Fatty acid compositions of triglycerides and free fatty acids in sebum depend on amount of triglycerides,and do not differ in presence or absence of acne vulgaris

To clarify the influence of the fatty acid composition of sebum in acne vulgaris, we investigated the amounts and fatty acid compositions of triglycerides (TG) and free fatty acids (FFA), and the amounts of cutaneous superficial Propionibacterium acnes in acne patients and healthy subjects. The foreheads of 18 female patients, 10 male patients, 10 healthy females and 10 healthy males were studied in a Japanese population. There were significant differences in the amounts of sebum, TG and cutaneous superficial P. acnes, as well as the fatty acid compositions of TG and FFA between acne patients and healthy subjects in females. Their fatty acid compositions were correlated with the amount of TG with or without acne. It was clarified that the fatty acid compositions of TG and FFA depended on the amount of TG, and there were no differences in the fatty acid composition in the presence and absence of acne.     

Clinical efficacy and safety of benzoyl peroxide for acne vulgaris: Comparison between Japanese and Western patients

Benzoyl peroxide (BPO) has been well established as a common medication for acne vulgaris in many countries (e.g. in Europe and the USA), where clinical data have been accumulated over a long time. In Japan, the use of BPO for acne treatment was approved in 2014, and the results of clinical trials in Japanese patients have recently been reported. This review compares clinical study results between Japanese and Western patients. Clinical studies that had been performed in Western countries were searched on the basis of the criteria, double‐blind studies of BPO monotherapy and comparison with a vehicle group. Two reports of Japanese studies were also selected by using the same criteria. Efficacy was assessed by comparing the mean difference between the BPO and the vehicle groups for reduction rate in the number of lesions from baseline, and there were no differences between Japanese and Western patients. Safety assessment also showed that the incidence of adverse events was higher in Japanese patients than in Western patients, but the characteristics of the adverse events were not different. Therefore, we conclude that there are no significant differences in the efficacy and safety of BPO between these patient populations. The efficacy and safety of long‐term use in Japanese patients are also expected to be applicable to those in Western patients.     

Facial lupus vulgaris of bilateral periorbital skin and conjunctiva: A case report and brief review

A 22-year-old male presented to the Dermatology Department with bilateral plaque lesions distributed symmetrically over malar area, bridge of nose and upper eyelids progressing over 1 year 3 months. Lesion remained unhealed after antibiotic treatment. Microscopy and culture for fungal and mycobacterial infections were negative. The Mantoux test showed an exaggerated response and PCR was positive for Mycobacterium tuberculosis complex. Patient was treated successfully with anti-tubercular therapy.     

加味桂枝汤联合红蓝光治疗寻常型痤疮的疗效观察及对痤疮丙酸杆菌的影响

目的 对比观察加味桂枝汤联合红蓝光治疗寻常型痤疮的疗效。方法 62例患者分为联合组(32例)与照光组(30例),前者口服加味桂枝汤并联合红蓝光治疗,后者单独采用红蓝光照射治疗。观察4周,每周复诊1次,并对皮损进行全球痤疮综合分级系统(GAGS)评分,治疗前后对痤疮内分泌物进行取材、培养观察痤疮丙酸杆菌浓度。结果 治疗后两组GAGS评分,组内、组间相比差异均有统计学意义(P＜0.05)；联合组总有效率为90.6%(29/32),照光组总有效率为60.0%(18/30),两组总有效率比较差异有统计学意义(χ₂=6.34,P＜0.05)；治疗后两组菌落半定量计数均减少或转为阴性,差异有统计学意义(P＜0.05),两组治疗后的菌落半定量计数比较,差异亦存在统计学意义(P＜0.05)。结论 加味桂枝汤联合红蓝光治疗寻常型痤疮,可有效改善粉刺、炎性丘疹、浅表脓疱等损害,对痤疮丙酸杆菌有抑制或杀菌作用,且疗效优于单独红蓝光治疗。     

Pemphigus with features of both vulgaris and foliaceus variants localized to the nose

We report the case of a 74‐year‐old man affected by an unusual variant of pemphigus. He presented with a crusty and scaly lesion of the nose. We performed reflectance confocal microscopy and optical coherence tomography on the lesion, which suggested an unexpected diagnosis of pemphigus. Therefore, to confirm our diagnostic suspicions, we executed indirect immunofluorescence and two biopsies, one for histopathological examination and one for direct immunofluorescence. Histopathological evaluation showed acantholysis with formation of clefts in the granular and spinous layers of the epidermis. Direct immunofluorescence revealed immunoglobulin G and C3 deposit to the full thickness of the epidermis. Indirect immunofluorescence showed intercellular antibodies at a titer of 1:40 in the suprabasal epidermis. The immunoblot analysis using epidermal extract revealed the presence of circulating antibodies directed to 130‐ and 160‐kDa antigens in the patient's serum. These two antigens were evidenced from nitrocellulose membrane with colorimetric AP systems, which highlighted the presence of autoantibodies against desmoglein (Dsg)1 and Dsg3 (sodium dodecylsulfate polyacrylamide gel electrophoresis). We also performed an enzyme‐linked immunoassay. All these findings suggested that this patient's pemphigus had features of both vulgaris and foliaceus variants.     

High‐Frequency Ultrasound in Blistering Skin Diseases: A Useful Method for Differentiating Blister Locations

Bullous pemphigoid and pemphigus vulgaris, which belong to the group of subepidermal and intraepidermal bullae, respectively, are two potentially devastating blistering skin diseases. We used high‐frequency ultrasound (US) in 3 cases of these diseases as prototypes to study the value of high‐frequency US in discriminating blister locations. Our findings showed that high‐frequency US has a strong correlation with histomorphometric findings because of its high resolution, and we hope that it will be helpful for differentiating blister locations.     

Twelve‐week,multicenter, placebo‐controlled,randomized, double‐blind,parallel‐group,comparative phase II/III study of benzoyl peroxide gel in patients with acne vulgaris: A secondary publication

A placebo‐controlled, randomized, double‐blind, parallel‐group, comparative, multicenter study was conducted to investigate the efficacy and safety of benzoyl peroxide (BPO) gel, administrated once daily for 12 weeks to Japanese patients with acne vulgaris. Efficacy was evaluated by counting all inflammatory and non‐inflammatory lesions. Safety was evaluated based on adverse events, local skin tolerability scores and laboratory test values. All 609 subjects were randomly assigned to receive the study products (2.5% and 5% BPO and placebo), and 607 subjects were included in the full analysis set, 544 in the per protocol set and 609 in the safety analyses. The median rates of reduction from baseline to the last evaluation of the inflammatory lesion counts, the primary end‐point, in the 2.5% and 5% BPO groups were 72.7% and 75.0%, respectively, and were significantly higher than that in the placebo group (41.7%). No deaths or other serious adverse events were observed. The incidences of adverse events in the 2.5% and 5% BPO groups were 56.4% and 58.8%, respectively; a higher incidence than in the placebo group, but there was no obvious difference between the 2.5% and 5% BPO groups. All adverse events were mild or moderate in severity. Most adverse events did not lead to study product discontinuation. The results suggested that both 2.5% and 5% BPO are useful for the treatment of acne vulgaris.     

Association of apolipoprotein allele ε2 with psoriasis vulgaris in Japanese population

Received: 7 October 1996