Search

Background: Although much research has been conducted into the origin of syringoma, the histogenesis and differentiation of it remains controversial. The published studies examined various antibodies, and our study is an additional immunohistochemical work-up., Objective: We attempted to identify the cell that acts as the precise origin of a syringoma, based on a comparative analysis of carcinoembryonic antigen (CEA), epithelial membrane antigen (EMA), and cytokeratin (CK) 5 through immunohistochemical staining in the solid strand of basophilic epithelial cells of syringoma., Methods: A total of 31 patients with biopsy-confirmed syringoma were included in this study. Each sample was analyzed with antibodies to CEA, EMA, and CK5. These markers were indicating each part of the normal sweat gland structure: CEA stains the luminal surface of sweat ductal structures; EMA stains the peripheral cells of normal dermal ducts and the intraepidermal duct; CK5 stains the outer cells of the dermal duct and lower intraepidermal duct but does not stain the intraepidermal duct located in the upper epidermis., Results: We were able to confirm that the solid strands stained for EMA and CK5, as did the outer cells of the ductal structure. However, the solid strands did not stain with CEA., Conclusions: The results indicated that solid strands observed in syringomas originate from the outer cells of the two layers of cells that compose the lower epidermal duct or the transitional portion between the intraepidermal duct and dermal duct in the normal eccrine or apocrine structure. Thus, we surmise that a syringoma is developed by the proliferation of these cells., (© 2011 The International Society of Dermatology.)

Background: Fractional technology overcomes the problems of ablative lasers, such as inaccurate depth control and damage to the epidermis. Minimally invasive fractional radiofrequency microneedle devices allow for more-selective heating of the dermis., Objective: To evaluate the clinical efficacy of fractional radiofrequency microneedle (ERM) treatment in acne scars and large facial pores., Materials and Methods: Thirty patients with acne scars and large facial pores were enrolled. Bipolar radiofrequency energy was delivered to the skin through the electrodes of the FRM device. Skin lesions were evaluated according to grade of acne scars, Investigator Global Assessment of large pores, skin surface roughness, transepidermal water loss (TEWL), dermal density, microscopic and composite image, sebum measurement, and questionnaires regarding patient satisfaction., Results: The grade of acne scars and Investigator Global Assessment of large pores improved in more than 70% of all patients. Skin surface roughness, dermal density, and microscopic and composite images also improved, whereas TEWL and sebum measurement did not change., Conclusion: Clinical improvement from FRM treatment appeared to be related to dermal matrix regeneration. FRM treatment may be effective in improving acne scars and facial pores., (© 2012 by the American Society for Dermatologic Surgery, Inc. Published by Wiley Periodicals, Inc.)

People with sensitive skin (SS) are those who state their skin is more sensitive than that of average persons. The stratum corneum is responsible for maintaining skin barrier function. Ceramides, major constituents of stratum corneum lipids, have been shown to predominantly contribute to the role. It has been suggested that barrier function in SS is decreased. However, we could find very few reports about stratum corneum ceramides in SS. This study was done to find out differences in stratum corneum ceramides between SS and non-SS groups. Fifty individuals (20 with SS and 30 with non-SS) were recruited. Lactic acid sting test (LAST) was performed on the left cheek. On six sites including the right cheek, arm, thigh, leg, back and palm, transepidermal water loss (TEWL) and erythema index (EI) were measured. On the above six sites, stratum corneum sheets were obtained by stripping with cyanoacrylate resin and stratum corneum lipids were extracted, then, analyzed by high-performance liquid chromatography electrospray ionization mass spectrometry. LAST scores were higher in the SS group, but not statistically significant. There were no differences in TEWL and EI values between the two groups. The mean value of the quantity of stratum corneum ceramides on the face was significantly lower in the SS group. On other sites, mean values were also lower in the SS group, but not statistically significant. The quantity of ceramides was significantly decreased in the face of the SS group compared to that of the non-SS group. These results suggest that the decrease in stratum corneum ceramides on facial skin could be related to SS development., (© 2011 Japanese Dermatological Association.)

Background: Psoriasis is a chronic skin disease that appears to be autoimmune in nature. Recently, it is thought that microbial pathogens of skin can affect the pathogenesis of psoriasis by inducing autoimmunity. Heat-shock proteins (HSPs) are known to play an important role in immune and inflammatory responses of the skin including psoriasis. Recent studies have suggested that Toll-like receptors (TLR) 2, 4 and gammadelta T-cell receptors (TCR-gammadelta) may recognize HSP60 as a ligand and consequently activate the immune system., Methods: The biopsy specimens of 12 of guttate psoriasis, 12 of plaque psoriasis and five of normal skin were studied using immunohistochemical staining. The expressions of HSP60, TLR2 and TLR4 were evaluated using an immunostaining-intensity-distribution (IID) index and TCR-gammadelta positive cells were counted., Results: The expression of HSP60 was significantly higher in guttate and plaque psoriasis than in normal skin. The expression of TLR4 was higher in guttate psoriasis than in plaque psoriasis and normal skin. The expression of TCR-gammadelta was higher in guttate and plaque psoriasis than in normal skin, but there was no correlation found between the expression of HSP60 and TLRs 2 and 4, or between that of HSP60 and TCR-gammadelta., Conclusions: HSP60 may be related to the pathogenesis of both guttate and plaque psoriasis and TLR4 may be related to the pathogenesis of guttate psoriasis.

This study was aimed to alert the hazard of accidental adverse reactions of photochemotherapy (Psoralen-UVA or PUVA) that has been used in the treatment for some skin diseases and commercially for cosmetic tanning. Aside from the predictable side effects of PUVA such as erythema and itching, the accidental adverse reactions such as extensive burns could occasionally occur. Our observations indicated that six cases resulted from mistakes of medical personnel, and six other cases resulted from unsupervised mistakes of patients. The conditions that needed photochemotherapy were seven cases of vitiligo, three cases of psoriasis and two cases of tanning. The accidental overdose of UV radiation was about 3-10 times the empirically normal dose. Five of our patients were supposed to undergo topical PUVA, but they were irradiated at the dose of oral PUVA. One patient applied 8-methoxypsoralen (8-MOP) cream together with taking 5-methoxypsoralen (5-MOP) tablets for oral PUVA. Three other patients enjoyed sunbathing 1-3h shortly after finishing PUVA. A young couple chose 5-MOP to enhance tanning and sunbathed about 1h later. When another patient resumed PUVA in a 6-month cessation, he was exposed at a previous dose instead of a starting dose. Erythema and blisters of second degree burns developed in all our cases, 36-72h after PUVA, with 5-25% of body surface involved. Among the 12 patients, 3 were admitted and 9 were treated on an outpatient basis. All patients recovered in 1-3 weeks with no skin graft or no significant sequelae except post-inflammatory hyperpigmentation.