Asunto(s)
Cuero Cabelludo/patología , Neoplasias de las Glándulas Sudoríparas/congénito , Neoplasias de las Glándulas Sudoríparas/patología , Adenomas Tubulares de las Glándulas Sudoríparas/congénito , Adenomas Tubulares de las Glándulas Sudoríparas/patología , Humanos , Recién Nacido , Masculino , Cuero Cabelludo/cirugíaRESUMEN
BACKGROUND: Cochineal dyes are used as additives in various foods for the purpose of red coloration. On the other hand, although it has been reported as a causative agent of immediate allergy, most of them are adult women. We report a case of an 8-year-old boy who developed a cochineal allergy.Current disease history: He has been suffering from atopic dermatitis, bronchial asthma, and food allergies since childhood. At the age of seven, he experienced an unknown anaphylaxis reaction twice. When he was 8 years old, he ate a frankfurter containing hypoallergenic cochineal for the first time; cold sweat, intraoral discomfort, respiratory distress, and urticaria appeared throughout the body. His skin prick tests were positive, with a result of 2+to frankfurter and cochineal dyes (color value 0.1 and 0.01). In the immunoblot assay, binding of IgE antibody was observed with CC38K (the main component of cochineal) and a protein of approximately 80-200 kDa in the high molecular weight region. DISCUSSION: We report a case of anaphylaxis with hypoallergenic cochineal onset in a school-age boy.
Asunto(s)
Anafilaxia/inducido químicamente , Carmín/efectos adversos , Hipersensibilidad a los Alimentos , Urticaria/inducido químicamente , Niño , Femenino , Humanos , Masculino , Pruebas CutáneasAsunto(s)
Pustulosis Exantematosa Generalizada Aguda/tratamiento farmacológico , Antirreumáticos/efectos adversos , Etretinato/uso terapéutico , Hidroxicloroquina/efectos adversos , Lupus Eritematoso Sistémico/tratamiento farmacológico , Pustulosis Exantematosa Generalizada Aguda/diagnóstico , Pustulosis Exantematosa Generalizada Aguda/etiología , Pustulosis Exantematosa Generalizada Aguda/patología , Adulto , Biopsia , Femenino , Humanos , Piel/efectos de los fármacos , Piel/patología , Resultado del TratamientoRESUMEN
A case of severe fever with thrombocytopenia syndrome (SFTS) in which a skin biopsy from the tick-bite region was analyzed is reported. The patient was a 72-year-old woman who developed fever and thrombocytopenia after a tick bite. SFTS was diagnosed from polymerase chain reaction (PCR) analysis of a blood sample. Histopathological analysis of a skin biopsy specimen from the tick-bite region showed CD20-positive perivascular and interstitial immunoblastic cells, which were positive to anti-SFTS virus (SFTSV) nucleoprotein antibody. In addition, SFTSV RNA was detected by real-time PCR from this biopsy specimen. Moreover, hemophagocytosis was also found in the tick-bite region. To the best of our knowledge, this is the first report to analyze the details of the tick-bite region of skin in SFTS, and the first to detect virus-infected cells in the skin. The present findings may help elucidate the mechanisms of entry of SFTSV.
Asunto(s)
Coagulación Intravascular Diseminada/virología , Fiebre por Flebótomos/virología , Phlebovirus/aislamiento & purificación , Trombocitopenia/virología , Mordeduras de Garrapatas/patología , Anciano , Biopsia , Coagulación Intravascular Diseminada/sangre , Coagulación Intravascular Diseminada/diagnóstico , Resultado Fatal , Femenino , Humanos , Fiebre por Flebótomos/sangre , Fiebre por Flebótomos/diagnóstico , Phlebovirus/genética , ARN Viral/aislamiento & purificación , Piel/patología , Piel/virología , Síndrome , Trombocitopenia/sangre , Trombocitopenia/diagnóstico , Mordeduras de Garrapatas/sangre , Mordeduras de Garrapatas/complicaciones , Mordeduras de Garrapatas/virologíaAsunto(s)
Anticuerpos Monoclonales Humanizados/uso terapéutico , Síndrome de Churg-Strauss/tratamiento farmacológico , Complicaciones Cardiovasculares del Embarazo/tratamiento farmacológico , Adulto , Síndrome de Churg-Strauss/diagnóstico por imagen , Síndrome de Churg-Strauss/patología , Angiografía por Tomografía Computarizada , Progresión de la Enfermedad , Resistencia a Medicamentos , Femenino , Dedos , Humanos , Inmunoglobulinas Intravenosas/administración & dosificación , Metilprednisolona/administración & dosificación , Embarazo , Complicaciones Cardiovasculares del Embarazo/diagnóstico por imagen , Complicaciones Cardiovasculares del Embarazo/patología , Quimioterapia por Pulso , Dedos del Pie , Resultado del TratamientoRESUMEN
BACKGROUND: Cochineal dye is used worldwide as a red coloring in foods, drinks, cosmetics, quasi-drugs, and drugs. The main component of the red color is carminic acid (CA). Carmine is an aluminum- or calcium-chelated product of CA. CA and carmine usually contain contaminating proteins, including a 38-kDa protein thought to be the primary allergen. Severe allergic reactions manifest as anaphylaxis. The aim of this study was to review all Japanese reported cases and propose useful diagnostic chart. METHODS: All reported Japanese cases of cochineal dye-induced immediate allergy were reviewed, and newly registered cases were examined by skin prick test (SPT) with cochineal extract (CE) and measurement of CE and carmine-specific serum IgE test. Two-dimensional (2D) western blotting using patient serum was conducted to identify the antigen. RESULTS: Twenty-two Japanese cases have been reported. SPT and the level of specific IgE test indicated that six cases should be newly registered as cochineal dye allergy. All cases were adult females, and all cases except three involved anaphylaxis; 13 cases involved past history of local symptoms associated with cosmetics use. Japanese strawberry juice and fish-meat sausage, and European processed foods (especially macarons made in France) and drinks were recent major sources of allergen. 2D western blotting showed that patient IgE reacted to the 38-kDa protein and other proteins. Serum from healthy controls also weakly reacted with these proteins. CONCLUSIONS: SPT with CE and determination of the level of CE and carmine-specific IgE test are useful methods for the diagnosis of cochineal dye allergy.
Asunto(s)
Alérgenos/efectos adversos , Carmín/efectos adversos , Colorantes/efectos adversos , Hipersensibilidad Inmediata/inducido químicamente , Hipersensibilidad Inmediata/diagnóstico , Adulto , Pueblo Asiatico , Femenino , Humanos , Hipersensibilidad Inmediata/sangre , Hipersensibilidad Inmediata/inmunología , Inmunoglobulina E/sangre , Japón , Persona de Mediana Edad , Pruebas CutáneasAsunto(s)
Esclerodermia Difusa/diagnóstico , Esclerodermia Localizada/complicaciones , Anciano , Biopsia , Dermis/patología , Diagnóstico Diferencial , Eosinofilia/diagnóstico , Fascitis/diagnóstico , Dedos , Humanos , Masculino , Esclerodermia Difusa/etiología , Esclerodermia Difusa/patología , Esclerodermia Localizada/patología , Tejido Subcutáneo/patologíaAsunto(s)
Dermatitis Atópica/genética , Ictiosis Ampollosa de Siemens/genética , Proteínas de Filamentos Intermediarios/genética , Queratina-2/genética , Adolescente , Adulto , Dermatitis Atópica/complicaciones , Proteínas Filagrina , Humanos , Ictiosis Ampollosa de Siemens/complicaciones , Inmunoglobulina E/sangre , Lactante , Recién Nacido , MasculinoRESUMEN
PURPOSE: This study was conducted with infants diagnosed with bilateral retinoblastoma (RB) and their mothers. It explored characteristics of the mother-infant interaction, the infants' developmental characteristics and related risk factors. METHOD: Cross-sectional statistical analysis was performed with 18 dyads of one-year-old infants with bilateral RB and their mothers. RESULTS: Using the Japanese Nursing Child Assessment Teaching Scale (JNCATS) results showed that infants with RB had significantly lower scores compared to normative Japanese scores on all of the infants' subscales and "Child's contingency" (p < 0.01). Five infants with visual impairment at high risk of developmental problems had a pass rate of 0% on six JNCATS items. There were positive correlations between Developmental quotients (DQ) and JNCATS score of "Responsiveness to caregiver" (ρ = 0.50, p < 0.05) and DQ and "Child's contingency" (ρ = 0.47, p < 0.05). CONCLUSIONS: Infants with visual impairment were characterized by high likelihood of developmental delays and problematic behaviors; they tended not to turn their face or eyes toward their mothers, smile in response to their mothers' talking to them or the latter's changing body language or facial expressions, or react in a contingent manner in their interactions. These infant behaviors noted by their mothers shared similarities with developmental characteristics of children with visual impairments. These findings indicated a need to provide support promoting mother-infant interactions consistent with the developmental characteristics of RB infants with visual impairment.
Asunto(s)
Desarrollo Infantil/fisiología , Conducta del Lactante/fisiología , Conducta del Lactante/psicología , Relaciones Madre-Hijo/psicología , Madres/psicología , Retinoblastoma/complicaciones , Trastornos de la Visión/psicología , Adolescente , Adulto , Pueblo Asiatico/psicología , Niño , Preescolar , Estudios Transversales , Femenino , Humanos , Lactante , Japón , Masculino , Persona de Mediana Edad , Retinoblastoma/psicología , Factores de RiesgoAsunto(s)
Tuberculosis Cutánea/diagnóstico , Tuberculosis Miliar/diagnóstico por imagen , Tuberculosis Pulmonar/diagnóstico por imagen , Anciano de 80 o más Años , Femenino , Articulación de la Cadera/diagnóstico por imagen , Humanos , Nariz , Tomografía Computarizada por Rayos X , Tuberculosis Cutánea/microbiología , Tuberculosis Miliar/microbiología , Tuberculosis Osteoarticular/diagnóstico por imagen , Tuberculosis Pulmonar/microbiologíaRESUMEN
Hereditary lactate dehydrogenase (LDH) M-subunit deficiency is very rare and we have found reports of close to a dozen cases in the published work, two of which were associated with pustular psoriasis-like lesions. We report a third case of pustular psoriasis-like eruptions associated with LDH M-subunit deficiency, which occurred 24 years after the diagnosis of LDH M-subunit deficiency. These cases indicate that abnormal activity of LDH can induce pustular psoriatic lesions in the long term. Some patients with symptoms of hereditary LDH M-subunit deficiency have antecedent annular scaly plaque lesions, that resemble psoriatic lesions. We discuss a hypothesis to explain this scenario.
Asunto(s)
L-Lactato Deshidrogenasa/deficiencia , L-Lactato Deshidrogenasa/genética , Psoriasis/genética , Enfermedades Raras/genética , Eliminación de Secuencia , Adulto , Secuencia de Aminoácidos/genética , Biopsia , Exones/genética , Femenino , Glucocorticoides/uso terapéutico , Humanos , Inmunohistoquímica , Isoenzimas/deficiencia , Isoenzimas/genética , Lactato Deshidrogenasa 5 , Prednisolona/uso terapéutico , Psoriasis/tratamiento farmacológico , ARN Mensajero/genética , Análisis de Secuencia de ADN , Análisis de Secuencia de ARN , Piel/patología , Factores de Tiempo , Valina/genéticaRESUMEN
Pigmented cosmetic dermatitis-like (Riehl's melanosis-like) pigmentation was reported in three of 27 patients with primary Sjögren's syndrome. But case reports of such eruptions are rare. We describe three cases of such eruptions associated with primary Sjögren's syndrome or anti-SSA antibody and possible associations with specific types of human leukocyte antigen (HLA) and infiltrating lymphocytes. These middle-aged Japanese women had reticular facial pigmentation and histopathological examination revealed interface dermatitis, melanophages, and dense lymphocytic infiltration around hair follicles and sweat ducts. HLA typing revealed common antigenic equivalents or genetic typing of HLA-A2, DR52, DPA1(02:02) and DPB1(05:01). Immunohistochemical staining revealed major subsets of T cells to be CD8 and CD45RO. Some Foxp3- and few IL17-positive cells were found in strong contrast to the major CD4 subset of infiltrated T cells in annular erythema associated with Sjögren's syndrome. Apparently, our patients' pigmentation represented a specific etiology associated with primary Sjögren's syndrome or anti-SSA antibody.
Asunto(s)
Anticuerpos Antinucleares/sangre , Dermatitis/inmunología , Dermatitis/patología , Síndrome de Sjögren/patología , Anciano , Dermatitis/etiología , Femenino , Prueba de Histocompatibilidad , Humanos , Persona de Mediana Edad , Trastornos de la Pigmentación/etiología , Trastornos de la Pigmentación/inmunología , Trastornos de la Pigmentación/patología , Síndrome de Sjögren/complicaciones , Síndrome de Sjögren/inmunologíaRESUMEN
Aim: There has been no indicator that allows an early quantitative evaluation of the severity of a mamushi snake (Gloydius blomhoffii) bite. Because the number of severe mamushi bite cases is much fewer than non-severe cases, a formal case-control study is difficult. Therefore, we tried to generate a preliminary quantitative, real-time index for its severity by referring to published reports of severe mamushi bite cases. Methods: We enrolled patients who presented with a mamushi bite and visited our outpatient clinic. Severe cases were collected from published works. Creatinine kinase levels and white blood cell counts of non-severe and severe cases were compared and analyzed. Results: There was a lag time of 10 h before the creatinine kinase level began to rise. The speed of the increase was higher in severe cases than in non-severe cases, and severe cases were recognized as those showing speeds of above 250 IU/L/h. White blood cell counts increased earlier than creatinine kinase levels without any lag time. Severe cases were recognized as those with the counts of over 1,000 × (h) + 6,000 [/µL] before 5 h and 300 × (h) + 10,000 [/µL] after 5 h. Conclusion: We herein present the creatinine kinase level and white blood cell count trends and demonstrate preliminary cut-off equations. The trends for both parameters serve as quantitative indicators of the severity of a mamushi bite until a large scale case-control study is achieved.
Asunto(s)
Adenocarcinoma/cirugía , Liquen Plano/patología , Síndromes Paraneoplásicos/diagnóstico , Penfigoide Ampolloso/patología , Neoplasias del Recto/cirugía , Adenocarcinoma/complicaciones , Adenocarcinoma/patología , Anciano de 80 o más Años , Biopsia con Aguja , Colectomía/métodos , Femenino , Estudios de Seguimiento , Humanos , Inmunohistoquímica , Liquen Plano/complicaciones , Liquen Plano/tratamiento farmacológico , Síndromes Paraneoplásicos/terapia , Penfigoide Ampolloso/complicaciones , Penfigoide Ampolloso/tratamiento farmacológico , Neoplasias del Recto/complicaciones , Neoplasias del Recto/patología , Medición de Riesgo , Resultado del TratamientoRESUMEN
BACKGROUND: Human leukocyte antigen (HLA) genotypes in lamotrigine -induced (LTG-induced) cutaneous adverse drug reactions (cADRs) have been described in several reports but controversy remains even for a given ethnic group. We attempted to clarify a possible association between LTG-induced cADRs and HLA alleles in Japanese patients. METHOD: Sixteen subjects, including eight patients with LTG-induced cADRs and eight LTG-tolerant controls were included in this study. All eight patients with LTG-induced cADRs gave positive results in a drug-induced lymphocyte stimulation test (DLST) with LTG. We performed HLA-typing for HLA-A, -B, -C, -DRB1, -DQA1, -DQB1, -DPA1 and -DPB1, using PCR with sequence-specific oligonucleotide probes and multiple analyte profiling (xMAP) technology (Luminex System; Luminex Corporation, Austin, TX). We examined differences between allele frequencies in our two groups of subjects and the allele frequencies in the general Japanese population. RESULTS: The frequencies of HLA-DRB1*0405, and HLA-DQB1*0401 alleles were higher in our LTG-cADRs patients than the reference frequencies in the general Japanese population. We also detected HLA-DQA1*0303 frequently in our LTG-cADRs patients, but data for this allele in the Japanese population was not available. Our observation was presumably due to the linkage disequilibrium among the three alleles. The haplotype frequency of HLA-DRB1*0405, DQB1*0401 and DQA1*0303 in our LTG-cADRs subjects was also different from the corresponding haplotype frequency in the database for the Japanese population and the difference was statistically significant. One patient with the HLA-DRB1*0405, -DQB1*0401 and DQA1*0303 haplotype was safely re-treated with LTG after results of a DLST with LTG ceased to be positive about 4 months after discontinuation of LTG. LIMITATIONS: Our analysis included only 16 patients. Associations between LTG-induced cADRs and specific HLA loci will have to be confirmed in larger studies. CONCLUSIONS: LTG-induced cADRs are associated with HLA-DRB1*0405, -DQB1*0401 and -DQA1*0303.
Asunto(s)
Alelos , Cadenas alfa de HLA-DQ/genética , Cadenas beta de HLA-DQ/genética , Cadenas HLA-DRB1/genética , Triazinas/efectos adversos , Adulto , Anciano , Pueblo Asiatico/genética , Estudios de Casos y Controles , Femenino , Frecuencia de los Genes , Haplotipos , Prueba de Histocompatibilidad , Humanos , Japón , Lamotrigina , Desequilibrio de Ligamiento , Masculino , Persona de Mediana Edad , Proyectos PilotoRESUMEN
This study investigated the effects of the Japanese Early Promotion Program (JEPP), which is based on the Infant Mental Health (IMH) program. The JEPP aims to promote mother-infant interactions by enhancing the mother's ability to respond appropriately her child. Mothers in the JEPP group (n = 15) received support from IMH nurses in a pediatric clinic until their infants reached 12 months of age. The nurses provided positive feedback that emphasized strength of parenting, and assisted the mothers in understanding the construct of their infants. Mother-infant interactions and mother's mental health status were assessed at intake (1-3 months), and at 6, 9, and 12 months of infants' age. The JEPP group data were compared with cross-sectional data of the control group (n = 120). Although JEPP dyads were not found to be significantly different from the control group in general dyadic synchrony, both before and after intervention, JEPP mothers significantly improved their ability to understand their infant's cues and to respond promptly. In the JEPP group, unresponsiveness to infants was reduced in mothers, while infants showed reduced passiveness and enhanced responsiveness to the mother. Furthermore, the intervention reduced the mothers' parenting stress and negative emotions, thereby enhancing their self-esteem.