Esomeprazole-induced DRESS syndrome. Studies of cross-reactivity among proton-pump inhibitor drugs. Allergy 2007; 62: 1342-1343. 2 Ogawa K, Morito H, Hasegawa A et al. Elevated serum thymus and activation-regulated chemokine (TARC/CCL17) relates to reactivation of human herpesvirus 6 in drug reaction with eosinophilia and systemic symptoms (DRESS)/drug-induced hypersensitivity syndrome (DIHS). Br J Dermatol 2014; 171: 425-427. 3 Ogawa K, Morito H, Hasegawa A et al. Identification of thymus and activation-regulated chemokine (TARC/CCL17) as a potential marker for early indication of disease and prediction of disease activity in drug-induced hypersensitivity syndrome (DIHS)/drug rash with eosinophilia and systemic symptoms (DRESS). J Dermatol Sci 2013; 69: 38-43. 4 Almudimeegh A, Rioux C, Ferrand H, Crickx B, Yazdanpanah Y, Descamps V. Drug reaction with eosinophilia and systemic symptoms, or virus reactivation with eosinophilia and systemic symptoms as a manifestation of immune reconstitution inflammatory syndrome in a patient with HIV? Br J Dermatol 2014; 171: 895-898.Spontaneous regression of genital warts at untreated sites following electrocoagulation treatment for lesions at the other sitesDear Editor, Although warts often persist for years, it is well known that spontaneous regression can be sometimes observed. For the mechanism of the regression, it is currently accepted that cellular immune response plays a crucial role. 1 However, it is still a major question how the immunological reactions can be spontaneously generated in a subset of patients. 2 A 40-year-old otherwise healthy Japanese man suffered from human papillomavirus (HPV)-6-induced genital warts (condyloma acuminate) around the anus for 6 months. Before he visited our hospital, he had been treated with topical imiquimod cream for 3 months and then with liquid nitrogen cryotherapy for the following 2 months at a local dermatology clinic. However, clinical signs of regression were not apparent at his initial attendance (Fig. 1a). He did not have any sexual partners. The patient showed no clinical or laboratory signs of immunodeficiency. Histological examination (Fig. 1b) showed acanthosis, papillomatosis, hyperkeratosis and dilatation of the small vessels with infiltrations of marked mononuclear cells and a few macrophages in the dermis. Intraepithelial mononuclear cell infiltration was also observed. Koilocytosis was not observed. 3 Although HPV antigen was not detected immunohistochemically, polymerase chain reaction analysis demonstrated the presence of HPV-6 DNA. Figure 1. (a) Pretreatment clinical feature of perianal genital warts. (b) Histopathological examination revealed hyperkeratosis, acanthosis, dilated blood vessels and mononuclear cell infiltration in the upper dermis (hematoxylin-eosin, original magnification 940). (c) Clinical features after scissor excision followed by electrocoagulation of selected lesions. (d) Clinical features 1 month after the treatment, showing almost complete resolution of the warts left untreated.
Skin aging is known to be enhanced by ultraviolet (UV) rays, smoking, stress, and eating habits. These factors affect skin cells, including keratinocytes and fibroblasts, causing epidermal atrophy and denaturation of the extracellular matrix (ECM), which contains collagen and elastic fibers. In addition, aging of endothelial cells has been reported to result in the loss of normal capillaries and in irregular dilation of the remaining vessels (1-4). Maintenance of normal vasculature becomes difficult because of these changes, and impaired blood circulation, decreased skin temperature, subcutaneous hematoma (referred to as senile purpura), and delayed wound healing are frequently noticed. The changes in vasculature are thought to play an important role in the problems that occur in aged skin. Royal jelly is a product synthesized from pollen and is secreted by worker honeybees. It is fed to larvae, and is used in large quantities for the morphological development of queen bees. Although the queen bee and worker bees are genetically identical, the queen's intake of royal jelly prolongs its lifespan by an order-Summary Although royal jelly is believed to prevent skin aging, the underlying mechanism is not known in detail. In the present study, we investigated the plausibility of the involvement of microRNAs in the manifestation of this effect of royal jelly. The expression of microRNAs was determined by PCR array analysis and real-time PCR and the number of cells was counted with a cell counter. Using PCR array, we identified four microRNAs that were downregulated by royal jelly in cultured human dermal microvascular endothelial cells (HDMEC). Upon comparison of the expression of the four microRNAs between young and senescent facial skin, miR-129-5p was found to be significantly upregulated in senescent skin. Consistently, the expression of miR-129-5p in HDMEC was significantly increased by UVB radiation, suggesting that this microRNA is related to photoaging. The royal jelly treatment increased the number of HDMEC. Furthermore, forced overexpression of miR-129-5p resulted in significant decrease in the number of HDMEC, and its forced downregulation increased the number of cells. The number and density of vessels is reported to be decreased in aged skin. Our results indicate that miR-129-5p is induced in damaged endothelial cells upon exposure to UV radiation, which decreases the cell number. Furthermore, administration of royal jelly downregulated the expression of miR-129-5p in endothelial cells, and might prevent skin aging by maintaining the number of cells. The present study elucidates the mechanism of vessel aging caused by UV exposure and the anti-aging effects of royal jelly through the involvement of microRNA.
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