Symmetrical Skin Lesions on the Gluteal Region in a Patient with Anti-Laminin-332 Mucous Membrane Pemphigoid

Mucous membrane pemphigoid (MMP), previously called cicatricial pemphigoid, is a rare subepidermal immunobullous disorder that primarily affects the mucous membranes (1,2). MMP is divided into two major subtypes, anti-BP180-type MMP and anti-laminin-332 (previously called laminin 5 or epiligrin) MMP. Anti-laminin-332 MMP is known to be associated with malignant tumors (3), which may cause overexpression of autoantibodies and induce autoimmunity to laminin-332 (4). MMP primarily affects the mucous membranes, and widespread skin lesions are rare. In MMP, circumscribed skin lesions have been previously reported as occurring on the head, neck, and upper trunk (5). We report a case of anti-laminin-332 MMP presenting with symmetrical skin lesions characteristic of MMP on the weightbearing areas of the gluteal regio

Symmetrical Skin Lesions on the Gluteal Region in a Patient with Anti-Laminin-332 Mucous Membrane Pemphigoid

Mucous membrane pemphigoid (MMP), previously called cicatricial pemphigoid, is a rare subepidermal immunobullous disorder that primarily affects the mucous membranes (1,2). MMP is divided into two major subtypes, anti-BP180-type MMP and anti-laminin-332 (previously called laminin 5 or epiligrin) MMP. Anti-laminin-332 MMP is known to be associated with malignant tumors (3), which may cause overexpression of autoantibodies and induce autoimmunity to laminin-332 (4). MMP primarily affects the mucous membranes, and widespread skin lesions are rare. In MMP, circumscribed skin lesions have been previously reported as occurring on the head, neck, and upper trunk (5). We report a case of anti-laminin-332 MMP presenting with symmetrical skin lesions characteristic of MMP on the weightbearing areas of the gluteal regio

CONSERVED EXPRESSION OF SOX13 ORTHOLOGS IN EARLY VERTEBRATE DEVELOPMENT

The skin and nervous tissue is derived from the ectoderm^. In Xenopus, ectodermal explants (animal caps) from blastula embryos show high tissue plasticity and can differentiate into a variety of tissues in vitro. Exploiting this property, we performed a functional screening for factors that can neuralize ectodermal explants, and isolated Xenopus Sox13 (XSox13), a member of the Sox (Sry-related high-mobility-group box) transcription factor family. During Xenopus embryogenesis, XSox13 mRNA is expressed in the entire ectoderm at blastula stages and in the organizer region at gastrula stages. Its expression becomes localized to the neural tube during neurulation and then to somites at tailbud stages.　Mouse Sox13 mRNA shows similar expression patterns to the Xenopus homolog during embryogenesis : Sox13 is expressed in the node, an equivalent to the Xenopus organizer, at the neural fold stage, exclusively in the nervous tissue at early-mid somite stages, and then showed a segmental expression in the somites at the late somite stage. We next generated Sox13-LacZ-knock-in mice, and examined the expression of mouse Sox13 in adult tissues by X-gal staining. In contrast to the expression during embryogenesis, Sox13 is scarcely expressed in the central nervous system in adult.　Moreover, Sox13-deficient mice showed no apparent abnormalities in neural development.　These results suggest that Sox13 expression in early development is conserved in Xenopus and mouse and Sox13 plays a redundant role during mouse neural development

OVEREXPRESSION OF PROGRANULIN INCREASES CELLS IN GROWTH PHASE, BUT IS INSUFFICIENT TO INDUCE SKIN TUMOR FORMATION

Progranulin (PGRN), a multifunctional secreted growth factor, is highly expressed in various types of human cancers. However, it is still unknown whether upregulation of PGRN is a cause or a result of cancerous transformation. To assess the consequences of enhanced PGRN expression in vivo, we generated transgenic mice in which PGRN is specifically expressed in keratinocytes using the Cre/lox system. PGRN overexpression in the epidermis promoted the entry of basal cells to the proliferation phases, as revealed by Ki-67 immunostaining, but was insufficient to facilitate it to the mitotic phase, as revealed by phosphohistone H3 immunoreactivity. Accordingly, we observed no significant difference in the incidence of spontaneously occurring and chemically induced skin tumors between the transgenic and wild-type mice. These results suggest that overexpression of PGRN alone is insufficient to cause cancerous transformation of keratinocytes

Skin Grafting Cases by Negative Pressure Wound Therapy for The Treatment of Skin Tumors and Instractable Cutaneous Ulcers

The most common causes of skin graft loss are hematoma, infection, or shear. To promote close contact between the graft and the wound, negative pressure wound therapy (NPWT) has been recently used particularly when a skin graft must be placed over an uneven wound bed surface. Hence, through a chart review of medical records from January 2015 to December 2017, we evaluated the effectiveness of NPWT as a coadjuvant treatment for 44 cases of surgical wounds of various body sites. Accordingly, our study suggests that the use of NPWT is a promising tool in skin grafting for the treatment of skin tumors and intractable cutaneous ulcers on the curved body parts. Further studies must be done to clarify the ideal conditions of performing NPWT in parallel with skin grafting on the wounds in difficult recipient wound beds

The Cost Burdan of Psoriasis Treated with Biologics in Akita Prefecture

Biologics have been dramatically effective in the treatment of psoriasis and have improved the quality of life of patients. However, to our knowledge, no comprehensive study has been implemented to explore the medical burden created by the administration of biologics. Consequently, we assessed the actual state of the cost burden of patients with psoriasis being treated with biologics in Akita University Hospital. Our results suggested that there were considerable differences in the co-payment of biologics up to the health insurance system. Future studies should carefully consider the cost of biologics from the perspective of the increase in medical expenses