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49歳, 男性。体幹・四肢に自覚症状のない紅斑, 丘疹が生じ増加してきた。病理組織にてCD4陽性を示す異型細胞の浸潤, TCR遺伝子再構成を認め, 皮膚T細胞リンパ腫 (CTCL) と診断した。ステロイドパルス療法後, ステロイドと低用量MTX内服投与で治療していたが, 皮疹が再燃した。病理組織にて大型の異型リンパ球の密な浸潤を認め, CD4陽性を示す異型T細胞とCD20, CD79a陽性を示す異型B細胞が混在していた。免疫グロブリンH鎖に遺伝子再構成を認めた。EBERs陽性細胞を少数認め, 組織学的にEBV感染が証明できた。以上よりCTCL患者にメトトレキセート関連リンパ増殖性疾患 (MTX-LPD) が発症したと考えた。MTX中止のみでは軽快せず, フルダラビンによる化学療法を施行した。MTX-LPDについて原疾患, Epstein-Barr Virusとの関連など過去の報告例と比較検討した。MTX-LPDは重篤な医原性疾患の一つであると考え報告する。

Presence of asymptomatic joint involvement is recognized in patients with psoriasis. However, it remains elusive whether such patients develop psoriatic arthritis (PsA). The aim of the present study was to examine the incidence of asymptomatic joint lesions, in particular, enthesitis in patients with psoriasis vulgaris (PsV) and to further assess the clinical features. Eighteen PsV and 28 PsA patients were enrolled for examination by positron emission tomography/computed tomography (PET/CT) using (18) F-fluorodeoxyglucose (FDG). Any nail, scalp and intergluteal involvements were reported. Levels of serum C-reactive protein (CRP), white blood cell (WBC) counts and erythrocyte sedimentation rate (ESR) were examined. All of the PsA patients showed FDG accumulation in the affected joints. Notably, asymptomatic enthesitis was detected in six out of 18 PsV patients (33%), and they were diagnosed as having subclinical PsA. Incidences of scalp, intergluteal and nail psoriasis in subclinical PsA patients were 100%, 83% and 64%, respectively, which were higher than those in PsV patients (67%, 25% and 40%, respectively). CRP, WBC counts and ESR were invariable between PsV and subclinical PsA groups. PET/CT imaging could discover asymptomatic enthesitis. Our data suggested that the subpopulation of subclinical PsA was much higher than expected. Higher prevalence of nail, scalp and intergluteal psoriasis confirmed the risk of PsA as previously described.

Background: Patients with oculocutaneous albinism (OCA) are prone to develop skin cancers. Aim and Objectives: To analyze reports of skin cancers in albinos published in the English and the Japanese literature in order to prepare guidelines for the successful management of skin cancer in albinos. Methods and Materials: We searched on PubMed, Web of Knowledge for English literature, and Ichushi-Web for the Japanese literature. Results: Between 1978 and 2013, 11 malignant melanoma, 4 basal cell carcinoma, and 6 squamous cell carcinoma cases were reported in Japan. The subtypes of the 11 malignant melanomas were nodular in 7 cases, superficial spreading in 3 cases, and metastatic lesions in 1 case. Amelanotic melanomas comprised 7 of the 11 malignant melanoma cases in Japanese patients with OCA. Twenty-five malignant melanoma, 50 basal cell carcinoma, and 151 squamous cell carcinoma cases were reported worldwide in the English literature during the period between 1952 and 2013. Conclusion: Regular skin monitoring by board-certified dermatologists is required for adult OCA patients.

35歳，女性。東南アジア出身。来日して初めての冬に両手指および両足趾に有痛性の浮腫性紫紅色斑が出現した。Chilblain lupus(凍瘡様狼瘡)として加療を受けるも3ヵ月後に発熱，関節痛および脱毛斑が出現し，まれとされるSLEへ進展した。Chilblain lupusは寒冷刺激により発症あるいは増悪するとされ，自験例では来日による生活環境の温度変化が誘引となったと考えた。

Enthesitis, defined as the inflammation of the origin and insertion of ligaments, tendons, aponeuroses, annulus fibrosis, and joint capsules, is a hallmark of spondyloarthritis (SpA). New imaging techniques including magnetic resonance imaging (MRI), ultrasonography, and positron emission tomography with computed tomography using 18F-fluorodeoxyglucose capable of detecting morphological and metabolic abnormalities and monitoring disease activity have improved the assessment and management of enthesitis of SpA.

Pseudoxanthoma elasticum is an inherited systemic disorder of connective tissue characterized by fragmentation of elastic fibers and calcification in cutaneous, ocular, and cardiovascular systems. Mutation in the ATP-binding cassette subfamily C member 6 gene has recently been found in people with pseudoxanthoma elasticum (1). However, the precise mechanisms of elastic fiber fragmentation and calcification remain obscure. Recently, it has been reported that mild chronic oxidative stress affects pseudoxanthoma elasticum fibroblasts (2). This suggests that reactive oxygen scavengers might improve this disorder.

Histamine is released from mast cells in the skin, causing urticaria and itching. However, little is known about the roles of histamine in development of eczematous lesions in contact dermatitis. Effects of histamine on development of eczematous lesions in contact dermatitis were assessed using histamine-deficient mice in which contact dermatitis was developed by repeated application of diphenylcyclopropenone. Development of eczematous lesions in contact dermatitis was suppressed in histamine-deficient mice compared to wild-type mice. H(1) agonist ((6-12-(4-imidazol)ethylamino)-N-(4-trifluoro- methylphenyl)hepatanecarboxamide) promoted development of eczematous lesions in histamine-deficient mice. H(1) receptor antagonist (loratadine) suppressed development of eczematous lesions in wild-type mice, whereas H(2) agonist (dimaprit) and receptor antagonist (cimetidine) were ineffective. These results suggest that histamine facilitates the development of eczematous lesions in a murine model of contact dermatitis via H(1) receptors.

The corresponding author regrets to inform that at the time of checking their proofs, they omitted to include Prof. Dr. Christos C. Zouboulis (Departments of Dermatology, Venereology, Allergology and Immunology, Dessau Medical Center, Auenweg 38, 06847 Dessau, Germany), who kindly provided them the SZ95 cells for their research, to the authors list, as initially agreed. The corresponding author would like to apologise for any inconvenience caused.