Assuntos
Antígeno B7-H1/metabolismo , Sarda Melanótica de Hutchinson/metabolismo , Melanoma/metabolismo , Neoplasias Cutâneas/metabolismo , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Japão , Masculino , Pessoa de Meia-Idade , Mucosa/metabolismo , Estudos Retrospectivos , Adulto Jovem , Melanoma Maligno CutâneoAssuntos
Carboxiliases/genética , Eczema/genética , Hipo-Hidrose/genética , Miopatias Congênitas Estruturais/diagnóstico , Proteína ORAI1/genética , Biópsia , Pré-Escolar , Análise Mutacional de DNA , Dermoscopia , Eczema/patologia , Humanos , Hipo-Hidrose/patologia , Masculino , Músculo Esquelético/patologia , Miopatias Congênitas Estruturais/complicações , Miopatias Congênitas Estruturais/genética , Miopatias Congênitas Estruturais/patologia , Pele/diagnóstico por imagem , Pele/patologia , Glândulas Sudoríparas/patologiaAssuntos
Dermatomiosite , Orthomyxoviridae , Estudos de Coortes , Humanos , Miosite , Proteína Estafilocócica AAssuntos
Antígenos CD/metabolismo , Carcinoma Basocelular/patologia , Carcinoma de Células Escamosas/patologia , Cadeias alfa de Integrinas/metabolismo , Neoplasias Cutâneas/patologia , Linfócitos T Reguladores/metabolismo , Carcinoma Basocelular/imunologia , Carcinoma de Células Escamosas/imunologia , Humanos , Memória Imunológica , Pele/imunologia , Neoplasias Cutâneas/imunologia , Linfócitos T Reguladores/imunologia , Linfócitos T Reguladores/patologia , Microambiente TumoralAssuntos
Linfócitos T CD8-Positivos/imunologia , Memória Imunológica , Interleucina-17/metabolismo , Psoríase/imunologia , Pele/patologia , Linfócitos T CD8-Positivos/metabolismo , Separação Celular , Células Cultivadas , Citometria de Fluxo , Humanos , Interferon gama/metabolismo , Interleucina-17/imunologia , Cultura Primária de Células , Psoríase/patologia , Pele/citologia , Pele/imunologia , Fatores de TempoRESUMO
BACKGROUND: Application of deep-learning technology to skin cancer classification can potentially improve the sensitivity and specificity of skin cancer screening, but the number of training images required for such a system is thought to be extremely large. OBJECTIVES: To determine whether deep-learning technology could be used to develop an efficient skin cancer classification system with a relatively small dataset of clinical images. METHODS: A deep convolutional neural network (DCNN) was trained using a dataset of 4867 clinical images obtained from 1842 patients diagnosed with skin tumours at the University of Tsukuba Hospital from 2003 to 2016. The images consisted of 14 diagnoses, including both malignant and benign conditions. Its performance was tested against 13 board-certified dermatologists and nine dermatology trainees. RESULTS: The overall classification accuracy of the trained DCNN was 76·5%. The DCNN achieved 96·3% sensitivity (correctly classified malignant as malignant) and 89·5% specificity (correctly classified benign as benign). Although the accuracy of malignant or benign classification by the board-certified dermatologists was statistically higher than that of the dermatology trainees (85·3% ± 3·7% and 74·4% ± 6·8%, P < 0·01), the DCNN achieved even greater accuracy, as high as 92·4% ± 2·1% (P < 0·001). CONCLUSIONS: We have developed an efficient skin tumour classifier using a DCNN trained on a relatively small dataset. The DCNN classified images of skin tumours more accurately than board-certified dermatologists. Collectively, the current system may have capabilities for screening purposes in general medical practice, particularly because it requires only a single clinical image for classification.
Assuntos
Aprendizado Profundo , Interpretação de Imagem Assistida por Computador/métodos , Neoplasias Cutâneas/diagnóstico , Pele/diagnóstico por imagem , Conjuntos de Dados como Assunto , Dermatologistas/estatística & dados numéricos , Dermoscopia , Humanos , Interpretação de Imagem Assistida por Computador/instrumentação , Interpretação de Imagem Assistida por Computador/estatística & dados numéricos , Aplicativos Móveis , Sensibilidade e Especificidade , SmartphoneAssuntos
Linfócitos T CD4-Positivos/imunologia , Memória Imunológica , Escleroderma Sistêmico/imunologia , Pele/imunologia , Antígenos CD/metabolismo , Linfócitos T CD4-Positivos/metabolismo , Humanos , Cadeias alfa de Integrinas/metabolismo , Escleroderma Sistêmico/sangue , Escleroderma Sistêmico/patologia , Pele/citologia , Pele/patologiaRESUMO
BACKGROUND: Myositis-specific autoantibodies (MSAs) are associated with unique clinical subsets in polymyositis/dermatomyositis (PM/DM). Autoantibodies against transcriptional intermediary factor (TIF)-1γ and TIF-1α are known to be MSAs. Previously, we reported that TIF-1ß is also targeted in patients with DM with or without concomitant anti-TIF-1α/γ antibodies. OBJECTIVES: To evaluate the clinical features of seven cases with anti-TIF-1ß antibodies alone. METHODS: Serum autoantibody profiles were determined, and protein and RNA immunoprecipitation studies were conducted. Western blotting was performed to confirm autoantibody reactivity against TIF-1ß. RESULTS: Anti-TIF-1ß antibody was identified by immunoprecipitation assay in 24 cases. Among them, seven patients were positive for anti-TIF-1ß antibody alone. Six of the seven patients were classified as having DM. Among the six cases of DM, two patients had no muscle weakness and normal creatine kinase (CK) levels, and were classified as having clinically amyopathic DM. Four patients had muscle weakness, but three of them had normal serum CK levels that responded well to systemic steroids. Characteristic features of DM included skin rashes, such as Gottron sign, periungual erythema, punctate haemorrhage on the perionychium and facial erythema including heliotrope, which were observed in 86%, 57%, 86% and 71% of our cases, respectively. One of the seven patients had appendiceal cancer. None of the patients had interstitial lung disease. CONCLUSIONS: Seven patients were confirmed to have anti-TIF-1ß antibody without any other MSAs, including TIF-1α/γ antibodies, and six of them were diagnosed with DM. We suggest that anti-TIF-1ß antibody is an MSA, and that it is associated with clinically amyopathic DM or DM with mild myopathy.
Assuntos
Autoanticorpos/imunologia , Dermatomiosite/imunologia , Proteína 28 com Motivo Tripartido/imunologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Autoanticorpos/sangue , Autoanticorpos/isolamento & purificação , Dermatomiosite/sangue , Dermatomiosite/diagnóstico , Feminino , Humanos , Imunoprecipitação , Masculino , Pessoa de Meia-Idade , Adulto JovemAssuntos
Autoanticorpos/isolamento & purificação , Dermatomiosite/diagnóstico , Orelha , Imunossupressores/administração & dosagem , Helicase IFIH1 Induzida por Interferon/imunologia , Idoso , Autoanticorpos/imunologia , Dermatomiosite/tratamento farmacológico , Dermatomiosite/imunologia , Diagnóstico Diferencial , Esquema de Medicação , Quimioterapia Combinada/métodos , Feminino , Humanos , Japão , Masculino , Pessoa de Meia-IdadeAssuntos
Anticorpos Antinucleares/sangue , Dermatomiosite/complicações , Eritema/sangue , Enzimas Ativadoras de Ubiquitina/imunologia , Administração Oral , Idoso , Anticorpos Antinucleares/imunologia , Dorso , Dermatomiosite/sangue , Dermatomiosite/tratamento farmacológico , Dermatomiosite/imunologia , Eritema/tratamento farmacológico , Eritema/imunologia , Feminino , Glucocorticoides/administração & dosagem , Humanos , Imunoglobulinas Intravenosas/administração & dosagem , Japão , Masculino , Pessoa de Meia-Idade , Estudos RetrospectivosRESUMO
Autoantibodies to melanoma differentiation-associated protein 5 (MDA5) are associated with a subset of patients with dermatomyositis (DM) who have rapidly progressive interstitial lung disease (RP-ILD) with poor prognosis. Intensive immunosuppressive therapy is initiated before irreversible lung damage can occur; however, there are few lines of evidence for the treatment of RP-ILD. Here, we report three cases of anti-MDA5 antibody-associated DM with RP-ILD in which the patients were treated with combined-modality therapy, including high-dose prednisolone, tacrolimus, intravenous cyclophosphamide and intravenous immunoglobulin (IVIG). In all three cases, serum ferritin levels, which are known to represent the disease activity of RP-ILD, were decreased after IVIG administration. IVIG might contribute to the control of the disease activity of anti-MDA5 antibody-positive DM. Moreover, palmar violaceous macules/papules around the interphalangeal joints, which was observed in all three cases in the incipient stage, might be a useful sign in suggesting a diagnosis of anti-MDA5 antibody-associated DM.
Assuntos
Dermatomiosite/prevenção & controle , Dermatoses da Mão/prevenção & controle , Imunoglobulinas Intravenosas/uso terapêutico , Helicase IFIH1 Induzida por Interferon/imunologia , Doenças Pulmonares Intersticiais/prevenção & controle , Idoso , Anti-Inflamatórios/administração & dosagem , Autoanticorpos/sangue , Terapia Combinada , Ciclofosfamida/administração & dosagem , Feminino , Humanos , Imunossupressores/administração & dosagem , Masculino , Pessoa de Meia-Idade , Prednisolona/administração & dosagem , Tacrolimo/administração & dosagem , Resultado do TratamentoRESUMO
BACKGROUND: Although dermatomyositis (DM)-associated facial erythema was noted in the nasolabial folds of Japanese patients, DM-associated facial erythema other than heliotrope rash has drawn little attention in previous studies. OBJECTIVES: To characterize phenotypical features and frequencies of erythema, especially those in the seborrheic area of the head, in DM patients. METHODS: A retrospective study on skin manifestations in 33 DM patients followed up at our department during the past 15 years was conducted. RESULTS: Macular violaceous erythema (MVE) in the seborrheic area of the face was most frequent (67%). Patients with facial MVE had also MVE in the scalp significantly more frequently than those without facial MVE. The pathology of the facial MVE was dominated by DM-associated changes with slight changes compatible with seborrheic dermatitis (SD). CONCLUSIONS: Japanese DM patients had MVE frequently in the seborrheic area of the head. Its phenotypical features suggested that it might be triggered by SD.
Assuntos
Dermatite Seborreica/etiologia , Dermatomiosite/complicações , Eritema/etiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Distribuição de Qui-Quadrado , Criança , Pré-Escolar , Dermatite Seborreica/diagnóstico , Dermatomiosite/diagnóstico , Eritema/diagnóstico , Dermatoses Faciais/etiologia , Feminino , Humanos , Japão , Masculino , Prontuários Médicos , Pessoa de Meia-Idade , Estudos Retrospectivos , Dermatoses do Couro Cabeludo/etiologiaRESUMO
Fluorogenic and fluorescent labeling reagents having a benzofurazan (2,1,3-benzoxadiazole) skeleton such as 4-fluoro-7-nitro-2,1,3-benzoxadiazole (NBD-F), 4-N,N-dimethylaminosulfonyl-7-fluoro-2,1,3-benzoxadiazole (DBD-F), 4-aminosulfonyl-7-fluoro-2,1,3-benzoxadiazole (ABD-F), ammonium 7-fluoro-2,1,3-benzoxadiazole-4-sulfonate (SBD-F), 4-hydrazino-7-nitro-2,1,3-benzoxadiazole (NBD-H), 4-N,N-dimethylaminosulfonyl-7-hydrazino-2,1,3-benzoxadiazole (DBD-H), 4-nitro-7-N-piperazino-2,1,3-benzoxadiazole (NBD-PZ), 4-N,N-dimethylaminosulfonyl-7-N-piperazino-2,1,3-benzoxadiazole (DBD-PZ), 4-(N-chloroformylmethyl-N-methyl)amino-7-N,N-dimethylaminosulfonyl-2,1,3-benzoxadiazole (DBD-COCl) and 7-N,N-dimethylaminosulfonyl-4-(2,1,3-benzoxadiazolyl) isothiocyanate (DBD-NCS) are reviewed in terms of synthetic method, reactivity, fluorescence characteristics, sensitivity and application to analytes.