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40. Outline of guidelines for the management of vasculitis and vascular disorders in Japan, 2016 revised edition.

Author

Ikeda, Takaharu, Furukawa, Fukumi, Kawakami, Tamihiro, Ishiguro, Naoko, Uzuki, Miwa, Ozaki, Shoichi, Katsuoka, Kensei, Kono, Takeshi, Kawana, Seiji, Kodera, Masanari, Sawai, Takashi, Sawada, Yasuyuki, Seishima, Mariko, Tanikawa, Akiko, Chen, Ko‐Ron, Hasegawa, Minoru, and Committee for Guidelines for the Management of Vasculitis and Vascular Disorders of The Japanese Dermatological Association

Abstract

Abstract: The proposal by the 1994 International Chapel Hill Consensus Conference on the Nomenclature of Systemic Vasculitides (CHCC1994) and by the CHCC2012 markedly influenced the classification and way of considering cutaneous vasculitis. In the proposal by the CHCC1994, hypersensitivity angiitis was defined as an equivalent pathological condition to microscopic polyangiitis or cutaneous leukocytoclastic angiitis (CLA), and it was not adopted as a disease name. However, CLA which was positioned as a type of small‐vessel vasculitis is only a pathological name. In the proposal by the CHCC2012, a new category of single‐organ vasculitis included CLA and cutaneous arteritis. Vasculitis allergica cutis (Ruiter) corresponded to CLA and cutaneous polyarteritis nodosa corresponded to cutaneous arteritis. The Japanese Dermatological Association (JDA) prepared guidelines for the management of vasculitis and vascular disorders in 2008 based on the proposal by the CHCC1994 and their original viewpoint of dermatology. The JDA subsequently revised the 2008 edition guidelines in 2016 following publication of the proposal of the CHCC2012 in Japanese. We presented the outline of the 2016 edition guidelines and propose a treatment algorithm for primary vasculitides based on the evaluation of the cutaneous symptoms for cases suspected as primary cutaneous vasculitides, which integrates the 2008 JDA guideline and CHCC2012 classification. This is the secondary English version of the original Japanese manuscript for the guideline for management of vasculitis and vascular disorders published in the Japanese Journal of Dermatology 127(3); 299–415, 2017. [ABSTRACT FROM AUTHOR]

Published
2018
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41. Increased number of mast cells in the dermis in actinic keratosis lesions effectively treated with imiquimod.

Author

Oyama, Satomi, Funasaka, Yoko, Tsuchiya, Shin‐ichi, Kawana, Seiji, and Saeki, Hidehisa

Abstract

Actinic keratosis ( AK) is a cutaneous cancer in situ which develops as a result of excessive exposure to ultraviolet ( UV). Toll-like receptor ( TLR)7 agonist imiquimod is a topical immune response modifier and is effective for the treatment of non-melanoma skin cancers. Recently, the diagnostic role of the dermatoscope has been reported in the course of treatment of AK. In addition, mast cells are now considered to contribute to both the innate and adaptive immune systems in topical imiquimod therapy. We assessed the effect of imiquimod treatment by dermatoscopic and immunohistochemical findings in 14 patients with a total of 21 AK lesions. With the dermatoscope, though the mean erythema score was not significantly different between the cured lesions and the unresponsive lesions, the erythema/red pseudo-network ('strawberry') pattern was decreased significantly in the cured lesions. By immunohistochemistry, the number of Ki-67-positive proliferative cells in the epidermis was decreased and that of CD117-positive mast cells in the dermis was increased in the responding lesions. To the best of our knowledge, this is the first study demonstrating that the number of mast cells in the dermis was increased in AK lesions effectively treated with imiquimod. Our present result suggests that mast cells may contribute an antitumor effect in human skin treated with topical imiquimod. [ABSTRACT FROM AUTHOR]

Published
2017
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