical revascularization was performed for the left cerebral hemisphere and improved ischemic symptoms and cerebral hypoperfusion, while the left choroidal anastomosis remained. At 13 years old, he presented with left thalamic hemorrhage attributed to the anterior choroidal artery, with rebleeding observed four days after the initial hemorrhage under strict blood pressure control. The patient was discharged without neurological deficits 20 days after the hemorrhagic stroke. Conclusion Presence of an RNF213 variant and choroidal anastomosis may represent risk factors for cerebral hemorrhage in patients with Down syndrome and moyamoya syndrome, as well as in patients with moyamoya disease.
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Affiliation(s)
- Keisuke Yamamoto
- Department of Pediatrics, National Hospital Organization Beppu Medical Center, Beppu, Japan
| | - Yasuyuki Kaku
- Department of Neurosurgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Hiroshi Koga
- Department of Pediatrics, National Hospital Organization Beppu Medical Center, Beppu, Japan
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13
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Tomiyama Y, Mochizuki T, Koga H, Omori G, Koga Y, Tanifuji O, Nishino K, Endo K, Endo N, Kawashima H. The Matsudai Knee Osteoarthritis Survey showed the longitudinal changes of knee phenotypes in alignment and structure during 23-28 years. Knee Surg Sports Traumatol Arthrosc 2023; 31:5034-5047. [PMID: 37682319 DOI: 10.1007/s00167-023-07554-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 08/24/2023] [Indexed: 09/09/2023]
Abstract
PURPOSE The longitudinal changes in alignment and structure, including the joint line and cortical bone thickness (CBT) of the femur and tibia, and knee phenotype in patients with knee osteoarthritis (OA) remain unknown. The aim of this retrospective study was to clarify the longitudinal changes in matched healthy subjects. METHODS The follow-up Matsudai Knee Osteoarthritis Survey was administered between 23 and 28 years. This study included 285 healthy knees from 235 females with an average age of 53 ± 6 years at baseline. The non-OA individuals, with an average age of 79 ± 4 years, were divided into three groups at baseline according to their follow-up radiographic results [the non-OA (n = 52), early OA (n = 131), and advanced OA groups (n = 102)]. Changes in alignment, joint line, CBT, and knee phenotype were assessed at baseline and at follow-up using standing anteroposterior radiographs. RESULTS This study showed significant varus changes in the alignment (p < 0.001) and tibial and femoral joint line parameters (p < 0.05) in the OA group. Decreased CBT and increased mediolateral CBT ratios were observed in all groups (p < 0.001). The knee phenotypes in the OA groups were changed to varus angles, especially in the alignment and tibial joint line. CONCLUSIONS The longitudinal changes of knee phenotypes in alignment and structure (CBT and joint line) from baseline to follow-up were shown in the OA groups. In addition, alignment and tibial structural factors at baseline are useful in predicting the incidence of knee OA in daily practice. LEVELS OF EVIDENCE III.
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Affiliation(s)
- Yasuyuki Tomiyama
- Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-Dori Chuo-Ku, Niigata, 951-8510, Japan
- Department of Orthopedic Surgery, Niigata Rehabilitation Hospital, Niigata, Japan
| | - Tomoharu Mochizuki
- Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-Dori Chuo-Ku, Niigata, 951-8510, Japan.
| | - Hiroshi Koga
- Division of Musculoskeletal Science for Frailty, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Go Omori
- Department of Health and Sports, Niigata University of Health and Welfare, Niigata, Japan
| | | | - Osamu Tanifuji
- Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-Dori Chuo-Ku, Niigata, 951-8510, Japan
| | | | - Kazuo Endo
- Department of Health & Nutrition, Niigata University of Health and Welfare, Niigata, Japan
| | - Naoto Endo
- Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-Dori Chuo-Ku, Niigata, 951-8510, Japan
- Deputy Hospital Director, orthopedic department, Tsubame Rosai Hospital, Niigata, Japan
| | - Hiroyuki Kawashima
- Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-Dori Chuo-Ku, Niigata, 951-8510, Japan
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14
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Kochi Y, Miyachi H, Tagashira R, Koga H, Ishii N, Sugiura K, Ikeda JI, Matsue H, Inozume T. Simultaneous development of generalized pustular psoriasis and pemphigoid with multiple autoantibodies in a complete responder of pembrolizumab for lung cancer. J Dermatol 2023; 50:1343-1346. [PMID: 37183481 DOI: 10.1111/1346-8138.16832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 04/14/2023] [Accepted: 04/30/2023] [Indexed: 05/16/2023]
Abstract
Patients with psoriasis vulgaris have a higher incidence of pemphigoid than the general population. However, there are only a few concise reports on the coexistence of generalized pustular psoriasis (GPP) and pemphigoid. The authors describe a rare case of the simultaneous development of GPP and pemphigoid with multiple autoantibodies (i.e., BP180-C-terminal, 200-kDa protein, and laminin 332 proteins) in a complete responder of immune checkpoint inhibitor (ICI) treatment for lung cancer. Anti-interleukin 17 inhibitors for the GPP and oral corticosteroids at 10 mg/day for the pemphigoid effectively achieved remission in both diseases. It may not be uncommon to detect multiple autoantibodies in patients with pemphigoid; however, the detection of autoantibodies to more than three antigens in a single patient is relatively rare. In the current patient, the severe inflammation of GPP might have generated multiple autoantibodies. In addition, although pembrolizumab achieved a complete response and was discontinued 9 months before the onset of GPP and pemphigoid, the ICI might have affected the development of the two diseases. This case report adds useful information to the limited knowledge regarding the coexistence of GPP and pemphigoid, and aids in a better understanding of the pathological mechanisms and treatment options for such patients. Furthermore, the possibility that more patients may develop multiple autoimmune and autoinflammatory diseases in the era of ICIs should be recognized.
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Affiliation(s)
- Yuna Kochi
- Department of Dermatology, Chiba University Hospital, Chiba, Japan
| | - Hideaki Miyachi
- Department of Dermatology, Chiba University Hospital, Chiba, Japan
- Department of Dermatology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | | | - Hiroshi Koga
- Department of Dermatology, Kurume University School of Medicine, Kurume, Japan
| | - Norito Ishii
- Department of Dermatology, Kurume University School of Medicine, Kurume, Japan
| | - Kazumitsu Sugiura
- Department of Dermatology, Fujita Health University School of Medicine, Toyoake, Japan
| | - Jun-Ichiro Ikeda
- Department of Pathology, Chiba University Hospital, Chiba, Japan
| | - Hiroyuki Matsue
- Department of Dermatology, Chiba University Hospital, Chiba, Japan
- Department of Dermatology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Takashi Inozume
- Department of Dermatology, Chiba University Hospital, Chiba, Japan
- Department of Dermatology, Graduate School of Medicine, Chiba University, Chiba, Japan
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15
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Yeruva S, Stangner K, Jungwirth A, Hiermaier M, Shoykhet M, Kugelmann D, Hertl M, Egami S, Ishii N, Koga H, Hashimoto T, Weis M, Beckmann BM, Biller R, Schüttler D, Kääb S, Waschke J. Correction: Catalytic antibodies in arrhythmogenic cardiomyopathy patients cleave desmoglein 2 and N-cadherin and impair cardiomyocyte cohesion. Cell Mol Life Sci 2023; 80:296. [PMID: 37728633 PMCID: PMC10511356 DOI: 10.1007/s00018-023-04942-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/26/2023] [Indexed: 09/21/2023]
Affiliation(s)
- Sunil Yeruva
- Chair of Vegetative Anatomy, Faculty of Medicine, Institute of Anatomy, Ludwig-Maximilians-University (LMU) Munich, Pettenkoferstrasse 11, 80336, Munich, Germany
| | - Konstanze Stangner
- Chair of Vegetative Anatomy, Faculty of Medicine, Institute of Anatomy, Ludwig-Maximilians-University (LMU) Munich, Pettenkoferstrasse 11, 80336, Munich, Germany
| | - Anna Jungwirth
- Chair of Vegetative Anatomy, Faculty of Medicine, Institute of Anatomy, Ludwig-Maximilians-University (LMU) Munich, Pettenkoferstrasse 11, 80336, Munich, Germany
| | - Matthias Hiermaier
- Chair of Vegetative Anatomy, Faculty of Medicine, Institute of Anatomy, Ludwig-Maximilians-University (LMU) Munich, Pettenkoferstrasse 11, 80336, Munich, Germany
| | - Maria Shoykhet
- Chair of Vegetative Anatomy, Faculty of Medicine, Institute of Anatomy, Ludwig-Maximilians-University (LMU) Munich, Pettenkoferstrasse 11, 80336, Munich, Germany
- Department of Otorhinolarynology, Technical University of Munich and University Hospital rechts der Isar, Ismaningerstrasse 22, 81675, Munich, Germany
| | - Daniela Kugelmann
- Chair of Vegetative Anatomy, Faculty of Medicine, Institute of Anatomy, Ludwig-Maximilians-University (LMU) Munich, Pettenkoferstrasse 11, 80336, Munich, Germany
| | - Michael Hertl
- Department of Dermatology and Allergology, Philipps-University Marburg, 35037, Marburg, Germany
| | - Shohei Egami
- Department of Dermatology, Keio University School of Medicine, Tokyo, Japan
| | - Norito Ishii
- Department of Dermatology, Kurume University School of Medicine, Kurume, Japan
| | - Hiroshi Koga
- Department of Dermatology, Kurume University School of Medicine, Kurume, Japan
| | - Takashi Hashimoto
- Department of Dermatology, Graduate School of Medicine, Osaka City Metropolitan University, Osaka, Japan
| | - Michael Weis
- Krankenhaus Neuwittelsbach, Fachklinik Für Innere Medizin, Munich, Germany
| | - Britt-Maria Beckmann
- Department of Medicine I, University Hospital Munich, Ludwig-Maximilians University Munich (LMU), Campus Großhadern, Munich, Germany
- Institute of Legal Medicine, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Ruth Biller
- ARVC-Selbsthilfe E.V, Patient Association, Munich, Germany
| | - Dominik Schüttler
- Department of Medicine I, University Hospital Munich, Ludwig-Maximilians University Munich (LMU), Campus Großhadern, Munich, Germany
- DZHK (German Centre for Cardiovascular Research), Munich Heart Alliance (MHA), Partner Site Munich, Munich, Germany
- Walter Brendel Centre of Experimental Medicine, Ludwig-Maximilians University Munich (LMU), Munich, Germany
- Interfaculty Center for Endocrine and Cardiovascular Disease Network Modelling and Clinical Transfer (ICON), LMU Munich, Munich, Germany
| | - Stefan Kääb
- Department of Medicine I, University Hospital Munich, Ludwig-Maximilians University Munich (LMU), Campus Großhadern, Munich, Germany
- DZHK (German Centre for Cardiovascular Research), Munich Heart Alliance (MHA), Partner Site Munich, Munich, Germany
- Interfaculty Center for Endocrine and Cardiovascular Disease Network Modelling and Clinical Transfer (ICON), LMU Munich, Munich, Germany
- Member of the European Reference Network for rare, low prevalance and complex diseases of the heart , ERN GUARD-Heart, Munich, Germany
| | - Jens Waschke
- Chair of Vegetative Anatomy, Faculty of Medicine, Institute of Anatomy, Ludwig-Maximilians-University (LMU) Munich, Pettenkoferstrasse 11, 80336, Munich, Germany.
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16
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Yeruva S, Stangner K, Jungwirth A, Hiermaier M, Shoykhet M, Kugelmann D, Hertl M, Egami S, Ishii N, Koga H, Hashimoto T, Weis M, Beckmann BM, Biller R, Schüttler D, Kääb S, Waschke J. Catalytic antibodies in arrhythmogenic cardiomyopathy patients cleave desmoglein 2 and N-cadherin and impair cardiomyocyte cohesion. Cell Mol Life Sci 2023; 80:203. [PMID: 37450050 PMCID: PMC10348947 DOI: 10.1007/s00018-023-04853-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 06/19/2023] [Accepted: 06/21/2023] [Indexed: 07/18/2023]
Abstract
AIMS Arrhythmogenic cardiomyopathy (AC) is a severe heart disease predisposing to ventricular arrhythmias and sudden cardiac death caused by mutations affecting intercalated disc (ICD) proteins and aggravated by physical exercise. Recently, autoantibodies targeting ICD proteins, including the desmosomal cadherin desmoglein 2 (DSG2), were reported in AC patients and were considered relevant for disease development and progression, particularly in patients without underlying pathogenic mutations. However, it is unclear at present whether these autoantibodies are pathogenic and by which mechanisms show specificity for DSG2 and thus can be used as a diagnostic tool. METHODS AND RESULTS IgG fractions were purified from 15 AC patients and 4 healthy controls. Immunostainings dissociation assays, atomic force microscopy (AFM), Western blot analysis and Triton X-100 assays were performed utilizing human heart left ventricle tissue, HL-1 cells and murine cardiac slices. Immunostainings revealed that autoantibodies against ICD proteins are prevalent in AC and most autoantibody fractions have catalytic properties and cleave the ICD adhesion molecules DSG2 and N-cadherin, thereby reducing cadherin interactions as revealed by AFM. Furthermore, most of the AC-IgG fractions causing loss of cardiomyocyte cohesion activated p38MAPK, which is known to contribute to a loss of desmosomal adhesion in different cell types, including cardiomyocytes. In addition, p38MAPK inhibition rescued the loss of cardiomyocyte cohesion induced by AC-IgGs. CONCLUSION Our study demonstrates that catalytic autoantibodies play a pathogenic role by cleaving ICD cadherins and thereby reducing cardiomyocyte cohesion by a mechanism involving p38MAPK activation. Finally, we conclude that DSG2 cleavage by autoantibodies could be used as a diagnostic tool for AC.
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Affiliation(s)
- Sunil Yeruva
- Chair of Vegetative Anatomy, Faculty of Medicine, Institute of Anatomy, Ludwig-Maximilians-University (LMU) Munich, Pettenkoferstrasse 11, 80336, Munich, Germany
| | - Konstanze Stangner
- Chair of Vegetative Anatomy, Faculty of Medicine, Institute of Anatomy, Ludwig-Maximilians-University (LMU) Munich, Pettenkoferstrasse 11, 80336, Munich, Germany
| | - Anna Jungwirth
- Chair of Vegetative Anatomy, Faculty of Medicine, Institute of Anatomy, Ludwig-Maximilians-University (LMU) Munich, Pettenkoferstrasse 11, 80336, Munich, Germany
| | - Matthias Hiermaier
- Chair of Vegetative Anatomy, Faculty of Medicine, Institute of Anatomy, Ludwig-Maximilians-University (LMU) Munich, Pettenkoferstrasse 11, 80336, Munich, Germany
| | - Maria Shoykhet
- Chair of Vegetative Anatomy, Faculty of Medicine, Institute of Anatomy, Ludwig-Maximilians-University (LMU) Munich, Pettenkoferstrasse 11, 80336, Munich, Germany
- Department of Otorhinolarynology, Technical University of Munich and University Hospital rechts der Isar, Ismaningerstrasse 22, 81675, Munich, Germany
| | - Daniela Kugelmann
- Chair of Vegetative Anatomy, Faculty of Medicine, Institute of Anatomy, Ludwig-Maximilians-University (LMU) Munich, Pettenkoferstrasse 11, 80336, Munich, Germany
| | - Michael Hertl
- Department of Dermatology and Allergology, Philipps-University Marburg, 35037, Marburg, Germany
| | - Shohei Egami
- Department of Dermatology, Keio University School of Medicine, Tokyo, Japan
| | - Norito Ishii
- Department of Dermatology, Kurume University School of Medicine, Kurume, Japan
| | - Hiroshi Koga
- Department of Dermatology, Kurume University School of Medicine, Kurume, Japan
| | - Takashi Hashimoto
- Department of Dermatology, Graduate School of Medicine, Osaka City Metropolitan University, Osaka, Japan
| | - Michael Weis
- Krankenhaus Neuwittelsbach, Fachklinik Für Innere Medizin, Munich, Germany
| | - Britt-Maria Beckmann
- Department of Medicine I, University Hospital Munich, Ludwig-Maximilians University Munich (LMU), Campus Großhadern, Munich, Germany
- Institute of Legal Medicine, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Ruth Biller
- ARVC-Selbsthilfe E.V, Patient Association, Munich, Germany
| | - Dominik Schüttler
- Department of Medicine I, University Hospital Munich, Ludwig-Maximilians University Munich (LMU), Campus Großhadern, Munich, Germany
- DZHK (German Centre for Cardiovascular Research), Munich Heart Alliance (MHA), Partner Site Munich, Munich, Germany
- Walter Brendel Centre of Experimental Medicine, Ludwig-Maximilians University Munich (LMU), Munich, Germany
- Interfaculty Center for Endocrine and Cardiovascular Disease Network Modelling and Clinical Transfer (ICON), LMU Munich, Munich, Germany
| | - Stefan Kääb
- Department of Medicine I, University Hospital Munich, Ludwig-Maximilians University Munich (LMU), Campus Großhadern, Munich, Germany
- DZHK (German Centre for Cardiovascular Research), Munich Heart Alliance (MHA), Partner Site Munich, Munich, Germany
- Interfaculty Center for Endocrine and Cardiovascular Disease Network Modelling and Clinical Transfer (ICON), LMU Munich, Munich, Germany
- Member of the European Reference Network for rare, low prevalance and complex diseases of the heart , ERN GUARD-Heart, Munich, Germany
| | - Jens Waschke
- Chair of Vegetative Anatomy, Faculty of Medicine, Institute of Anatomy, Ludwig-Maximilians-University (LMU) Munich, Pettenkoferstrasse 11, 80336, Munich, Germany.
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17
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Koga H, Takagi M, Teye K, Kuwahara-Sakurada F, Ishii N, Hamada T, Nakama T. Mosaicism for ATP2A2 Mutation and Mutant Allelic Fractions Detected by Droplet Digital PCR in Simple Segmental Darier Disease. Acta Derm Venereol 2023; 103:adv12337. [PMID: 37448212 PMCID: PMC10391532 DOI: 10.2340/actadv.v103.12337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 06/20/2023] [Indexed: 07/15/2023] Open
Abstract
Abstract is missing (Short communication)
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Affiliation(s)
- Hiroshi Koga
- Department of Dermatology, Kurume University School of Medicine, 67 Asahimachi, Kurume, Fukuoka 830-0011, Japan
| | - Marie Takagi
- Department of Dermatology, Kurume University School of Medicine, 67 Asahimachi, Kurume, Fukuoka 830-0011, Japan
| | | | - Fumi Kuwahara-Sakurada
- Department of Dermatology, Kurume University School of Medicine, 67 Asahimachi, Kurume, Fukuoka 830-0011, Japan
| | - Norito Ishii
- Department of Dermatology, Kurume University School of Medicine, 67 Asahimachi, Kurume, Fukuoka 830-0011, Japan
| | - Takahiro Hamada
- Department of Dermatology, Kurume University School of Medicine, 67 Asahimachi, Kurume, Fukuoka 830-0011, Japan.
| | - Takekuni Nakama
- Department of Dermatology, Kurume University School of Medicine, 67 Asahimachi, Kurume, Fukuoka 830-0011, Japan
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18
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Nagakura KI, Sato S, Shinahara W, Kido H, Fujita H, Yanai T, Akiyama N, Futamura M, Koga H, Fujiwara M, Kaneko H, Taniguchi H, Makita E, Takahashi K, Yanagida N, Ebisawa M, Urashima M. Effect of Maternal Egg Intake During the Early Neonatal Period and Risk of Infant Egg Allergy at 12 Months Among Breastfeeding Mothers: A Randomized Clinical Trial. JAMA Netw Open 2023; 6:e2322318. [PMID: 37428506 DOI: 10.1001/jamanetworkopen.2023.22318] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/11/2023] Open
Abstract
Importance Egg introduction in infants at age 4 to 6 months is associated with a lower risk of immunoglobulin E-mediated egg allergy (EA). However, whether their risk of EA at age 12 months is affected by maternal intake of eggs at birth is unknown. Objective To determine the effect of maternal egg intake during the early neonatal period (0-5 days) on the development of EA in breastfed infants at age 12 months. Design, Setting, and Participants This multicenter, single-blind (outcome data evaluators), randomized clinical trial was conducted from December 18, 2017, to May 31, 2021, at 10 medical facilities in Japan. Newborns with at least 1 of 2 parents having an allergic disease were included. Neonates whose mothers had EA or were unable to consume breast milk after the age of 2 days were excluded. Data were analyzed on an intention-to-treat basis. Interventions Newborns were randomized (1:1) to a maternal egg consumption (MEC) group, wherein the mothers consumed 1 whole egg per day during the first 5 days of the neonate's life, and a maternal egg elimination (MEE) group, wherein the mothers eliminated eggs from their diet during the same period. Main Outcomes and Measures The primary outcome was EA at age 12 months. Egg allergy was defined as sensitization to egg white or ovomucoid plus a positive test result in an oral food challenge or an episode of obvious immediate symptoms after egg ingestion. Results Of the 380 newborns included (198 [52.1%] female), 367 (MEC: n = 183; MEE: n = 184) were followed up for 12 months. On days 3 and 4 after delivery, the proportions of neonates with ovalbumin and ovomucoid detection in breast milk were higher in the MEC group than in the MEE group (ovalbumin: 10.7% vs 2.0%; risk ratio [RR], 5.23; 95% CI, 1.56-17.56; ovomucoid: 11.3% vs 2.0%; RR, 5.55; 95% CI, 1.66-18.55). At age 12 months, the MEC and MEE groups did not differ significantly in EA (9.3% vs 7.6%; RR, 1.22; 95% CI, 0.62-2.40) or sensitization to egg white (62.8% vs 58.7%; RR, 1.07; 95% CI, 0.91-1.26). No adverse effects were reported. Conclusions and Relevance In this randomized clinical trial, EA development and sensitization to eggs were unaffected by MEC during the early neonatal period. Trial Registration UMIN Clinical Trials Registry: UMIN000027593.
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Affiliation(s)
- Ken-Ichi Nagakura
- Department of Pediatrics, National Hospital Organization Sagamihara National Hospital, Kanagawa, Japan
- Department of Pediatrics, Jikei University School of Medicine, Tokyo, Japan
| | - Sakura Sato
- Department of Allergy, Clinical Research Center for Allergy and Rheumatology, National Hospital Organization Sagamihara National Hospital, Kanagawa, Japan
| | - Wakako Shinahara
- Division of Enzyme Chemistry, Institute for Enzyme Research, Tokushima University, Tokushima, Japan
| | - Hiroshi Kido
- Division of Enzyme Chemistry, Institute for Enzyme Research, Tokushima University, Tokushima, Japan
| | | | - Takanori Yanai
- Department of Pediatrics, National Hospital Organization Yokohama Medical Center, Kanagawa, Japan
| | - Nao Akiyama
- Department of Pediatrics, National Hospital Organization Saitama Hospital, Saitama, Japan
| | - Masaki Futamura
- Department of Pediatrics, National Hospital Organization Nagoya Medical Center, Aichi, Japan
| | - Hiroshi Koga
- Department of Pediatrics, National Hospital Organization Beppu Medical Center, Oita, Japan
| | - Michimasa Fujiwara
- Department of Pediatrics, National Hospital Organization Fukuyama Medical Center, Hiroshima, Japan
| | - Hideo Kaneko
- Department of Pediatrics, National Hospital Organization Nagara Medical Center, Gifu, Japan
- Department of Pediatric Medical Care, Gifu Prefectural General Medical Center, Gifu, Japan
| | | | - Eishi Makita
- Department of Pediatrics, Saitama Medical Center Jichi Medical University, Saitama, Japan
| | - Kyohei Takahashi
- Department of Pediatrics, National Hospital Organization Sagamihara National Hospital, Kanagawa, Japan
| | - Noriyuki Yanagida
- Department of Pediatrics, National Hospital Organization Sagamihara National Hospital, Kanagawa, Japan
- Department of Allergy, Clinical Research Center for Allergy and Rheumatology, National Hospital Organization Sagamihara National Hospital, Kanagawa, Japan
| | - Motohiro Ebisawa
- Department of Allergy, Clinical Research Center for Allergy and Rheumatology, National Hospital Organization Sagamihara National Hospital, Kanagawa, Japan
| | - Mitsuyoshi Urashima
- Division of Molecular Epidemiology, Jikei University School of Medicine, Tokyo, Japan
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19
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Koga H, Teye K, Sugawara A, Tsutsumi M, Ishii N, Nakama T. Elevated levels of interleukin-9 in the serum of bullous pemphigoid: possible association with the pathogenicity of bullous pemphigoid. Front Immunol 2023; 14:1135002. [PMID: 37398641 PMCID: PMC10311483 DOI: 10.3389/fimmu.2023.1135002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Accepted: 05/30/2023] [Indexed: 07/04/2023] Open
Abstract
Bullous pemphigoid (BP) is an autoimmune subepidermal blistering disease (sAIBD). In addition to disease causing autoantibodies, several leukocyte subsets, including mast cells and eosinophils, play key roles in mediating skin inflammation. Detailed immunophenotyping and, more recently, the therapeutic effects of interleukin-4 (IL-4) receptor alpha inhibition in BP pointed to a prominent role of T helper 2 (Th2) cells. Among other cell types, IL-9 is expressed by Th2 and mast cells and potentially drives allergic, Th2-dominated inflammation. Although cytokines in BP have been relatively well investigated, the role of IL-9 has remained enigmatic. This study aimed to evaluate the effect of IL-9 in BP. Serum IL-9 levels were significantly elevated in patients with BP and decreased upon induction of remission. Serum IL-9 levels were not elevated in epidermolysis bullosa acquisita, another sAIBD. The time-course analysis using serum sets from four patients with BP revealed that serum IL-9 was a sensitive biomarker of BP. IL-9-positive cells infiltrated dominantly in BP lesions, especially in the blister fluid, and Th9 cells were abundant. Therefore, IL-9 was elevated in the serum and lesions of BP, which could be a biomarker of BP.
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Affiliation(s)
- Hiroshi Koga
- Department of Dermatology, Kurume University School of Medicine, Fukuoka, Japan
| | - Kwesi Teye
- Kurume University Institute of Cutaneous Cell Biology, Kurume University, Fukuoka, Japan
| | - Arisa Sugawara
- Department of Dermatology, Kurume University School of Medicine, Fukuoka, Japan
| | - Masahiro Tsutsumi
- Department of Dermatology, Kurume University School of Medicine, Fukuoka, Japan
| | - Norito Ishii
- Department of Dermatology, Kurume University School of Medicine, Fukuoka, Japan
| | - Takekuni Nakama
- Department of Dermatology, Kurume University School of Medicine, Fukuoka, Japan
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20
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Minakawa S, Matsuzaki Y, Yao S, Sagara C, Akasaka E, Koga H, Ishii N, Hashimoto T, Sawamura D. Case report: A case of epidermolysis bullosa acquisita with IgG and IgM anti-basement membrane zone antibodies relapsed after COVID-19 mRNA vaccination. Front Med (Lausanne) 2023; 10:1093827. [PMID: 37324140 PMCID: PMC10267980 DOI: 10.3389/fmed.2023.1093827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 05/02/2023] [Indexed: 06/17/2023] Open
Abstract
We report a case of autoimmune bullous disease (AIBD) with IgG and IgM autoantibodies against epidermal basement membrane zone (BMZ), which showed recurrence of mucocutaneous lesions after coronavirus disease 2019 (COVID-19) mRNA vaccination. A 20-year-old Japanese woman with a 4-year history of epidermolysis bullosa acquisita (EBA) presented to our clinic. She noticed fever and rash on the same day and visited at our hospital 2 days later. Physical examination revealed blisters, erosions and erythema on the face, shoulder, back, upper arms, and lower lip. A skin biopsy from the forehead showed subepidermal blister. Direct immunofluorescence showed linear depositions of IgG, IgM, and C3c in the epidermal BMZ. By indirect immunofluorescence of 1M NaCl-split normal human skin, circulating IgG autoantibodies were bound to the dermal side of the split at 1:40 serum dilution, and circulating IgM antibodies were bound to the epidermal side of the spilt. After the increase of prednisolone dose to 15 mg/day, the mucocutaneous lesions resolved in a week. The present case is the first case of possible EBA with IgG and IgM anti-BMZ antibodies, in which the mucocutaneous lesions were recurred after COVID-19 mRNA vaccination. Clinicians should be aware that bullous pemphigoid-like AIBDs, including EBA and IgM pemphigoid, might be developed after COVID-19 mRNA vaccination.
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Affiliation(s)
- Satoko Minakawa
- Department of Dermatology, Hirosaki University Graduate School of Medicine, Aomori, Japan
- Department of Clinical Laboratory, Hirosaki University Hospital, Aomori, Japan
| | - Yasushi Matsuzaki
- Department of Dermatology, Hirosaki University Graduate School of Medicine, Aomori, Japan
| | - Shogo Yao
- Department of Dermatology, Hirosaki University Graduate School of Medicine, Aomori, Japan
| | - Chihiro Sagara
- Department of Dermatology, Hirosaki University Graduate School of Medicine, Aomori, Japan
| | - Eijiro Akasaka
- Department of Dermatology, Hirosaki University Graduate School of Medicine, Aomori, Japan
| | - Hiroshi Koga
- Department of Dermatology, Kurume University School of Medicine, Fukuoka, Japan
| | - Norito Ishii
- Department of Dermatology, Kurume University School of Medicine, Fukuoka, Japan
| | - Takashi Hashimoto
- Department of Dermatology, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Daisuke Sawamura
- Department of Dermatology, Hirosaki University Graduate School of Medicine, Aomori, Japan
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21
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Kawamura T, Muramatsu K, Orita A, Mai Y, Sugai T, Haga N, Fujimura Y, Miyauchi T, Izumi K, Koga H, Ishii N, Ujiie H. Two cases of Hallopeau-type pemphigus vegetans with anti-desmoglein 1 and anti-desmocollin 3 antibodies without mucosal involvement. J Eur Acad Dermatol Venereol 2023; 37:e508-e510. [PMID: 36305887 DOI: 10.1111/jdv.18704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 10/25/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Takuya Kawamura
- Department of Dermatology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Ken Muramatsu
- Department of Dermatology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Akihiro Orita
- Department of Dermatology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Yosuke Mai
- Department of Dermatology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Tatsuro Sugai
- Department of Dermatology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Naoya Haga
- Department of Dermatology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Yu Fujimura
- Department of Dermatology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Toshinari Miyauchi
- Department of Dermatology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Kentaro Izumi
- Department of Dermatology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Hiroshi Koga
- Department of Dermatology, Kurume University School of Medicine, and Kurume University Institute of Cutaneous Cell Biology, Fukuoka, Japan
| | - Norito Ishii
- Department of Dermatology, Kurume University School of Medicine, and Kurume University Institute of Cutaneous Cell Biology, Fukuoka, Japan
| | - Hideyuki Ujiie
- Department of Dermatology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
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22
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Yanagihara S, Koga H. On the Work Autonomy Supported by Information and Communication Technology A Case Study of Work from Home in Japan before the COVID-19 Epidemic. Rev Socionetwork Strat 2023; 17:87-103. [PMID: 37123459 PMCID: PMC10047464 DOI: 10.1007/s12626-023-00133-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 02/23/2023] [Indexed: 03/30/2023]
Abstract
Telecommuting increased during the COVID-19 pandemic. To make telecommuting the "new normal," it is essential to not only change the legal system and employment contracts but also reform organizational processes. Prior research has demonstrated a positive correlation between telecommuting and perceived autonomy using questionnaire surveys, but the lack of a widely accepted measurement scale to capture the reality of telecommuting has hindered the capacity to understand its current status. In this study, we conducted unstructured interview surveys to elucidate the mechanisms of the relationship of perceived autonomy and telecommuting, while focusing on perceived autonomy in organizational processes. The paper is organized as follows: it reviews previous studies on telecommuting and describes the related advantages and disadvantages; examines changes in the environment and attitudes based on interviews conducted with employed telecommuters; examines changes in telecommuters' attitudes toward perceived autonomy.
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23
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Hirae K, Hoshina T, Koga H. Impact of the COVID-19 pandemic on the epidemiology of other communicable diseases in Japan. Int J Infect Dis 2023; 128:265-271. [PMID: 36642212 PMCID: PMC9837205 DOI: 10.1016/j.ijid.2023.01.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 12/29/2022] [Accepted: 01/09/2023] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVES To elucidate the impact of the COVID-19 pandemic on the epidemiology of other infectious diseases. DESIGN We investigated the epidemiology of 36 communicable diseases during 2015-2021 in Japan and compared the number of cases in each disease between the prepandemic (2015-2019) and intrapandemic (2020-2021) periods. Relationships between the incidence of the infectious diseases and the COVID-19 pandemic were also investigated. RESULTS Of 36 communicable diseases, the number of cases in the 27 diseases (75%) mainly caused by pathogens transmitted by droplet or contact was lower intrapandemic than prepandemic, and the cases of 21 diseases (58%) continued to decrease intrapandemic. The number of cases of six diseases (17%) was higher intrapandemic than prepandemic, and the cases of two diseases (5.6%), Japanese spotted fever and syphilis, continued to increase intrapandemic. Time trend analyses revealed a positive correlation between case numbers of communicable diseases and the COVID-19 pandemic, whereas the case numbers of hand-foot-and-mouth disease and respiratory syncytial virus infection rebounded in 2021 after decreasing in 2020. CONCLUSION The COVID-19 pandemic has greatly impacted the epidemiology of communicable diseases, suggesting that countermeasures against COVID-19 and lifestyle changes might be involved in these epidemiological changes.
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Affiliation(s)
- Kenji Hirae
- Department of Pediatrics, National Hospital Organization Beppu Medical Center, Beppu, Japan.
| | - Takayuki Hoshina
- Department of Pediatrics, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.
| | - Hiroshi Koga
- Department of Pediatrics, National Hospital Organization Beppu Medical Center, Beppu, Japan.
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Minagawa A, Meling MT, Koga H, Okuyama R. Near-ultraviolet Light Dermoscopy for Identification of Pigmented Skin Tumours. Acta Derm Venereol 2023; 103:adv00876. [PMID: 36852578 PMCID: PMC9986760 DOI: 10.2340/actadv.v103.5302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 01/11/2023] [Indexed: 03/01/2023] Open
Abstract
Abstract is missing (Short communication)
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Affiliation(s)
- Akane Minagawa
- Department of Dermatology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan.
| | - Maureen T Meling
- Department of Dermatology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan
| | - Hiroshi Koga
- Department of Dermatology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan
| | - Ryuhei Okuyama
- Department of Dermatology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan
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Kawaguchi A, Matsuda M, Koga H, Ohata C, Hamada T, Mishima H, Yoshiura KI, Jinnin M, Minami H, Kanazawa N. Anti-desmoglein 1 antibody-positive mother and antibody-negative child with Darier's disease. J Dermatol 2023; 50:250-253. [PMID: 36074695 DOI: 10.1111/1346-8138.16568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 08/08/2022] [Accepted: 08/18/2022] [Indexed: 02/04/2023]
Abstract
We report a mother and an adult son with Darier's disease. The mother, 76 years old and Japanese, had positivity for anti-desmoglein (Dsg)1 antibodies. She had erythema with hyperkeratosis and seborrheic and interstitial blistering. A high level of anti-Dsg1 antibodies was detected in the serum. Histopathological examination showed acantholysis and direct immunofluorescence testing revealed intercellular IgG and C3 deposition of the epidermis. Although she was diagnosed as having pemphigus foliaceus, the skin lesions slightly improved with immunosuppressive therapy. Her son, 47 years old, had similar skin lesions on the seborrheic and interstitial parts, but the anti-Dsg1 antibodies were negative in his serum. Histopathological examination showed acantholysis and dyskeratotic cells. Although Hailey-Hailey disease was first suspected, no mutation in the ATP2C1 was detected in either patient. Trio-exome analysis including the father showed a heterozygous c.2027C>A transition on exon 14 of ATP2A2, causing a replacement at amino acid 676 (p.Ala676Asp) in the mother and son only. The two patients were then diagnosed as having Darier's disease. Exome analysis further showed that a novel heterozygous missense mutation of DSG1 was identified only in the affected mother. Anti-Dsg1 antibody-positive Darier's disease is reported here for the first time. Very rare coexistence of Darier's disease and anti-Dsg1 antibody-positivity might be associated with this novel heterozygous DSG1 mutation. Experimental evidence is required to validate this hypothesis.
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Affiliation(s)
- Ami Kawaguchi
- Department of Dermatology, Wakayama Medical University, Wakayama, Japan
| | | | - Hiroshi Koga
- Department of Dermatology, Kurume University, Kurume, Japan
| | - Chika Ohata
- Department of Dermatology, Kurume University, Kurume, Japan.,Department of Dermatology, Osaka General Medical Center, Osaka, Japan
| | | | - Hiroyuki Mishima
- Department of Human Genetics, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan
| | - Koh-Ichiro Yoshiura
- Department of Human Genetics, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan
| | - Masatoshi Jinnin
- Department of Dermatology, Wakayama Medical University, Wakayama, Japan
| | - Hironori Minami
- Department of Dermatology, National Hospital Organization Minami Wakayama Medical Center, Wakayama, Japan
| | - Nobuo Kanazawa
- Department of Dermatology, Wakayama Medical University, Wakayama, Japan.,Department of Dermatology, Hyogo Medical University, Nishinomiya, Japan
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Koga H, Tsutsumi M, Teye K, Ishii N, Yamaguchi M, Nagafuji K, Nakama T. Subcorneal pustular dermatosis-type IgA pemphigus associated with multiple myeloma: A case report and literature review. J Dermatol 2023; 50:234-238. [PMID: 35838241 DOI: 10.1111/1346-8138.16516] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 06/09/2022] [Accepted: 06/29/2022] [Indexed: 02/04/2023]
Abstract
Immunoglobulin A (IgA) pemphigus, also known as intercellular IgA dermatosis, is a rare autoimmune bullous disease presenting with IgA anti-keratinocyte cell surface autoantibodies. Concomitant lymphoproliferative disorders have been reported in IgA pemphigus, including IgA monoclonal gammopathy of undetermined significance and IgA type multiple myeloma (MM). A 35-year-old Japanese woman with a 3-year history of pruritic papulovesicles on her lower legs and trunk was referred to our department. Histopathological examination revealed acantholytic blisters, and results of both direct and indirect immunofluorescence were negative. Direct and indirect immunofluorescence were still negative 3 years and 7 months later. Approximately 7 years after her first visit, the patient was re-referred to us because of disease exacerbation. Histopathological findings revealed subcorneal blistering with acantholysis, in which neutrophil-dominant inflammatory cells were present. Indirect immunofluorescence was positive for IgA on the epidermal cell surface and both desmoglein (Dsg) 1/3 and (Dsc) desmocollin 1-3 enzyme-linked immunosorbent assays (ELISAs) for IgA were positive. The histological findings and positive Dsc1 IgA ELISA led to the diagnosis of subcorneal pustular dermatosis (SPD)-type IgA pemphigus. Further examination revealed hyper-IgA globulinemia, increased serum IgA-κ protein, and increased plasma cells in the bone marrow, enabling the diagnosis of IgA type MM. Daratumumab, lenalidomide, and dexamethasone (DLd) therapy was effective for both the MM and the skin lesions, resulting in negative results on Dsg1/3 and Dsc1-3 IgA ELISAs. The association between IgA pemphigus and IgA type multiple myeloma remains unclear, and only seven cases including the present case have been reported. Literature review revealed associations between SPD-type and IgA κ chain in IgA pemphigus and MM, and that in most cases the onset or diagnosis of MM was simultaneous or occurred after the diagnosis of IgA pemphigus. Therefore, clinicians should be aware of the development of multiple myeloma during the clinical course of patients with SPD-type IgA pemphigus.
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Affiliation(s)
- Hiroshi Koga
- Department of Dermatology, Kurume University School of Medicine, Fukuoka, Japan
| | - Masahiro Tsutsumi
- Department of Dermatology, Kurume University School of Medicine, Fukuoka, Japan
| | - Kwesi Teye
- Kurume University Institute of Cutaneous Cell Biology, Fukuoka, Japan
| | - Norito Ishii
- Department of Dermatology, Kurume University School of Medicine, Fukuoka, Japan
| | - Maki Yamaguchi
- Division of Hematology and Oncology, Department of Medicine, Kurume University School of Medicine, Fukuoka, Japan
| | - Koji Nagafuji
- Division of Hematology and Oncology, Department of Medicine, Kurume University School of Medicine, Fukuoka, Japan
| | - Takekuni Nakama
- Department of Dermatology, Kurume University School of Medicine, Fukuoka, Japan
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Tomiyama Y, Mochizuki T, Tanifuji O, Nishino K, Tanaka M, Omori G, Yamamoto N, Koga H, Koga Y, Kawashima H. Normal coronal kinematics of dynamic alignment and bony positions relative to the ground in three-dimensional motion analysis during gait: A preliminary study. Biomed Mater Eng 2023; 34:37-49. [PMID: 35694913 DOI: 10.3233/bme-211383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND During gait, healthy knee coronal kinematics of each bony axis and lower extremity alignment are important because they could be useful as reference data for several surgeries and provide clarification of the etiology of diseases around the knee in healthy participants; however, it remains unknown. OBJECTIVE The objective of this study was to clarify the kinematics of lower extremity alignment and the bony axes relative to the ground during gait, focused on the coronal plane, in healthy individuals by applying our unique three-dimensional (3D) motion analysis. METHODS The study included 21 healthy individuals, including 9 healthy females and 12 healthy males with an average age of 36 ± 17 years. Knee kinematics were calculated in a gait analysis by combining the data from a motion-capture system and a 3D lower-extremity alignment assessment system on biplanar long-leg radiographs by using a 3D-2D registration technique. The main kinematic parameters were the dynamic position change relative to the ground, applying the femoral anatomical axis (FAA), tibial anatomical axis (TAA), and dynamic alignment in the coronal plane during the stance phase of gait. RESULTS The average changes in FAA, TAA, and dynamic varus alignment were 3.7° ± 1.2°, 3.5° ± 0.8°, and 3.0° ± 1.2°, respectively. The TAA tilted laterally during the loading response and a plateau area appeared afterwards; the FAA gradually inclined laterally until the terminal stance phase, and the dynamic alignment showed varus angular change during the loading response. CONCLUSIONS The tibia and femur were found to change approximately 2-5° of the position of the bony axes relative to the ground. In terms of clinical relevance, our findings can be used to clarify the etiology of diseases around the knee joint and as reference data for surgeries.
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Affiliation(s)
- Yasuyuki Tomiyama
- Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Science, Niigata, Japan.,Department of Orthopaedic Surgery, Niigata Rehabilitation Hospital, Niitaga, Japan
| | - Tomoharu Mochizuki
- Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Science, Niigata, Japan
| | - Osamu Tanifuji
- Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Science, Niigata, Japan
| | | | - Masaei Tanaka
- Niigata Institute for Health and Sports Medicine, Niigata, Japan
| | - Go Omori
- Department of Health and Sports, Faculty of Health Sciences, Niigata University of Health and Welfare, Niigata, Japan
| | - Noriaki Yamamoto
- Department of Orthopaedic Surgery, Niigata Rehabilitation Hospital, Niitaga, Japan
| | - Hiroshi Koga
- Division of Musculoskeletal Science for Frailty, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Yoshio Koga
- Department of Orthopaedic Surgery, Nioji Onsen Hospital, Niigata, Japan
| | - Hiroyuki Kawashima
- Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Science, Niigata, Japan
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Fujita N, Yamashita T, Abe F, Nara M, Yoshioka T, Koga H, Ishii N, Takahashi N. [Refractory esophageal stricture of esophageal mucous membrane pemphigoid after allogeneic hematopoietic stem cell transplantation]. Rinsho Ketsueki 2023; 64:107-112. [PMID: 36990729 DOI: 10.11406/rinketsu.64.107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
Haploidentical allogeneic hematopoietic stem cell transplantation from her brother was performed on a 41-year-old lady with no prior history of pemphigoid to treat recurrent AML. On day 59 following transplantation, she experienced esophageal stenosis. During immunosuppressive therapy for graft vs. host disease, this condition was controlled with periodic esophageal dilatation (GVHD). Her esophageal stricture, which required periodic dilatation, grew worse after she stopped immunosuppressive therapy because of recurrent AML. The esophageal mucosa was easily hemorrhagic and desquamative. Histologic analysis revealed that the squamous cell layers had been divided. Indirect immunofluorescence was negative for IgG and positive for IgA on the epidermal layers, while direct immunofluorescence showed a linear deposition of IgG on the basement membrane zone. It was determined through immunoblotting utilizing recombinant protein of BP180 C-terminal domain that both IgG and IgA antibodies were present, supporting the diagnosis of mucous membrane pemphigoid with anti-BP180. After allogeneic transplantation, basal epidermal cell destruction by GVHD may result in autoimmune blistering disorders, which expose basement membrane proteins and antigen presentation. A similar mechanism could apply to our situation. For rare GVHD cases, a thorough histological diagnosis is required.
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Affiliation(s)
- Nanako Fujita
- Department of Hematology, Nephrology, and Rheumatology, Akita University Graduate School of Medicine
| | - Takaya Yamashita
- Department of Hematology, Nephrology, and Rheumatology, Akita University Graduate School of Medicine
| | - Fumito Abe
- Department of Hematology, Nephrology, and Rheumatology, Akita University Graduate School of Medicine
| | - Miho Nara
- Division of Blood Transfusion, Akita University Hospital
| | - Tomoko Yoshioka
- Department of Hematology and Nephrology, Akita City Hospital
| | - Hiroshi Koga
- Department of Dermatology, Kurume University School of Medicine
| | - Norito Ishii
- Department of Dermatology, Kurume University School of Medicine
| | - Naoto Takahashi
- Department of Hematology, Nephrology, and Rheumatology, Akita University Graduate School of Medicine
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Koga H. On the Lost Property of Telework During the COVID-19 Pandemic in Japan: From the Perspective of Sociomateriality and Organizational Citizenship Behaviour. Rev Socionetwork Strateg 2023; 17:73-86. [PMID: 37123463 PMCID: PMC10123583 DOI: 10.1007/s12626-023-00134-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Accepted: 03/03/2023] [Indexed: 05/02/2023]
Abstract
When telework was discussed in Japan during the COVID-19 pandemic, the context of staying home was strongly considered. As a result, the primary focus has been on carrying out one's assigned work at home. In other words, people tend to focus on the fact that they can carry out their work without being restricted by location. However, the networked aspect of telework is important. In other words, to realize telework, it is necessary to fully consider the aspect of making one's own work visible and collaborating with others. In this paper, the author clarifies the significance of the "connection" that information systems engender by examining the mechanism of inducing organizational citizenship behaviour from the perspective of "sociomateriality" proposed by Wanda Orlikowski et al. in information systems research. Furthermore, we warn against "discretionary bias," a tendency to "free oneself from the constraints of time and place," which appears, because telework was introduced as a measure to prevent the spread of infection. In addition, this paper examines the case of intranets in the 1990s to clarify the nature of connection through information systems and to find new insights in old cases, just as the Industrial Revolution is referenced in discussions of whether AI will take away jobs.
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Affiliation(s)
- Hiroshi Koga
- Faculty of Informatics, Kansai University, Suita, Japan
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Watanuki K, Koga H. Case report: Diagnostic clues for anti-3-hydroxy-3-methylglutaryl-coenzyme A reductase myopathy in pediatric patients. Front Pediatr 2023; 11:1102539. [PMID: 36994439 PMCID: PMC10040642 DOI: 10.3389/fped.2023.1102539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Accepted: 02/27/2023] [Indexed: 03/31/2023] Open
Abstract
Introduction Anti-3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMGCR) myopathy is a recently recognized pathology, but appears less common in children and the characteristics of pediatric cases remain unclear. Case report We report a pediatric case of anti-HMGCR myopathy accompanied by skin rash. Motor function and serum creatine kinase level normalized after combinational treatment including early intravenous immunoglobulin, methotrexate, and corticosteroid. Literature review We searched PubMed and identified reports with detailed clinical information of 33 pediatric patients <18 years old with anti-HMGCR myopathy. Among these 33 patients and our own case, skin rash and maximum serum creatine kinase level >5,000 IU/L were observed in 44% (15 patients) and 94% (32 patients), respectively. Skin rash was present in 15 of the 22 patients (68%) ≥7 years old and none of the 12 patients (0%) <7 years old. Among the 15 patients with skin rash, 12 (80%) presented with erythematous rash. Conclusion Erythematous skin rash may offer a clue to the diagnosis of anti-HMGCR myopathy in children with muscle weakness and serum creatine kinase level >5,000 IU/L in the absence of other myositis-specific antibodies, particularly in patients ≥7 years old. Our results suggest the importance of early anti-HMGCR testing in pediatric patients with these manifestations.
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Affiliation(s)
- Keisuke Watanuki
- Department of Pediatrics, National Hospital Organization Beppu Medical Center, Beppu, Japan
| | - Hiroshi Koga
- Department of Pediatrics, National Hospital Organization Beppu Medical Center, Beppu, Japan
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Higuchi R, Koga H, Sugino N, Bonno M. Mild small-for-gestational-age as a non-negligible risk factor for short stature. Early Hum Dev 2023; 176:105704. [PMID: 36580856 DOI: 10.1016/j.earlhumdev.2022.105704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 11/21/2022] [Accepted: 12/19/2022] [Indexed: 12/25/2022]
Abstract
Risk of subsequent short stature remains unclear among mild small-for-gestational-age (SGA) infants with birthweight <10th percentile and ≥-2 standard deviations. In this multicenter cohort study in Japan, height was found to be <-2 standard deviations at 3 years old even in 18 % of mild-SGA infants.
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Affiliation(s)
- Ryunosuke Higuchi
- Department of Pediatrics, National Hospital Organization Beppu Medical Center, Beppu, Japan
| | - Hiroshi Koga
- Department of Pediatrics, National Hospital Organization Beppu Medical Center, Beppu, Japan.
| | - Noriko Sugino
- Division of Neonatology, National Hospital Organization Mie Chuo Medical Center, Tsu, Japan
| | - Motoki Bonno
- Division of Neonatology, National Hospital Organization Mie Chuo Medical Center, Tsu, Japan
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Minagawa A, Uhara H, Ashida A, Koga H, Okuyama R. Clinical history analysis of Japanese melanoma cases and characteristics of melanoma with childhood onset. J Dermatol 2022; 49:1334-1337. [PMID: 35946357 DOI: 10.1111/1346-8138.16545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 07/13/2022] [Accepted: 07/27/2022] [Indexed: 11/28/2022]
Abstract
It remains debatable whether melanoma with a clinical history of early childhood onset truly arises from a nevus. To clarify the clinical and genetic characteristics of melanoma detected at birth or several years afterwards, 249 melanoma cases seen at Shinshu University Hospital between 2006 and 2015 were retrospectively analyzed. Ten (4.0%) cases (median age 39.5 years, range 19-70 years; male/female 2/8; lesion site, 6 extremities, 2 trunk, 1 head, 1 face; cumulative sun damage [CSD] skin, 9 low-CSD, 1 high-CSD; detection at birth 3) had recorded early childhood onset. Median Breslow's tumor thickness in those cases was 6.0 mm (range: 0.4-17.5 mm). The frequency of lesions detected at <20 years of age was significantly higher for low-CSD melanoma (17.5%) than for high-CSD (3.3%) and acral (0.8%) melanoma. Although melanoma with a history of early childhood onset is rare, the characteristics of such cases should be established since most have progressed to an advanced stage at the initial visit.
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Affiliation(s)
- Akane Minagawa
- Department of Dermatology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Hisashi Uhara
- Department of Dermatology, Shinshu University School of Medicine, Matsumoto, Japan.,Department of Dermatology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Atsuko Ashida
- Department of Dermatology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Hiroshi Koga
- Department of Dermatology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Ryuhei Okuyama
- Department of Dermatology, Shinshu University School of Medicine, Matsumoto, Japan
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Saida T, Koga H, Uhara H. Dermoscopy for acral melanocytic lesions: Revision of the 3-step algorithm and refined definition of the regular and irregular fibrillar pattern. Dermatol Pract Concept 2022; 12:e2022123. [PMID: 36159128 PMCID: PMC9464531 DOI: 10.5826/dpc.1203a123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/26/2021] [Indexed: 12/02/2022] Open
Affiliation(s)
- Toshiaki Saida
- Department of Dermatology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Hiroshi Koga
- Department of Dermatology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Hisashi Uhara
- Department of Dermatology, Sapporo Medical University School of Medicine, Sapporo, Japan
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Kosaka K, Endo Y, Toki S, Oka A, Uehara A, Ishikawa O, Koga H, Ishii N, Motegi SI. Pemphigus vegetans with antibodies against desmoglein 1 and desmocollin 1-3: A case report and literature review. J Eur Acad Dermatol Venereol 2022; 36:e998-e1000. [PMID: 35829665 DOI: 10.1111/jdv.18401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Keiji Kosaka
- Department of Dermatology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Yukie Endo
- Department of Dermatology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Sayaka Toki
- Department of Dermatology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Aina Oka
- Department of Dermatology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Akihito Uehara
- Department of Dermatology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Osamu Ishikawa
- Department of Dermatology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Hiroshi Koga
- Department of Dermatology, Kurume University School of Medicine, Kurume, Japan
| | - Norito Ishii
- Department of Dermatology, Kurume University School of Medicine, Kurume, Japan
| | - Sei-Ichiro Motegi
- Department of Dermatology, Gunma University Graduate School of Medicine, Maebashi, Japan
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35
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Nakamura K, Koga H, Takazawa Y, Omodaka T, Kiniwa Y, Okuyama R. Late Onset of Cardiac Metastasis of a Melanoma following Nivolumab Immunotherapy. Case Rep Oncol 2022; 15:654-658. [PMID: 35949903 PMCID: PMC9294951 DOI: 10.1159/000524429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 03/29/2022] [Indexed: 11/19/2022] Open
Abstract
In this report, we present a case of cardiac metastasis of a malignant melanoma originating from the nasal cavity and presenting with cardiac tamponade detected during immunotherapy. The patient was a 66-year-old man diagnosed with malignant melanoma of the right nasal cavity 4 years ago. Two years ago, the size of the melanoma increased making it unresectable; therefore, he was treated thrice with a combination therapy of nivolumab and ipilimumab. Subsequently, the treatment was changed to single-agent nivolumab therapy, which was continuously administered for one and a half years. Imaging evaluation conducted every 3 months showed no distant metastasis. General malaise occurred, and the patient visited our department. He was diagnosed to have cardiac tamponade using echocardiography and was admitted to the emergency department of our hospital. He underwent pericardiocentesis. Computed tomography revealed an irregular mass extending from the right atrium to the inferior vena cava, and malignant melanoma metastasis was diagnosed through catheter biopsy and histology. As the tumor was unresectable, radiotherapy (30 Gy/10 fractions) and dacarbazine administration were performed on the right atrial mass, and pericardial effusion improved.
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Yamazaki N, Isei T, Kiyohara Y, Koga H, Kojima T, Takenouchi T, Yokota K, Namikawa K, Yi M, Keegan A, Fukushima S. A phase I study of the safety and efficacy of talimogene laherparepvec in Japanese patients with advanced melanoma. Cancer Sci 2022; 113:2798-2806. [PMID: 35656636 PMCID: PMC9357627 DOI: 10.1111/cas.15450] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 05/11/2022] [Accepted: 05/23/2022] [Indexed: 11/02/2022] Open
Affiliation(s)
- Naoya Yamazaki
- Department of Dermatologic Oncology, National Cancer Center Hospital Tokyo Japan
| | - Taiki Isei
- Department of Dermatologic Oncology Osaka International Cancer Institute Osaka Japan
| | - Yoshio Kiyohara
- Division of Dermatology Shizuoka Cancer Center Hospital Shizuoka Japan
| | - Hiroshi Koga
- Department of Dermatology Shinshu University School of Medicine, Matsumoto Nagano Japan
| | - Takashi Kojima
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa‐shi Chiba Japan
| | - Tatsuya Takenouchi
- Division of Dermatology Niigata Cancer Center Hospital, Niigata‐shi Niigata Japan
| | - Kenji Yokota
- Department of Dermatology Nagoya University Hospital Nagoya‐shu Aichi Japan
| | - Kenjiro Namikawa
- Department of Dermatologic Oncology, National Cancer Center Hospital Tokyo Japan
| | - Min Yi
- Amgen Inc., Thousand Oaks California USA
| | | | - Satoshi Fukushima
- Department of Dermatology and Plastic Surgery, Faculty of Life Sciences Kumamoto University Kumamoto Japan
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Kamimura A, Nakamura Y, Takenouchi T, Matsushita S, Omodaka T, Yamamura K, Uchi H, Yoshikawa S, Yanagisawa H, Ito T, Kiyohara Y, Nakamura Y, Aoki M, Ishizuki S, Oashi K, Miyagawa T, Maeda T, Ogata D, Hatta N, Ohe S, Isei T, Takahashi A, Umeda Y, Yamaguchi B, Ishikawa M, Horimoto K, Fujsawa Y, Uehara J, Shibayama Y, Kiniwa Y, Kawahara Y, Matsuya T, Uhara H, Kato J, Nakamura Y, Murakami T, Namikawa K, Yoshino K, Funakoshi T, Takatsuka S, Matsui Y, Sasaki J, Koga H, Yokota K, Komori T, Fukushima S, Yamazaki N. Concordance in judgment of clinical borders of basal cell carcinomas in Japanese patients: A preliminary study of JCOG2005 (J-BASE-MARGIN). J Dermatol 2022; 49:837-844. [PMID: 35510662 DOI: 10.1111/1346-8138.16422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 04/07/2022] [Accepted: 04/18/2022] [Indexed: 11/29/2022]
Abstract
Basal cell carcinoma is the most common type of skin cancer, and surgical excision with clear margins is the standard of care. Surgical margins are determined based on risk factors (high or low risk) for recurrence according to the National Comprehensive Cancer Network and Japanese basal cell carcinoma guidelines. The clarity of the clinical tumor border (well-defined or poorly defined) is considered a risk factor, and significant discrepancies in the judgment of clinical tumor borders among dermato-oncologists may occur. Therefore, we analyzed the dermato-oncologists' concordance in judging the clinical tumor border of basal cell carcinoma. Forty-seven dermato-oncologists (experts: 37; young trainees: 10) participated in this study. The datasets of clinical and dermoscopic photographs of 79 Japanese cases of head and neck basal cell carcinoma were used to determine the concordance in the judgment of clinical tumor border. The probability of the border that was selected more often was used to calculate the rater agreement rate for each dataset. Correct judgment was defined as a more frequently selected border, and the concordance rate of clarity of clinical tumor border for each dermato-oncologist was calculated based on the definition of the correct judgment. A median concordance rate of 85% or higher for all dermato-oncologists was predefined as an acceptable rate for clinical use. Of the 79 datasets, rater agreement rates were 80-100%, 60-79%, and 51-59% for 55, 19, and five datasets, respectively. The median concordance rate for all dermato-oncologists was 86% (interquartile range: 82-89%). There was no significant difference in the concordance rate between the experts and the trainees (median, 87% vs. 85.5%; p = 0.58). The concordance rates of dermato-oncologists for all datasets were relatively high and acceptable for clinical use.
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Affiliation(s)
- Anna Kamimura
- Department of Skin Oncology/Dermatology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Yasuhiro Nakamura
- Department of Skin Oncology/Dermatology, Saitama Medical University International Medical Center, Saitama, Japan
| | | | - Shigeto Matsushita
- Department of Dermato-Oncology/Dermatology, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan
| | | | - Kentaro Yamamura
- Department of Dermato-Oncology/Dermatology, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan
| | - Hiroshi Uchi
- Department of Dermatologic Oncology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | | | - Hiroto Yanagisawa
- Department of Dermatology, Saitama Medical University, Saitama, Japan
| | - Takamichi Ito
- Department of Dermatology, Kyushu University, Fukuoka, Japan
| | - Yoshio Kiyohara
- Dermatology Division, Shizuoka Cancer Center, Shizuoka, Japan
| | | | - Megumi Aoki
- Department of Dermato-Oncology/Dermatology, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan
| | - Shoichiro Ishizuki
- Department of Dermatology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Kohei Oashi
- Department of Dermatology, Saitama Cancer Center, Saitama, Japan
| | - Takuya Miyagawa
- Department of Dermatology, University of Tokyo, Tokyo, Japan
| | - Taku Maeda
- Department of Plastic and Reconstructive Surgery, Hokkaido University, Sapporo, Japan
| | - Dai Ogata
- Department of Dermatologic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Naohito Hatta
- Department of Dermatology, Toyama Prefectural Central Hospital, Toyama, Japan
| | - Shuichi Ohe
- Department of Dermatologic Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Taiki Isei
- Department of Dermatologic Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Akira Takahashi
- Department of Dermatologic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Yoshiyasu Umeda
- Department of Skin Oncology/Dermatology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Buntaro Yamaguchi
- Department of Skin Oncology/Dermatology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Masashi Ishikawa
- Department of Dermatology, Saitama Cancer Center, Saitama, Japan
| | - Kohei Horimoto
- Department of Dermatology, Sapporo Medical University Hospital, Sapporo, Japan
| | - Yasuhiro Fujsawa
- Department of Dermatology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Jiro Uehara
- Department of Dermatologic Oncology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | | | - Yukiko Kiniwa
- Department of Dermatology, Shinshu University, Matsumoto, Japan
| | - Yu Kawahara
- Department of Skin Oncology/Dermatology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Taisuke Matsuya
- Department of Dermatology, Asahikawa Medical University, Asahikawa, Japan
| | - Hisashi Uhara
- Department of Dermatology, Sapporo Medical University Hospital, Sapporo, Japan
| | - Junji Kato
- Department of Dermatology, Sapporo Medical University Hospital, Sapporo, Japan
| | - Yoshiyuki Nakamura
- Department of Dermatology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Takuo Murakami
- Department of Dermatology, Saitama Medical University, Saitama, Japan
| | - Kenjiro Namikawa
- Department of Dermatologic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Koji Yoshino
- Department of Dermatologic Oncology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | | | - Sumiko Takatsuka
- Department of Dermatology, Niigata Cancer Center, Niigata, Japan
| | - Yu Matsui
- Department of Dermatology, Niigata Cancer Center, Niigata, Japan
| | - Jin Sasaki
- Department of Dermatology, Niigata Cancer Center, Niigata, Japan
| | - Hiroshi Koga
- Department of Dermatology, Shinshu University, Matsumoto, Japan
| | - Kenji Yokota
- Department of Dermatology, Nagoya University, Nagoya, Japan
| | - Takaya Komori
- Department of Dermatology, Kyoto University, Kyoto, Japan
| | - Satoshi Fukushima
- Department of Dermatology and Plastic Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Naoya Yamazaki
- Department of Dermatologic Oncology, National Cancer Center Hospital, Tokyo, Japan
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Shirahama T, Hamada T, Abe T, Arakawa M, Teye K, Koga H, Ishii N, Nakama T. Dermoscopic furrow ink test of the palmar lesion in loricrin keratoderma. J Dermatol 2022; 49:783-786. [PMID: 35467044 DOI: 10.1111/1346-8138.16405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 04/04/2022] [Accepted: 04/07/2022] [Indexed: 11/27/2022]
Abstract
Palmoplantar keratodermas (PPK) comprise a heterogeneous group of keratinization disorders that gradually progress during childhood, resulting in difficulties to establish a diagnosis and to identify a candidate gene for sequencing. Dermoscopic examination with staining of palmoplantar skin using a whiteboard marker, so-called "furrow ink test", could be a useful tool for differentiation between furrow and ridge in understanding the morphological characteristics of PPK. One of the striking features in autosomal dominant loricrin keratoderma (LK) is diffuse PPK with honeycomb pattern. In this study, we performed dermoscopic furrow ink test in a Japanese family of LK with the most frequent mutation c.684dup, p.Ser229Valfs*107 in the loricrin gene. The severe lesion revealed that irregular circular hyperkeratoses were aggregated and normal structures of furrows and ridges were disrupted. To accurately describe the nature of this dermoscopic patterned skin surface, we suggest that the condition could be termed as "irregular cobblestone appearance" rather than "honeycomb pattern". Regular cobblestone appearance to maintain parallel furrow structure was observed in early or mild hyperkeratotic lesions. Eccrine sweat glands that open on the surface of ridges nearly disappeared, resulting in hypohidrosis.
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Affiliation(s)
- Toshihiro Shirahama
- Department of Dermatology, Kurume University School of Medicine, Kurume, Japan
| | - Takahiro Hamada
- Department of Dermatology, Kurume University School of Medicine, Kurume, Japan
| | - Toshifumi Abe
- Department of Dermatology, Kurume University School of Medicine, Kurume, Japan
| | - Masataka Arakawa
- Department of Dermatology, Kurume University School of Medicine, Kurume, Japan
| | - Kwesi Teye
- Kurume University Institute of Cutaneous Cell Biology, Kurume, Japan
| | - Hiroshi Koga
- Department of Dermatology, Kurume University School of Medicine, Kurume, Japan.,Kurume University Institute of Cutaneous Cell Biology, Kurume, Japan
| | - Norito Ishii
- Department of Dermatology, Kurume University School of Medicine, Kurume, Japan.,Kurume University Institute of Cutaneous Cell Biology, Kurume, Japan
| | - Takekuni Nakama
- Department of Dermatology, Kurume University School of Medicine, Kurume, Japan.,Kurume University Institute of Cutaneous Cell Biology, Kurume, Japan
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39
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Ohtaki S, Ashida K, Matsuo Y, Moritaka K, Iwata S, Nagayama A, Kawaguchi A, Koga H, Yoshinobu S, Hasuzawa N, Motomura S, Akiba J, Nakama T, Nomura M. Eruptive xanthomas as a marker for metabolic disorders: A specific form of xanthoma that reflects hypertriglyceridemia. Clin Case Rep 2022; 10:e05671. [PMID: 35474985 PMCID: PMC9021930 DOI: 10.1002/ccr3.5671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 03/18/2022] [Indexed: 11/17/2022] Open
Abstract
Eruptive xanthomas are skin manifestations associated with hypertriglyceridemia. Accordingly, the improvement of hypertriglyceridemia can ameliorate this condition. We report a case of a patient with type 2 diabetes mellitus who was diagnosed with this skin lesion. Clinicians should be aware that eruptive xanthomas could indicate metabolic disorders associated with atherosclerosis.
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Affiliation(s)
- Sohichiroh Ohtaki
- Division of Endocrinology and Metabolism Department of Internal Medicine Kurume University School of Medicine Fukuoka Japan
| | - Kenji Ashida
- Division of Endocrinology and Metabolism Department of Internal Medicine Kurume University School of Medicine Fukuoka Japan
| | - Yuko Matsuo
- Division of Endocrinology and Metabolism Department of Internal Medicine Kurume University School of Medicine Fukuoka Japan
| | - Kanoko Moritaka
- Division of Endocrinology and Metabolism Department of Internal Medicine Kurume University School of Medicine Fukuoka Japan
| | - Shimpei Iwata
- Division of Endocrinology and Metabolism Department of Internal Medicine Kurume University School of Medicine Fukuoka Japan
| | - Ayako Nagayama
- Division of Endocrinology and Metabolism Department of Internal Medicine Kurume University School of Medicine Fukuoka Japan
| | - Aya Kawaguchi
- Department of Diagnostic Pathology Kurume University Hospital Fukuoka Japan
- Department of Dermatology Kurume University School of Medicine Fukuoka Japan
| | - Hiroshi Koga
- Department of Dermatology Kurume University School of Medicine Fukuoka Japan
| | - Satoko Yoshinobu
- Division of Endocrinology and Metabolism Department of Internal Medicine Kurume University School of Medicine Fukuoka Japan
| | - Nao Hasuzawa
- Division of Endocrinology and Metabolism Department of Internal Medicine Kurume University School of Medicine Fukuoka Japan
| | - Seiichi Motomura
- Division of Endocrinology and Metabolism Department of Internal Medicine Kurume University School of Medicine Fukuoka Japan
| | - Jun Akiba
- Department of Diagnostic Pathology Kurume University Hospital Fukuoka Japan
| | - Takekuni Nakama
- Department of Dermatology Kurume University School of Medicine Fukuoka Japan
| | - Masatoshi Nomura
- Division of Endocrinology and Metabolism Department of Internal Medicine Kurume University School of Medicine Fukuoka Japan
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40
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Hirano Y, Iwata H, Tsujuwaki M, Mai S, Mai Y, Imafuku K, Izumi K, Koga H, Ujiie H. Super-resolution imaging detects BP180 autoantigen in immunoglobulin M pemphigoid. J Dermatol 2022; 49:374-378. [PMID: 34845743 DOI: 10.1111/1346-8138.16260] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 11/16/2021] [Accepted: 11/16/2021] [Indexed: 12/01/2022]
Abstract
Bullous pemphigoid is generally caused by immunoglobulin (Ig)G autoantibodies against hemidesmosomal BP180 and/or BP230. Recently, the concept of IgM pemphigoid has been proposed. A 23-year-old Japanese woman presented with a 4-month history of severely itchy papules showing subepidermal separations with mild neutrophil infiltration. Direct immunofluorescence (DIF) revealed IgM deposits at the dermoepidermal junction, but neither IgG nor IgA deposits. Indirect immunofluorescence on 1 M NaCl-split skin demonstrated deposits on the epidermal side. The optical density (OD) value of a modified IgM enzyme-linked immunosorbent assay for full-length BP180, but not for BP180-NC16A, was increased. The patient was diagnosed with IgM pemphigoid and was treated with diphenyl sulfone at 50 mg/day without recurrence. To confirm the precise autoantigen, we tried to obtain super-resolution imaging. The deposition pattern of IgM autoantibodies seemed to be oriented parallel to that of BP180. The detailed images detect DIF deposits apart from BP180-NC16A staining, but are close to type VII collagen-NC1 staining. This result suggests that the IgM autoantibodies in the patient might target the C-terminus of BP180. IgM pemphigoid is still not a widely accepted concept, and the clinical course remains unknown. We will carefully follow-up the patient. Super-resolution images may help to detect precise autoantigens in autoimmune blistering diseases.
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Affiliation(s)
- Yoko Hirano
- Department of Dermatology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Hiroaki Iwata
- Department of Dermatology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Masumi Tsujuwaki
- Department of Dermatology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Shoko Mai
- Department of Dermatology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Yosuke Mai
- Department of Dermatology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Keisuke Imafuku
- Department of Dermatology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Kentaro Izumi
- Department of Dermatology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Hiroshi Koga
- Department of Dermatology, Kurume University School of Medicine, Fukuoka, Japan
| | - Hideyuki Ujiie
- Department of Dermatology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
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Yabe T, Itonaga T, Kuga S, Koga H, Kusaba T, Nishida H, Daa T, Maeda T, Ihara K. An autopsy case of recurrent pneumothorax and peliosis-like intrapulmonary hematoma with X-linked myotubular myopathy. Brain Dev 2022; 44:234-238. [PMID: 34840057 DOI: 10.1016/j.braindev.2021.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 11/04/2021] [Accepted: 11/14/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND The typical non-muscle complications of long-surviving X-linked myotubular myopathy (XLMTM) include scoliosis, head deformity, macrocephaly, gastroesophageal reflux disease and peliosis hepatis. Recently, pulmonary blebs and recurrent pneumothorax have also been reported as uncommon complications, whereas no reports on autopsy cases have focused on lung lesions. CASE PRESENTATION An 8-year-old boy with XLMTM presented recurrent pneumothorax requiring bleb resection and pleurodesis. He subsequently developed multiple pulmonary mass lesions. He died of hemorrhagic shock due to peliosis hepatis. Autopsy showed multiple peliosis-like hematomas in the blebs of the lung. The histopathological examination of the hematomas revealed pooled blood without a pathway to bronchus. No apparent increase in desmin- or α-smooth muscle actin (α-SMA)-positive cells, namely myofibroblasts, was observed around hematomas, suggesting that the mutation in the myotubularin gene was involved in the defective repair process in the liver and lung tissues. CONCLUSION Recurrent pneumothorax should be considered as a non-muscle complication of XLMTM. Peliosis-like intrapulmonary hematoma may also be a critical complication caused by poor proliferation of myofibroblasts in the tissue repair process.
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Affiliation(s)
- Tomona Yabe
- Department of Pediatrics, Oita University Faculty of Medicine, Japan
| | - Tomoyo Itonaga
- Department of Pediatrics, Oita University Faculty of Medicine, Japan
| | - Shuji Kuga
- Department of Pediatrics, Oita University Faculty of Medicine, Japan
| | - Hiroshi Koga
- Department of Pediatrics, National Hospital Organization Beppu Medical Center, Japan
| | - Takahiro Kusaba
- Department of Diagnostic Pathology, Oita University Faculty of Medicine, Japan
| | - Haruto Nishida
- Department of Diagnostic Pathology, Oita University Faculty of Medicine, Japan
| | - Tsutomu Daa
- Department of Diagnostic Pathology, Oita University Faculty of Medicine, Japan
| | - Tomoki Maeda
- Department of Pediatrics, Oita University Faculty of Medicine, Japan.
| | - Kenji Ihara
- Department of Pediatrics, Oita University Faculty of Medicine, Japan
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Mochizuki T, Omori G, Nishino K, Tanaka M, Tanifuji O, Koga H, Mori T, Koga Y, Kawashima H. The medial inclination of the proximal tibia is associated with the external knee adduction moment in advanced varus knee osteoarthritis. Knee Surg Sports Traumatol Arthrosc 2022; 30:574-583. [PMID: 33067660 DOI: 10.1007/s00167-020-06323-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 10/05/2020] [Indexed: 01/04/2023]
Abstract
PURPOSE Whether the inclined articular surface on the medial proximal tibia and the external knee adduction moment (KAM) correlate remains unclear. The hypothesis was that a steeper inclined articular surface correlated with a larger KAM in advanced knee osteoarthritis (OA). METHODS A total of 44 females (non-OA, 9 knees; early OA, 14 knees; advanced OA, 21 knees; mean age, 58 ± 16 years) were examined. Three-dimensional (3D) assessment was used on biplanar long-leg radiographs and 3D bone models using a 3D to 2D image registration technique. The approximation plane in the proximal tibia was determined using the least-square method. The joint moments were mathematically calculated in a gait analysis, applying a motion capture system and force plates. The main evaluation parameters were the femorotibial angle (FTA), the coronal inclination of the approximation plane in the medial proximal tibia (coronal inclination), and internal knee joint moments. The KAM means the external moments balanced with the internal knee abduction moments. RESULTS The advanced OA showed a larger internal abduction moment (p = 0.017) at the loading response than the other groups. The larger FTA and steeper coronal inclination correlated with the larger internal abduction moment (FTA, p < 0.001; coronal inclination, p = 0.003) at the loading response. CONCLUSIONS As the clinical relevance, the association among the coronal inclination of the medial proximal tibia, lower extremity alignment, and KAM is one of the key factors to help better understand the etiology of knee OA. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Tomoharu Mochizuki
- Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Science, 1-757 Asahimachi-dori Chuo-ku, Niigata City, Niigata, 951-8510, Japan.
| | - Go Omori
- Department of Health and Sports, Faculty of Health Sciences, Niigata University of Health and Welfare, Niigata, Japan
| | | | - Masaei Tanaka
- Niigata Institute for Health and Sports Medicine, Niigata, Japan
| | - Osamu Tanifuji
- Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Science, 1-757 Asahimachi-dori Chuo-ku, Niigata City, Niigata, 951-8510, Japan
| | - Hiroshi Koga
- Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Science, 1-757 Asahimachi-dori Chuo-ku, Niigata City, Niigata, 951-8510, Japan
| | - Takahiro Mori
- Graduate School of Science and Technology, Niigata University, Niigata, Japan
| | - Yoshio Koga
- Department of Orthopaedic Surgery, Nioji Onsen Hospital, Niigata, Japan
| | - Hiroyuki Kawashima
- Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Science, 1-757 Asahimachi-dori Chuo-ku, Niigata City, Niigata, 951-8510, Japan
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Nakashima Y, Koga H. Using a Minimal Parameter Set for Early Diagnosis of Hemophagocytic Lymphohistiocytosis in Non-European Children. Am J Case Rep 2022; 23:e934037. [PMID: 35078966 PMCID: PMC8802814 DOI: 10.12659/ajcr.934037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Case series
Patients: Male, 4-day-old • Male, 29-day-old
Final Diagnosis: Hemophagocytic lymphohistiocytosis (HLH)
Symptoms: Fever
Medication: —
Clinical Procedure: —
Specialty: Hematology • Immunology
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Affiliation(s)
- Yu Nakashima
- Department of Pediatrics, National Hospital Organization Beppu Medical Center, Beppu, Ōita, Japan
| | - Hiroshi Koga
- Department of Pediatrics, National Hospital Organization Beppu Medical Center, Beppu, Ōita, Japan
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44
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Sasaki H, Fujishima C, Hioki C, Yoshida H, Watanabe M, Murata T, Koga H, Ishii N, Kudo H. A case of paraneoplastic pemphigus associated with other iatrogenic immunodeficiency-associated lymphoproliferative disorders. J Dermatol 2022; 49:e165-e166. [PMID: 34989428 DOI: 10.1111/1346-8138.16302] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 12/22/2021] [Accepted: 12/23/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Hiroka Sasaki
- Department of Dermatology, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
| | - Chieko Fujishima
- Department of Dermatology, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
| | - Chika Hioki
- Department of Dermatology, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
| | - Haruka Yoshida
- Department of Dermatology, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
| | - Mitsumasa Watanabe
- Department of Hematology, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
| | - Teruasa Murata
- Department of Dermatology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Hiroshi Koga
- Department of Dermatology, Kurume University School of Medicine, Kurume, Japan
| | - Norito Ishii
- Department of Dermatology, Kurume University School of Medicine, Kurume, Japan
| | - Hitoshi Kudo
- Department of Dermatology, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
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45
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Kimura Y, Kiyota K, Koga H, Suenobu S, Ihara K. Renal lesions mimicking acute focal bacterial nephritis in pediatric leukemia. Pediatr Int 2022; 64:e14838. [PMID: 34747125 DOI: 10.1111/ped.14838] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 04/02/2021] [Accepted: 05/07/2021] [Indexed: 11/27/2022]
Affiliation(s)
- Yuka Kimura
- Department of Pediatrics, Faculty of Medicine, Oita University, Yufu, Oita, Japan
| | - Kyoko Kiyota
- Department of Pediatrics, Faculty of Medicine, Oita University, Yufu, Oita, Japan
| | - Hiroshi Koga
- Department of Pediatrics, National Hospital Organization Beppu Medical Center, Beppu, Oita, Japan
| | - Souichi Suenobu
- Department of Pediatrics, Faculty of Medicine, Oita University, Yufu, Oita, Japan
| | - Kenji Ihara
- Department of Pediatrics, Faculty of Medicine, Oita University, Yufu, Oita, Japan
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Yada M, Koga H. Influenza-associated myositis with unusual clinical manifestations. Pediatr Int 2022; 64:e14672. [PMID: 34490960 DOI: 10.1111/ped.14672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 01/28/2021] [Accepted: 02/25/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Mariko Yada
- Department of Pediatrics, National Hospital Organization Beppu Medical Center, Beppu, Oita, Japan
| | - Hiroshi Koga
- Department of Pediatrics, National Hospital Organization Beppu Medical Center, Beppu, Oita, Japan
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Hamada T, Teye K, Katayama E, Kawamura M, Koga H, Ishii N, Nakama T. Life-long Skin Eruptions along Blaschko's Lines in a 27-year-old Woman: A Quiz. Acta Derm Venereol 2021; 101:adv00610. [PMID: 34842932 PMCID: PMC9472097 DOI: 10.2340/actadv.v101.193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Abstract is missing (Quiz)
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Affiliation(s)
- Takahiro Hamada
- Department of Dermatology, Kurume University School of Medicien.
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Ishikura T, Kiyosaki K, Koga H. Recurrent Tolosa-Hunt Syndrome in a Child Accompanied by Idiopathic Aseptic Meningitis. Pediatr Neurol 2021; 125:16-17. [PMID: 34583233 DOI: 10.1016/j.pediatrneurol.2021.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 09/02/2021] [Accepted: 09/04/2021] [Indexed: 11/24/2022]
Affiliation(s)
- Toshiya Ishikura
- Department of Pediatrics, National Hospital Organization Beppu Medical Center, Beppu, Oita, Japan
| | - Kunihiko Kiyosaki
- Department of Ophthalmology, National Hospital Organization Beppu Medical Center, Beppu, Oita, Japan
| | - Hiroshi Koga
- Department of Pediatrics, National Hospital Organization Beppu Medical Center, Beppu, Oita, Japan.
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Qian H, Natsuaki Y, Koga H, Kawakami T, Tateishi C, Tsuruta D, Ishii N, Li X, Hashimoto T. The Second Study of Clinical and Immunological Findings in Anti-laminin 332-Type Mucous Membrane Pemphigoid Examined at Kurume University-Diagnosis Criteria Suggested by Summary of 133 Cases. Front Immunol 2021; 12:771766. [PMID: 34899722 PMCID: PMC8660687 DOI: 10.3389/fimmu.2021.771766] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 11/05/2021] [Indexed: 11/13/2022] Open
Abstract
Background Recently, we published an article retrospectively summarizing the results in 55 anti-laminin 332 (LM332)-type mucous membrane pemphigoid (MMP) cases examined at Kurume University, which were diagnosed by strict inclusion criteria, including positive reactivity in direct immunofluorescence and absence of antibodies to non-LM332 autoantigens. However, indirect immunofluorescence using 1M-NaCl-split normal human skin (ssIIF) is also valuable for diagnosis of anti-LM332-type MMP. Methods In this second study, we selected 133 anti-LM332-type MMP cases, which were diagnosed by our different inclusion criteria: (i) immunoglobulin G (IgG) deposition to basement membrane zone (BMZ) by direct immunofluorescence or IgG reactivity with dermal side of split skin by ssIIF, (ii) positivity for at least one of the three subunits of LM332 by immunoblotting of purified human LM332, and (iii) the presence of mucosal lesions. Clinical, histopathological, and immunological findings were summarized and analyzed statistically. Although these cases included the 55 previous cases, the more detailed study for larger scale of patients was conducted for further characterization. Results Clinically, among the 133 patients, 89% and 43% patients had oral and ocular mucosal lesions, respectively, 71% had cutaneous lesions, and 17% had associated malignancies. Histopathologically, 93% patients showed subepidermal blisters. The sensitivities of ssIIF and direct immunofluorescence are similar but are significantly higher than indirect immunofluorescence using non-split human skin (both p < 0.001). In immunoblotting of purified LM332, patient IgG antibodies most frequently reacted with LMγ2 subunit (58%), followed by LMα3 (49%) and LMβ3 (36%). Thirty-four percent patients recognized additional non-LM332 autoantigens. Statistical analysis revealed that autoantibodies against non-LM332 autoantigens might stimulate the production of anti-LMγ2 antibodies. Conclusions This retrospective study further characterized in more detail the clinical and immunological features of 133 cases of anti-LM332-type MMP, in which the new diagnostic criteria without positive direct immunofluorescence reactivity were useful for the diagnosis. Higher frequency with anti-LMγ2 antibodies suggested more significant pathogenic role of this subunit. Additional autoantibodies to non-LM332 autoantigens detected in one-third of the patients may contribute to complexity in anti-LM332-type MMP, including the induction of anti-LMγ2 antibodies.
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Affiliation(s)
- Hua Qian
- Central Laboratory, Dermatology Hospital of Jiangxi Province, Dermatology Institute of Jiangxi Province, and The Affiliated Dermatology Hospital of Nanchang University, Nanchang, China
- Department of Dermatology, Kurume University School of Medicine, and Kurume University Institute of Cutaneous Cell Biology, Kurume, Japan
| | - Yohei Natsuaki
- Department of Dermatology, Kurume University School of Medicine, and Kurume University Institute of Cutaneous Cell Biology, Kurume, Japan
| | - Hiroshi Koga
- Department of Dermatology, Kurume University School of Medicine, and Kurume University Institute of Cutaneous Cell Biology, Kurume, Japan
| | - Tamihiro Kawakami
- Department of Dermatology, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Chiharu Tateishi
- Department of Dermatology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Daisuke Tsuruta
- Department of Dermatology, Kurume University School of Medicine, and Kurume University Institute of Cutaneous Cell Biology, Kurume, Japan
- Department of Dermatology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Norito Ishii
- Department of Dermatology, Kurume University School of Medicine, and Kurume University Institute of Cutaneous Cell Biology, Kurume, Japan
| | - Xiaoguang Li
- Central Laboratory, Dermatology Hospital of Jiangxi Province, Dermatology Institute of Jiangxi Province, and The Affiliated Dermatology Hospital of Nanchang University, Nanchang, China
- Department of Dermatology, Kurume University School of Medicine, and Kurume University Institute of Cutaneous Cell Biology, Kurume, Japan
| | - Takashi Hashimoto
- Department of Dermatology, Kurume University School of Medicine, and Kurume University Institute of Cutaneous Cell Biology, Kurume, Japan
- Department of Dermatology, Osaka City University Graduate School of Medicine, Osaka, Japan
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Tanaka A, Inoue M, Hoshina T, Koga H. Correlation of Coronary Artery Abnormalities with Fever Pattern in Patients with Kawasaki Disease. J Pediatr 2021; 236:95-100. [PMID: 34019881 DOI: 10.1016/j.jpeds.2021.05.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 05/06/2021] [Accepted: 05/09/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To investigate the incidence of coronary artery abnormalities (CAAs) by fever pattern after intravenous immunoglobulin (IVIG) therapy in patients with Kawasaki disease. STUDY DESIGN This retrospective cohort study included 172 patients with Kawasaki disease aged ≤12 years who underwent IVIG therapy and had no CAAs before treatment. Resistance to initial IVIG was defined as persistent fever ≥37.5 °C for ≥24 hours after therapy or the recurrence of Kawasaki disease after initial defervescence. The patients were divided into 3 groups: IVIG responders, nonresponders with persistent fever, and nonresponders with recurrent fever. CAAs were evaluated 2 or 4 weeks and 12 months after onset and were defined by a coronary artery z-score ≥2.5. RESULTS The incidence of CAAs within 12 months after onset was significantly higher in nonresponders with persistent fever (27%) compared with the other 2 groups. On multivariate logistic regression analysis, being a nonresponder with persistent fever was an independent risk factor for having CAAs within 12 months after the onset of Kawasaki disease (OR, 6.48; P = .007). CONCLUSIONS In patients with Kawasaki disease resistant to IVIG therapy, persistent fever, but not recurrent fever, was found to be a risk factor for the incidence of CAAs. Aggressive additional therapy may be beneficial to prevent CAA formation in patients with Kawasaki disease with persistent fever.
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Affiliation(s)
- Atsushi Tanaka
- Department of Pediatrics, National Hospital Organization Beppu Medical Center, Beppu, Japan
| | - Masataka Inoue
- Department of Pediatrics, National Hospital Organization Beppu Medical Center, Beppu, Japan
| | - Takayuki Hoshina
- Department of Pediatrics, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Hiroshi Koga
- Department of Pediatrics, National Hospital Organization Beppu Medical Center, Beppu, Japan.
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