akita hirotaka

Background Monopolar radiofrequency (mRF) devices have been shown to be clinically effective for treating aging skin, but there are few histologic studies about the mechanisms. Objective To histologically analyze chronologic and quantitative change in collagens after mRF treatment to determine the mechanisms of the antiaging effect. Methods Five patients were enrolled in this study. Skin specimens were taken before and 1 and 3months after treatment. Immunostaining was performed to determine change in type I and III collagen levels and stem and other cell counts in skin layers. Results In all cases, both types of collagen significantly increased after irradiation in the dermis (p<.05), and their changes were noticed uniformly in all layers. No significant change was noticed in stem and other cell counts. Conclusions This study histologically demonstrated that type I and III collagen increased significantly in the dermis after mRF treatment. The amount of stem cells did not affect the increase in collagens.

A 16-year-old girl presented with a 9-year history of vesicles on the vulva. She had initially taken a wait-and-see approach, but required treatment because of bleeding. Histological examination of a biopsied vesicle revealed dilated lymph channels in the upper dermis, suggesting lymphangioma circumscriptum (LC). The challenge for this pathology has been to find a conservative treatment with low morbidity and better results than those reported for surgical excision, which has been the mainstay of therapy. In this case, LC of the vulva was successfully treated using a 10,600-nm CO2 laser and long-pulsed Nd:YAG laser. Use of the 10,600-nm CO2 laser and long-pulsed Nd:YAG laser appeared effective for treating LC. © 2014 S. Karger AG, Basel.

Background Quality-switched (QS) lasers are well-known effective treatment for removing solar lentigines. However, the high incidence of post-inflammatory hyperpigmentation (PIH) raises concern in darker skin types. This is the first study comparing efficacies and incidences of PIH in Asian skin with different degrees of irradiation between two QS lasers. Method In total, 355 solar lentigines in 193 cases, skin types III-V, were randomly divided into four groups. All cases received single laser treatment. Clinical results were evaluated after 4 weeks. Groups 1 and 3 were treated 'aggressively' with endpoints of very obvious immediate whitening (IW) of the lesion. Groups 2 and 4 were treated 'mildly' with endpoints of slight IW of the lesion. Groups 1 and 2 were irradiated with the QS ruby, and groups 3 and 4 with the QS frequency doubled Nd:YAG laser. Results There were no statistically significant differences in degrees of clearance among the four groups. However, PIH incidences were very different: 33.33%, 7.47%, 23.18% and 8.47% in groups 1, 2, 3 and 4 respectively. The difference between aggressively and mildly irradiated groups (1 and 3 vs. 2 and 4) was statistically significant (P &lt 0.001). However, there was no statistical difference between the two aggressively or the two mildly irradiated groups. There were no significant differences between skin types. Conclusion Aggressive irradiation using QS lasers resulted in a high PIH incidence, while having no advantage in efficacy. For darker skin types, mild irradiation reduces the PIH risk with no disadvantage in efficacy. © 2011 European Academy of Dermatology and Venereology.

Background Paget's disease is an intraepidermal adenocarcinoma that is difficult to diagnose clinically as it mimics inflammatory or infectious diseases. As a consequence, it may be clinically misdiagnosed resulting in a delay in appropriate management. Reflectance confocal microscopy allows the visualization of the upper layers of the skin and mucosa at cellular resolution. Paget's disease is characterized histologically by the presence of neoplastic cells scattered throughout all layers of the epidermis in a pattern similar to that also observed in melanoma (and termed Pagetoid spread). Objective In vivo confocal microscopy is an excellent diagnostic tool for detecting Pagetoid spread and for diagnosing melanoma. We therefore hypothesized that it may also assist in the diagnosis of Paget's disease. Methods In this study, we describe the confocal features of nine cases of extramammary Paget's disease and one case of mammary one. Results Large atypical Pagetoid cells were present singly and in clusters in all 10 cases and were readily visualized on ex vivo and in vivo confocal microscopy. The presence of Pagetoid spread and other confocal features, in the appropriate clinical context, is suggestive Paget's disease and should allow distinction from other inflammatory diseases that may appear similar clinically. Conclusion The use of confocal microscopy is likely to facilitate earlier diagnosis of Paget's disease and the instigation of appropriate management with concomitant improvement in clinical outcomes. © 2012 European Academy of Dermatology and Venereology.

We carried out a four-week study of female patients with acne vulgaris in order to assess the safety of make-up cosmetics for sensitive skin, consisting of powder foundation, liquid foundation, and loose powder in the "d Program^®" series developed by Shiseido Co., Ltd. Eighty-five subjects completed the study. We found adverse skin reactions in 2.1% of the subjects who used the powder foundation. On the basis of these findings, it was concluded that these make-up cosmetics for sensitive skin can be used safely by the great majority of female patients with acne vulgaris.Skin Research, 10: 170-182, 2011

We report two cases of anaphylaxis due to ingestion of mite-contaminated Okonomi-yaki (Japanese pancake) mix. Case 1: A 50-year-old female developed anaphylaxis after eating Okonomi-yaki prepared from Okonomi-yaki mix that had been stored at room temperature after opening. She demonstrated serum specific IgE against Dermatophagoides farinae (Der. f.), but did not demonstrate any wheat- or gluten-specific IgE antibodies. Prick tests showed positive reactions to Der. f. antigen (Torii) but not to previously unopened Okonomi-yaki mix or wheat flour that had been stored in a freezer. Case 2: A 28-year-old female developed anaphylaxis after eating Monja-yaki prepared from Okonomi-yaki mix that had been stored at room temperature after opening. She demonstrated serum specific IgE antibodies against Der. f. but no wheat- or gluten-specific IgE antibodies. Prick tests showed positive reactions to the responsible Okonomi-yaki mix and Der. f. antigen (Torii), but not to wheat flour that had been stored in a freezer. The responsible Okonomi-yaki mix contained 50 heads/g of Der. f., and a high level (64.1 μg/g) of Der f1 antigen was detected by specific ELISA. Immunoblotting revealed a specific 25 kDa band in patient sera against the responsible Okonomi-yaki mix, which was absorbed by Der. f. crude antigen.

We reported three cases of papular tuberculid after receiving Bacille Calmette-Guerin (BCG) vaccination. Case 1 was a 5-month-old girl who developed eruptions on her extremities five weeks after the BCG vaccination. Case 2 was a 6-month-old boy who developed eruptions on his extremities one month after the BCG vaccination. Case 3 was a 5-month-old boy who developed eruptions all over his body 6 weeks after BCG vaccination. Histopathologically, dermal perivascular lymphocytic inflammatory infiltrate and non-caseous epithelioid cell granulomas were observed in all cases. We diagnosed these cases as papular tuberculid resulting from BCG vaccination. All lesions resolved in three months without treatment. To establish the diagnosis when discrete eruptions are observed in a child under one year old, it is important to ask the guardians about the time of BCG vaccination.

We experienced that two Japanese women diagnosed with syringoma, confirmed by a punch biopsy, were successfully treated with fractional resurfacing. Both clinical cases have had positive results after only a few treatments, with high patient satisfaction, not only for the improvement of syringoma, but also for the improvement of aging skin, and with no side effects. From that aspect, laser treatment with fractional photothermolysis may be considered to be one of the effective treatment methods for syringoma. Although fractional photothermolysis was originally developed for an aesthetic purpose, it also can be utilized for intractable skin disease, as demonstrated by taking the concept of fractional photothermolysis and the results from this study with skin biopsy.