Abstract

Citrus jabara (CJ) is a rare citrus fruit that used to grow naturally only in the southern part of the Kii Peninsula in Japan. Human intervention studies with oral intake of CJ fruit have shown its anti-allergic effects, but the testing method was a pre-post comparison study. In this study, we conducted a randomized, double-blind, parallel-group interventional study to evaluate the volume-dependent effects of oral intake of CJ fruit peel powder (Japanese Patent No. 5,323,127) on nasal and eye allergy-like symptoms. Ninety healthy adults were allocated to three groups and given test foods containing 1,000, 500, and 0 mg of CJ peel powder, with one packet per day for 4 weeks. After excluding those who dropped out or deviated from the study protocol, 73 were included in the efficacy analysis and 86 in the safety analysis. The high-dose group (1,000 mg/day) was significantly lower than the placebo group in the scores of “nasal and eye symptoms” at week 4, and “blocked nose” at weeks 2 and 4 in the evaluation of question I of Japanese Rhino-conjunctivitis Quality of Life Questionnaire (JRQLQ No. 1). The changes in scores (difference from the pre-observation period) on the Nasal and Eye Symptom Questionnaire showed a dose-dependent reduction in rhinorrhea. In the safety evaluation, there were no significant differences in examinations of physiology, hematology, and blood biochemistry between the groups, and no adverse events attributable to the test foods were observed. These results suggest that intake of CJ peel powder can alleviate allergy-like symptoms.

Abstract

Immune-related adverse events (irAEs) are commonly observed in patients treated with immune checkpoint inhibitors (ICI), and prompt diagnosis and treatment of irAEs is of utmost importance. Gastrointestinal (GI) events are among the most frequent irAEs and the hallmark symptom is diarrhea. Intestinal hypomotility as irAEs is exceedingly rare, and needs wider recognition given that the presentation is insidious.

Here, we report a case of 79-year-old woman with metastatic melanoma under nivolumab and ipilimumab combination therapy. She developed ileus symptom, and was diagnosed with acute colonic pseudo-obstruction. The symptom relieved soon after administering high-dose prednisolone five days after the onset. ICI therapy was discontinued.

Intestinal hypomotility as GI irAEs is exceedingly rare and there have been five reported cases to our knowledge. In reviewing past cases, we speculate that the prompt initiation of corticosteroids resulted in a favorable outcome. Our case illustrates that early recognition of these rare irAEs is essential in order to ensure prompt treatment.

Abstract

A 15-year-old girl underwent allogenic bone marrow transplantation for neuroblastoma. A few years later, she noticed a round lesion on her left buttock. Since the lesion had been asymptomatic and never grown, more than 20 years had passed before she saw a local doctor to consult about it. Although the lesion was suspected to be tinea corporis, no fungi were found on microscopic examination. Subsequently, administered topical corticosteroids were not effective. She was referred to our hospital for further evaluation, and a skin biopsy confirmed the diagnosis of porokeratosis. There was a possibility that chemotherapy, total body radiation, or immunosuppressive therapy associated with allogeneic bone marrow transplantation was involved in the development of porokeratosis. Numerous cases of acquired porokeratosis in immunocompromised status have been observed; as for those after allogenic bone marrow transplantation, 12 cases have been reported in the English literature, 4 of which had only one or a few lesions on a limited area of body surface. Our case was relatively uncommon in that the lesion was solitary and comparatively large. In a localized type of porokeratosis, it was suggested that a malignant skin tumor developed earlier than in other types. Careful follow-up for malignant transformation is especially required.

Abstract

Lichen planopilaris (LPP) is characterized by erythematous, keratotic follicular papules and cicatricial alopecia. LPP, the most common cause of cicatricial alopecia, is usually seen in women and causes significant psychosocial morbidity. We describe here a 42-year-old woman with a 6-month history of hair loss accompanied by itching on the scalp. Dermatological examination revealed patchy cicatricial alopecia in the vertex and band-like purple flat patches and plaques following the Blaschko lines on the right half of the body, together with post-inflammatory hyperpigmentation. Histopathological examination of the scalp biopsy was consistent with LPP, while thigh biopsy was consistent with lichen planus. With the histopathological and clinical evidence, our patient was evaluated as LPP associated with LP and successfully treated with topical corticosteroid. A few LPP and LP cases following the Blaschko lines have previously been reported separately. However, LPP, together with LP following Blaschko lines, have not been reported in the same patient.

Abstract

Aging of organs starts from the time of birth and continues throughout life. Aging of skin can be divided into two distinct types—intrinsic aging and extrinsic, based on the fact that the skin is the outermost organ exposed to the external environment. However, despite their different histological features and triggers, intrinsic and extrinsic aging share common biochemical mechanisms. β-galactosidase, p16^INK4a, and senescence-associated secretory phenotype (SASP) factors are detected in skin cells as biomarkers of senescence. In particular, inflammatory cytokines, the constituents of SASP, play pivotal roles in “inflammaging” which is a concept involving the relationship between aging and low-grade inflammation. In this review, the features of skin aging and its underlying mechanism of skin aging are summarized.