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High lev els of serum am yloid A in patients with generalized pustular psoriasis
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Abstracts / Journal of Dermatological Science 84 (2016) e1–e88
Materials and methods: We examined the expression of gp100, MART-1 and tyrosinase mRNA for the routine diagnosis, and of ABCB5, CD133, CD271, KDM5B and RANK mRNA for the MIC markers. The presence of metastasis was confirmed immunohistochemically, using antibodies to S-100, HMB-45, MART-1 and tyrosinase. Results: The discordance between immunohistochemical and molecular data was observed in 14 of 68 (20.6%) patients, in which 5 (7.4%) patients were positive for only molecular markers, and 2 false-negative cases were re-confirmed being positive for metastasis. The expression levels of gp100, MART-1, and tyrosinase mRNA were significantly higher in the metastatic LNs, although the cut-off values remain to be elucidated. The ABCB5 mRNA expression was detected more frequently in the metastatic SLNs (P < 0.05), and a group of patients with recurrence. Conclusions: To make the definite diagnosis of metastasis, we still need a combination of immunohistochemical and molecular probes. ABCB5 might be a possible molecular markers. http://dx.doi.org/10.1016/j.jdermsci.2016.08.116 P04-22 Morphological alteration of the eccrine sweat apparatus in amputated feet and legs of patients with diabetes mellitus Mikiko Sugiyama 1,5,∗ , Yuuka Suzuki 2 , Tokio Nakada 2 , Hitoshi Nemoto 3 , Hiroshi Suzuki 4 , Shigeki Nagata 5 , Hirohiko Sueki 1 1 Department of Dermatology, Higashi Hospital, Showa University School of Medicine, Tokyo, Japan 2 Department of Dermatology, Fujigaoka Hospital, Showa University School of Medicine, Yokohama, Japan 3 Department of Plastic Surgery, Fujigaoka Hospital, Showa University School of Medicine, Yokohama, Japan 4 Department of Cardiology, Fujigaoka Hospital, Showa University School of Medicine, Yokohama, Japan 5 Department of Dermatology, Koto-Toyosu Hospital, Showa University School of Medicine, Tokyo, Japan
Several physiological studies have demonstrated decreased or absent thermoregulatory sweating preferentially in the distal legs and feet of patients with diabetes. The aim of the present study was to clarify the pathogenesis of the structural alteration of the eccrine sweat apparatus in patients with diabetes. Seventeen patients with diabetic ulcers or gangrene with neuropathy and limb ischemia who had undergone amputation of the foot participated in this study. Skin specimens were obtained 30 mm proximal to the ulcer or gangrene using a 6-mm trepan after amputation. Twelve normal skin samples adjacent to the pigmented nevus or benign skin tumor on the legs or feet served as controls. The number and morphological abnormalities of the eccrine sweat glands and ducts were quantified under light microscopy. The pathogenesis of the morphological alterations was examined by electron microscopy and immunoelectron microscopy of type IV collagen. The incidence of lumen absence, shrunken morphology, and irregularity of the outline of the eccrine sweat glands and ducts was significantly higher in the study specimens than in the controls (P = 0.00020.0001) Ultrastructurally, prominent thickening of the basement membrane of the eccrine sweat glands admixed with cellular debris and narrowing of the luminal space were observed. The thickened basement membranes resulted in a shrunken morphology and
irregularity of the outline of the eccrine ducts. Immunoelectron microscopy revealed immuno-gold particles labeling type IV collagen distributed throughout the thickened basement membrane zone. These findings suggest that the pathogenesis of the shrunken morphology in the eccrine sweat apparatus in patients with diabetic neuropathy is similar to that of diabetic microangiopathy. http://dx.doi.org/10.1016/j.jdermsci.2016.08.117 P04-23 High lev els of serum am yloid A in patients with generalized pustular psoriasis Tatsuhiko Mori ∗ , Toshiyuki Yamamoto Dermatology, Fukushima Medical University, Fukushima, Japan Introduction: Psoriasis is considered to be a chronic inflammatory disease, and especially generalized pustular psoriasis (GPP) is a systemic inflammatory disorder showing extensive pustular eruptions over the entire body. Recent studies have shown that serum amyloid A (SAA) protein level is elevated in various inflammatory diseases. Methods: We analyzed SAA protein of GPP patients (n = 5), psoriasis vulgaris patients (n = 15) and healthy controls (n = 12) by ELISA. Results: SAA levels were 464.2 ± 368.6 g/ml (GPP), 20.0 ± 31.0 g/ml (psoriasis vulgaris) and 4.1 ± 3.4 g/ml (control) (mean ± SD). SAA levels of GPP patients were significantly and extremely higher than that of psoriasis vulgaris patients and controls (p < 0.05). Conclusions: High levels of SAA in GPP patients may be caused by systemic inflammation. http://dx.doi.org/10.1016/j.jdermsci.2016.08.118 P04-24 Comparison of indigo naturalis extract in oil (Lindioil) to calcipotriol solution in treating psoriatic nails: A randomized trial Yin-Ku Lin 1,2 1
Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital at Keelung, Taiwan 2 School of Traditional Chinese Medicine, Chang Gung University, Taoyuan, Taiwan Background: Psoriatic nails cannot be cured and is notoriously difficult to treat; however, a safe and effective treatment for long term use is needed. Objectives: To determine the efficacy and safety of a Chinese herb, indigo naturalis extract in oil (Lindioil), in treating psoriatic nails topically using calcipotriol solution as an active control. Methods: This study was a randomized, rater-blinded, activecontrolled, intra-subject comparison trial. Thirty-three outpatients with symmetrically comparable psoriatic nails were enrolled in this trial. Lindioil was applied topically to psoriatic nails on one hand and calcipotriol on the other hand of the same subject twice daily for 24 weeks. Efficacy was evaluated blindly using the single hand Nail Psoriasis Severity Index (shNAPSI) and modified target NAPSI (mtNAPSI) for the single most severely affected nail. The subject and physician’s global assessments (SGA and PGA, respectively) were measured at week 24. Results: Of the 33 recruited subjects, 28 completed the trial. At week 24, the mixed-effect model revealed significant interactions
Abstracts / Journal of Dermatological Science 84 (2016) e1–e88
Materials and methods: We examined the expression of gp100, MART-1 and tyrosinase mRNA for the routine diagnosis, and of ABCB5, CD133, CD271, KDM5B and RANK mRNA for the MIC markers. The presence of metastasis was confirmed immunohistochemically, using antibodies to S-100, HMB-45, MART-1 and tyrosinase. Results: The discordance between immunohistochemical and molecular data was observed in 14 of 68 (20.6%) patients, in which 5 (7.4%) patients were positive for only molecular markers, and 2 false-negative cases were re-confirmed being positive for metastasis. The expression levels of gp100, MART-1, and tyrosinase mRNA were significantly higher in the metastatic LNs, although the cut-off values remain to be elucidated. The ABCB5 mRNA expression was detected more frequently in the metastatic SLNs (P < 0.05), and a group of patients with recurrence. Conclusions: To make the definite diagnosis of metastasis, we still need a combination of immunohistochemical and molecular probes. ABCB5 might be a possible molecular markers. http://dx.doi.org/10.1016/j.jdermsci.2016.08.116 P04-22 Morphological alteration of the eccrine sweat apparatus in amputated feet and legs of patients with diabetes mellitus Mikiko Sugiyama 1,5,∗ , Yuuka Suzuki 2 , Tokio Nakada 2 , Hitoshi Nemoto 3 , Hiroshi Suzuki 4 , Shigeki Nagata 5 , Hirohiko Sueki 1 1 Department of Dermatology, Higashi Hospital, Showa University School of Medicine, Tokyo, Japan 2 Department of Dermatology, Fujigaoka Hospital, Showa University School of Medicine, Yokohama, Japan 3 Department of Plastic Surgery, Fujigaoka Hospital, Showa University School of Medicine, Yokohama, Japan 4 Department of Cardiology, Fujigaoka Hospital, Showa University School of Medicine, Yokohama, Japan 5 Department of Dermatology, Koto-Toyosu Hospital, Showa University School of Medicine, Tokyo, Japan
Several physiological studies have demonstrated decreased or absent thermoregulatory sweating preferentially in the distal legs and feet of patients with diabetes. The aim of the present study was to clarify the pathogenesis of the structural alteration of the eccrine sweat apparatus in patients with diabetes. Seventeen patients with diabetic ulcers or gangrene with neuropathy and limb ischemia who had undergone amputation of the foot participated in this study. Skin specimens were obtained 30 mm proximal to the ulcer or gangrene using a 6-mm trepan after amputation. Twelve normal skin samples adjacent to the pigmented nevus or benign skin tumor on the legs or feet served as controls. The number and morphological abnormalities of the eccrine sweat glands and ducts were quantified under light microscopy. The pathogenesis of the morphological alterations was examined by electron microscopy and immunoelectron microscopy of type IV collagen. The incidence of lumen absence, shrunken morphology, and irregularity of the outline of the eccrine sweat glands and ducts was significantly higher in the study specimens than in the controls (P = 0.00020.0001) Ultrastructurally, prominent thickening of the basement membrane of the eccrine sweat glands admixed with cellular debris and narrowing of the luminal space were observed. The thickened basement membranes resulted in a shrunken morphology and
irregularity of the outline of the eccrine ducts. Immunoelectron microscopy revealed immuno-gold particles labeling type IV collagen distributed throughout the thickened basement membrane zone. These findings suggest that the pathogenesis of the shrunken morphology in the eccrine sweat apparatus in patients with diabetic neuropathy is similar to that of diabetic microangiopathy. http://dx.doi.org/10.1016/j.jdermsci.2016.08.117 P04-23 High lev els of serum am yloid A in patients with generalized pustular psoriasis Tatsuhiko Mori ∗ , Toshiyuki Yamamoto Dermatology, Fukushima Medical University, Fukushima, Japan Introduction: Psoriasis is considered to be a chronic inflammatory disease, and especially generalized pustular psoriasis (GPP) is a systemic inflammatory disorder showing extensive pustular eruptions over the entire body. Recent studies have shown that serum amyloid A (SAA) protein level is elevated in various inflammatory diseases. Methods: We analyzed SAA protein of GPP patients (n = 5), psoriasis vulgaris patients (n = 15) and healthy controls (n = 12) by ELISA. Results: SAA levels were 464.2 ± 368.6 g/ml (GPP), 20.0 ± 31.0 g/ml (psoriasis vulgaris) and 4.1 ± 3.4 g/ml (control) (mean ± SD). SAA levels of GPP patients were significantly and extremely higher than that of psoriasis vulgaris patients and controls (p < 0.05). Conclusions: High levels of SAA in GPP patients may be caused by systemic inflammation. http://dx.doi.org/10.1016/j.jdermsci.2016.08.118 P04-24 Comparison of indigo naturalis extract in oil (Lindioil) to calcipotriol solution in treating psoriatic nails: A randomized trial Yin-Ku Lin 1,2 1
Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital at Keelung, Taiwan 2 School of Traditional Chinese Medicine, Chang Gung University, Taoyuan, Taiwan Background: Psoriatic nails cannot be cured and is notoriously difficult to treat; however, a safe and effective treatment for long term use is needed. Objectives: To determine the efficacy and safety of a Chinese herb, indigo naturalis extract in oil (Lindioil), in treating psoriatic nails topically using calcipotriol solution as an active control. Methods: This study was a randomized, rater-blinded, activecontrolled, intra-subject comparison trial. Thirty-three outpatients with symmetrically comparable psoriatic nails were enrolled in this trial. Lindioil was applied topically to psoriatic nails on one hand and calcipotriol on the other hand of the same subject twice daily for 24 weeks. Efficacy was evaluated blindly using the single hand Nail Psoriasis Severity Index (shNAPSI) and modified target NAPSI (mtNAPSI) for the single most severely affected nail. The subject and physician’s global assessments (SGA and PGA, respectively) were measured at week 24. Results: Of the 33 recruited subjects, 28 completed the trial. At week 24, the mixed-effect model revealed significant interactions