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Concomitant Occurrence of Segmental Neurofibromatosis and Lung Adenocarcinoma

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Journal of Cosmetics, Dermatological Sciences and Applications 2012年第4期2卷 265-266页

作者： Ryoko Morita naoki oiso Akira Kawada Department of Dermatology Faculty of Medicine Kinki University Osaka Japan Department of Dermatology Faculty of Medicine Kinki University Osaka Japan.

Neurofibromatosis type 1 (NF1) caused by a loss-of functional mutation in NF1 encoding neurofibromin is an autosomal dominant disorder characterized by café-au-lait spots, neurofibromas, intertriginous freckles, and Lisch nodules. Segmental neurofibromatosis (SN) represents a postzygotic mutation and loss of heterozygosity in neurofibromin. SN occurring in the elder persons may be associated with internal malignant tumors. Here, we reported a case of 58-year-old woman with concomitant occurrence of SN and lung adenocarcinoma. The onset of SN in aged persons would be a sign of concomitant occurrence of internal malignant tumors.

关键词： Segmental Neurofibromatosis Lung Adenocarcinoma Internal Malignant Tumors

Dermoscopic Appearances in the Superficial and Deep Type of Infantile Hemangioma

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Journal of Cosmetics, Dermatological Sciences and Applications 2012年第3期2卷 212-213页

作者： Muneharu Miyake naoki oiso Akira Kawada Department of Dermatology Kinki University Faculty of Medicine Osaka Japan

Infantile hemangioma is clinically classified as superficial, superficial and deep (mixed), and deep. Dermoscopy can be used for analyzing vascular structure and for classifying infantile hemangioma. Here, we focus on vascular features of the superficial and deep type of infantile hemangioma and show the three characteristic dermoscopic forms, mostly reddish, diffuse reddish, and cerebriform reddish.

关键词： Dermoscopy Infantile Hemangioma Classification

Reed Nevus (Pigmented Spindle Cell Nevus) in an 11-Month-Old Japanese Infant

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Journal of Cosmetics, Dermatological Sciences and Applications 2012年第4期2卷 239-240页

作者： Miyuki Fujita naoki oiso Akira Kawada Department of Dermatology Faculty of Medicine Kinki University Osaka Japan.

Reed nevus (pigmented spindle cell nevus) is a nevus with the histopathological features of abundant melanin, monomorphic spindle-epithelioid melanocytes, spindle cell nests confined within the epidermis and papillary dermis, and occasional upward interepidermal progression of melanocytes. Here, we reported an unusual case of Reed nevus in an 11-month-old Japanese male infant. Infantile Reed nevus should be included as a differential diagnosis for nevus pigmentosus in infancy.

关键词： Reed Nevus Pigmented Spindle Cell Nevus Spitz Nevus Malignant Melanoma Infant

Dermoscopic Features of Hyperpigmented Dots in Crista Cutis in Two Siblings in a Japanese Family with Inherited Acanthosis Nigricans

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Journal of Cosmetics, Dermatological Sciences and Applications 2012年第4期2卷 252-253页

作者： Shusuke Uchida naoki oiso Tamio Suzuki Akira Kawada Department of Dermatology Faculty of Medicine Kinki University Osaka Japan Department of Dermatology Yamagata Uni- versity School of Medicine Yamagata Japan

Acanthosis nigricans is characterized by papillomatous brownish lesions mainly in the intertriginous areas. We used dermoscopy to examine such lesions in a family with acanthosis nigricans. The dermoscopic images showed an aberrant skin structure of linear crista cutis and sulcus cutis, and hyperpigmented dots in crista cutis. The hyperpigmented dots, which could not be seen with the naked eyes, may contribute to the color of the pigmented skin. Dermoscopy can be useful for evaluating disorders involving the structure of area cutanea and a change in skin color.

关键词： Dermoscopy Acanthosis Nigricans Hyperpigmented Dots Crista Cutis Sulcus Cutis

Scleredema Diabeticorum in a Patient with the Normal Range of the Hemoglobin A1c Level and Impaired Glucose Tolerance

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Journal of Cosmetics, Dermatological Sciences and Applications 2012年第3期2卷 141-143页

作者： Hiromasa Matsuda naoki oiso Yukie Fujita Hiroshi Ikegami Akira Kawada Departments of Dermatology Kinki University Faculty of Medicine Osaka Japan Departments of Endocrinology Metabolism and Diabetes Kinki University Faculty of Medicine Osaka Japan

Scleredema diabeticorum is an uncommon skin disorder showing a diffuse, symmetrical, and non-pitting persistent in-duration developing initially on the nape. It usually occurs in patients with poorly controlled or insulin-resistant diabetes mellitus. We present a 57-year-old woman with scleredema diabeticorum with hemoglobin A1c 6.1% (normal, 4.7% - 6.2%) and impaired glucose tolerance. Alcian blue staining at pH 7.0 illustrated deposits of acid mucopolysaccharides between the collagen bundles in the reticular dermis, but the staining at pH 1.5 did not show the deposits. This case indicates that scleredema diabeticorum may be an early indicator of undiagnosed diabetes mellitus in some cases, and that impaired glucose tolerance test should be performed for individuals with scleredema even though the hemoglobin A1c level is within the normal range.

关键词： Scleredema Diabeticorum Alcian Blue Staining Diabetes Mellitus Hemoglobin A1c Impaired Glucose Tolerance An Early Indicator

Allergic Contact Dermatitis from Diethyl Sebacate in a Topical Antimycotic Medicament

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Journal of Cosmetics, Dermatological Sciences and Applications 2012年第3期2卷 216-218页

作者： Ayaka Hirao naoki oiso Megumi Hama Noriko Higashimori Yoichi Tatsumi Akira Kawada Departments of Dermatology Kinki University Faculty of Medicine Osaka Japan Departments of Patient Safety and Management Kinki University Faculty of Medicine Osaka Japan

Diethyl sebacate is used in topical medicaments in United States and Japan. We described a case of allergic contact dermatitis from diethyl sebacate in a topical antimycotic medicament. Allergic reaction to diethyl sebacate is likely more common because our group has found three of eight sensitized cases. We believe that an investigation regarding the sensitized frequency to diethyl sebacate would conduct to improve the safety of products in United States and Japan.

关键词： Allergic Contact Dermatitis Patch Test Allergen Diethyl Sebacate Safety Evaluation

The Disturbance of Melanogenesis and Melanosome Transfer in the Leukoderma Lesions of Extramammary Paget’s Disease

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Journal of Cosmetics, Dermatological Sciences and Applications 2018年第1期8卷 10-13页

作者： Atsushi Tanemura Aya Tanaka Fei Yang Eiji Kiyohara Yorihisa Kotobuki Mari Wataya-Kaneda naoki oiso Ichiro Katayama Department of Dermatology Graduate School of Medicine Osaka University Osaka Japan Department of Dermatology Faculty of Medicine Kinki University Osaka Japan

We frequently encounter characteristic color variation including hypopigmentation, hyperpigmentation, and erythema in extramammary Paget’s disease (EMPD) lesions. Owing to unclear hypopigmentation, the lesional border of EMPD can be poorly defined and it is likely insufficient to perform its complete resection. Although the existence of Toker’s cells and lack of lesional bFGF production have been reported to cause hypopigmentation inside of EMPD lesions, exact mechanisms of hypopigmentation in EMPD are not fully explored. We experienced three EMPD patients with obviously hypopigmented EMPD macules and histopathologically confirmed a reduced number of melanocytes on the hypopigmented macules and their loss on the erythematous plaques or nodules. An ultrastructural analysis on the hypopigmented lesions revealed disturbance of melanosome maturation and melanosome transfer to the adherent Pagets’ cell on the basal layer. No Paget’s cells even adhered to remaining melanocytes with dendrites contained matured melanosome and a few number of matured melanosome complexes were observed in basal keratinocytes. In the present study, we hypothesize that severe disturbance of not only melanogenesis but also melanosome transfer to surrounding Paget’s cells and basal keratinocytes may cause characteristic hypopigmentation in EMPD. Future bioanalysis would reveal molecular mechanisms for hypopigmentation in EMPD.

关键词： Hypopigmentation Extramammary Paget’s Disease (EMPD) Melanocyte to Paget’s Cell Interaction Ultrastructural Analysis Mechanism

Pigmentary mosaicism and specific forms of phylloid hypoand hypermelanosis

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World Journal of Dermatology 2012年第2期1卷 6-9页

作者： naoki oiso Akira Kawada Department of Dermatology Kinki University Faculty of Medicine

Pigmentary mosaicism is proposed to encompass all pigment anomalies caused by chromosomal mosaicism. The concept includes, not only pigment anomalies following the lines of Blaschko, but also pigmentary disorders with phylloid, checkerboard and patchy pigmentation without midline separation. The representative disorders are hypomelanosis of Ito(pigmentary mosaicism of hypopigmented or Ito type), linear and whorled nevoid hypermelanosis(pigmentary mosaicism of hyperpigmented type), pigmentary mosaicism of hypopigmented and hyperpigmented type, and phylloid hypo- and hypermelanosis. Pigmentary mosaicism is nowadays recognized as a pigmentary disorder caused by somatic chromosomal abnormalities disrupting or accelerating the function of pigmentary genes. Affected individuals with pigmentary mosaicism commonly have multiple congenital abnormalities, developmental delays and/or mental retardation. However, the complication is not a syndrome because functional loss or acquisition due to various chromosomal abnormalities induces pigment abnormalities and specific complications. Cytogenetic abnormalities, including polyploidy, aneuploidy, deletions, insertions and translocations, are associated with almost any chromosome and tissue-limited mosaicism for chromosome abnormalities. Cytogenetic find-ings in cases with the phylloid pattern demonstrate the obvious causal relationship between phylloid hypomelanosis and mosaic trisomy 13. The pattern of cutaneous mosaicism depends on the trajectory of migration and proliferation during embryogenesis. The chromosomal regions of hot breakpoints in pigmentary mosaicism may contain pigmentation-associated genes. The accumulation of relationships between cases and chromosomal analyses may provide the opportunity to identify and understand the pigmentation-associated genes because more than 800 phenotypic alleles are known in the mice models of pigmentary anomalies and not all color loci have been identified. Here, we summarize the clini

关键词： Pigmentary mosaicism Hypomelanosis of Ito Linear and whorled nevoid hypermelanosis Phylloid hypomelanosis Phylloid hypermelanosis The lines of Blaschko Phylloid pattern

Analysis of Closed Claims in the Clinical Management of Rheumatoid Arthritis in Japan

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Chinese Medical Journal 2017年第12期130卷 1454-1458页

作者： Yasuhiro Otaki Makiko DaSilva Ishida Yuichi Saito Yasuaki Oyama Giichiro oiso Mitsuru Moriyama General Medical Education and Research Center Teikyo University Tokyo 1738605 Japan National Center of Neurology and Psychiatry Tokyo 1878551 Japan Specialty Claims Department Sompo Japan Nipponkoa Insurance Incorporated Tokyo 1648608 Japan Department of Integrated Human Sciences Hamamatsu University School of Medicine Shizuoka 4313192 Japan Moriyama Management Law Office Tokyo 1010052 Japan

Background： Despite an increasing awareness of the risk of medical errors, few data sources are available to highlight the characteristics and patterns of medical errors in the clinical management of rheumatoid arthritis （RA）. The present study aimed to evaluate medical malpractice claims associated with the management of RA and other atltoimmune connective tissue diseases （ACTDs）. Methods： We analyzed 38 ACTD-associated closed claims extracted from a total of 8530 claims processed between July 2004 and June 2014 by the Tokyo headquarters office of Sompo Japan Nipponkoa Incorporated, a leading malpractice insurer in Japan. Results： RA was the most common ACTD assessed in this study, accounting for 20 cases. Although the male-to-female ratio among these cases was 5：15, in accordance with the general demographic distribution of RA, the proportion of patients older than 60 years （77.8%） was relatively high as the general range of RA susceptibility is 30-50 years. The analysis of allegation types among RA cases revealed statistically significant differences from non-RA cases （Fisher＇s exact test） as well as the following key findings： diagnosis-related allegations were absent （P 〈 0.01 ）, whereas medication-related allegations were distinctively common （P=0.02）. Clinical processes related to the assessment process were most vulnerable to breakdown and leading to negligence identified with subsequent medication-related allegations, particularly among RA cases. Conclusions： The characteristics of malpractice claims associated with RA management, including the high frequency of medication-related allegations, breakdowns in the assessment process, and high claim numbers among patients older than 60 years, suggest the importance of caution exercised by physicians when administering immunosuppressants for the clinical treatment of RA.

关键词： Autoinlmune Connective Tissue Disease Closed Claim Rheumatoid Arthritis