T Harada

Tokyo Women's Medical University, Edo, Tōkyō, Japan

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Publications (37)75.4 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: A 63-year-old healthy female patient presented with well defined itchy erythematous lesions on the area of her eyebrows. Her eyebrows had been tattooed two months before her visit to us. The lesions had previously been treated by application of steroid ointment and anti-histamine and steroid tablets by mouth without success. We suspected the lesions to be contact dermatitis caused by some metal element contained in the dye used for tattooing. Treatment was continued for two weeks, but the lesions spread to her cheeks and forehead. No fungal element was found from the lesions by direct microscopy at this stage. The patch-testing to 20 metal substances on her skin showed no allergic reaction. After one more week of treatment, we reexamined the scale taken from the lesions by direct microscopy, and fungal elements were found at that time. Microsporum (M.) gypseum was isolated from the scale taken from the lesions. The lesions cleared after treatment of 11 weeks' oral intake of itraconazole 100mg daily.It was found that the patient was accustomed to sleep with her dog, a Chihuahua. On examination by a veterinarian, no skin lesions were found on the dog. We speculate that the paws of the dog might have carried soil contaminated by M. gypseum, a geophilic fungus, to the area of her eyebrows which had minor trauma after being tattooed.
    Nippon Ishinkin Gakkai Zasshi 01/2012; 53(4):263-6.
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    ABSTRACT: We describe the simultaneous initial coexistence of mucous membrane pemphigoid (MMP) with blepharosynechia and anti-bullous pemphigoid (BP)180 antibodies and pemphigus vulgaris (PV) with lesions limited to the oral mucosa, with the presence of anti-desmoglein (Dsg)3 antibodies. A 75-year-old woman had severe oropharyngeal erosions and ulcers with blisters, and blepharoconjunctivitis and blepharosynechia of the left eye. Histopathological examination of the oral mucosa found acantholysis. Indirect immunofluorescence revealed IgG antikeratinocyte cell surface antibodies, and ELISA disclosed anti-Dsg3 antibodies. Immunoblotting found positive reactivity with recombinant proteins of both the BP180-NC16a domain and the BP180 C-terminal domain. To our knowledge, the simultaneous initial occurrence of MMP and PV has never been reported previously. We present a rare case of concurrent PV and anti-BP180 MMP, the diagnosis of which was confirmed by ELISA and immunoblotting assays.
    Clinical and Experimental Dermatology 09/2009; 34(8):e785-8. · 1.33 Impact Factor
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    ABSTRACT: We report two cases of candidal onychomycosis with severe nail deformities. Case 1: The patient was an 81-year-old man who complained of onycholysis and nail deformity of the right forefinger nail which had occurred over a period of a year. He had no obvious previous illness. Case 2: The patient was an 81-year-old woman who complained of nail deformity with periungual erythema which had occurred over a period of several months. She had been treated with oral corticosteroid for bronchial asthma and with Ca blocker for hypertension for a long period. The initial KOH-prepared direct microscopy in each case failed to detect any spores or pseudohyphae. Therefore, an incisional biopsy was performed in both cases. Histopathological findings demonstrated numerous fungal elements with similar appearance of dermatophytes in the middle to lower level of the horny cell layer by PAS and Grocott staining in each case. Candida albicans was isolated and identified by cultivation on ATG agar. In case 1, oral itraconazole (100 mg/day) was administered for 14 weeks, which was effective clinically and mycologically. In case 2, however, a coadministered drug (Ca blocker), oral terbinafine (125 mg/day) was not effective mycologically. Therefore, after having changed the antihypertensive agent, oral itraconazole (100 mg/day) was administered for 16 weeks, which was effective clinically and mycologically.
    Nippon Ishinkin Gakkai Zasshi 01/2009; 50(4):253-7.
  • British Journal of Dermatology 06/2008; 159(2):479-80. · 3.76 Impact Factor
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    ABSTRACT: We report a case of inflammatory tinea corporis by Epidermophyton ( E. ) floccosum. A 73-year-old man visited our hospital with an eruption on his left arm where he wore his wristwatch. He had treated himself with a topical steroid. On KOH preparation, many hyphal elements were observed in the scale. Histological findings revealed granulomatous inflammation around hair follicles and positive fungal elements by PAS and Grocott staining in these follicles. Topical luliconazole and oral terbinafin were effective clinically and mycologically. Epidemiological survey in Japan has shown the number of cases of tinea caused by E. floccosum to be on the decrease recently. The anthropophilic dermatophyte, E. floccosum is known usually not to invade the hair follicle, and no case of inflammatory tinea corporis by this species has been reported in Japan. We consider this case of inflammatory tinea corporis due to E. floccosum to be very rare.
    Nippon Ishinkin Gakkai Zasshi 02/2008; 49(3):211-5.
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    ABSTRACT: We herein report a case of tinea capitis initially showing a couple of nodular lesions. The patient was a 66-year-old woman who had seen a nearby dermatologist for itching on her head and had been treated with a topical steroid followed by tacrolimus application for one month. Because pseudolymphoma-like erythematous nodules developed at two sites, she visited us. Two weeks after stopping all medication, some slight scaling was found around these nodules. On KOH direct microscopic examination, many filamentous elements around hair shafts were observed. Biopsy of the nodules confirmed the destruction of hair follicles surrounded by granulomatous inflammation histologically. Grocott staining of the same specimen revealed a few short fungal hyphae as well as spores. She was also diagnosed as tinea pedis by direct microscopic examination of her feet. Trichophyton rubrum was isolated from scales of both her head and feet on Sabouraud's dextrose agar at 25 degrees C. Kerion celsi (KC) is usually clinically preceded by a gray patch or black dots. Such a typical course of KC, however, was not observed in our patient. Tacrolimus was thought to have possibly played an important role in modifying tinea capitis.
    Nippon Ishinkin Gakkai Zasshi 02/2004; 45(3):177-80.
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    ABSTRACT: Kindler syndrome is an autosomal recessive disorder characterized by neonatal blistering, sun sensitivity, atrophy, abnormal pigmentation, and fragility of the skin. Linkage and homozygosity analysis in an isolated Panamanian cohort and in additional inbred families mapped the gene to 20p12.3. Loss-of-function mutations were identified in the FLJ20116 gene (renamed "KIND1" [encoding kindlin-1]). Kindlin-1 is a human homolog of the Caenorhabditis elegans protein UNC-112, a membrane-associated structural/signaling protein that has been implicated in linking the actin cytoskeleton to the extracellular matrix (ECM). Thus, Kindler syndrome is, to our knowledge, the first skin fragility disorder caused by a defect in actin-ECM linkage, rather than keratin-ECM linkage.
    The American Journal of Human Genetics 08/2003; 73(1):174-87. · 11.20 Impact Factor
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    ABSTRACT: We report two cases of tinea capitis by Microsporum (M) ferrugineum. A two year old boy (case 1) visited our hospital 3 months after his return from Myanmar. About a year later, we observed the same symptom on the scalp of his mother (case 2). In both cases itraconazole was effective clinically and mycologically. In Japan, although M. ferrugineum was the most common organism of tinea capitis before the 1960s, no cases of tinea are found caused by this species nowdays. We believe these cases to have been infected in Myanmar, and suggest the possibility that tinea caused by M. ferrugineum may become a re-emergent infection or an imported fungal disease in Japan.
    Nippon Ishinkin Gakkai Zasshi 02/2003; 44(3):203-7.
  • Nishi Nihon Hifuka 01/2003; 65(2):134-137.
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    ABSTRACT: The possibility of one-week application of terbinafine cream for tinea pedis was studied in a double-blind test at four institutes, comparing four-week application as a control. Of a total of forty-three patients studied, nineteen were randomized into a four-week application group, Group I, and twenty into a one-week application group, Group II. Group I was evaluated as moderate to extremely useful in twelve (63.2%) of the nineteen patients and Group II in twelve (60.0%) of the twenty patients. No statistical differences were observed between two groups. These findings appeared to indicate that the short term, one-week application of terbinafine cream had results equivalent to the four-week application. This short-term treatment which aids in improving patient compliance and reducing the total amount of drug applied, thus lowering drug cost, is viewed as a useful way of treating tinea pedis.
    Nippon Ishinkin Gakkai Zasshi 02/2001; 42(4):223-8.
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    ABSTRACT: Ascospore formation of Arthroderma simii was observed using electron microscopy. Using scanning electron microscopy, many round asci were observed inside the gymnothecia obtained by 4 weeks of incubation after mating. Ascospores were produced inside the asci, then discoid-shaped mature ascospores were observed through the degenerate and disrupted ascus cell wall. Disseminated ascospores were observed outside the gymnothecium 7 weeks after inoculation. Using transmission electron microscopy, the enveloping membrane system of two unit membranes invaginated and delimited the cytoplasm. The inner membranes were found to have changed into ascospore plasma membranes, whereas the outer membranes and intercisternal space were changed into ascus cell wall. The subcellular events of ascospore formation were found to be essentially similar to those of other dermatophytes.
    Mycoses 03/1998; 41(3-4):133-7. · 1.28 Impact Factor
  • S Ishizaki, H Ito, H Hanyaku, T Harada
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    ABSTRACT: We report cases of two 4-year-old boys with tinea capitis who attend the same daynursery. Clinically, on the first visit both lesions were a superficial type, however we initiated treatment with a dose of 50 mg/day of oral itraconazole. Althougth the lesion of case 2 improved after 11 weeks of treatment, case 1 developed to kerion celsi and required continued treatment for 22 weeks for cure. Microsporum canis was isolated from the hairs of both cases and MIC of itraconazole against both isolates was 1 micro g/ml. We specurate that secondary bacterial infection was responsible for the development to kelion celsi in case 2.
    Nippon Ishinkin Gakkai Zasshi 02/1998; 39(2):109-12.
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    ABSTRACT: Epidermolysis bullosa acquisita and bullous systemic lupus erythematosus are autoimmune bullous disorders, with tissue-bound and circulating autoantibodies reactive with the noncollagenous NC1 domain of type VII collagen (C-VII). Here, we describe a novel acquired bullous dermatosis with autoantibodies against the triple-helical domain of C-VII. Three patients, all Japanese children, presented with widespread inflammatory tense blisters. Histologically, subepidermal tissue separation was noted with inflammatory infiltrate in the superficial dermis. Direct immunofluorescence staining revealed linear IgG/C3 deposits along the dermal-epidermal junction. Circulating IgG anti-basement membrane zone autoantibodies stained the dermal side of normal skin separated with 1 M NaCl. Direct and indirect immunoelectron microscopy using colloidal gold labeling showed that patient sera reacted with anchoring fibrils. The gold particles were localized both near the lamina densa and on the central banded portion of the fibrils. The sera reacted with C-VII in immunoblots. Epitope analyses with natural and recombinant fragments of C-VII disclosed that the sera did not recognize the NC1 domain of C-VII, but the central triple-helical domain of this anchoring fibril protein. Thus, the present probands show a hitherto unrecognized variant of epidermolysis bullosa acquisita, with autoantibodies against epitopes in the collagenous domain of C-VII.
    Laboratory Investigation 01/1998; 77(6):623-32. · 3.96 Impact Factor
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    ABSTRACT: Kindler syndrome is a rare, inherited skin disease characterized by acral bullae formation, fusion of fingers and toes, and generalized progressive poikiloderma. The purpose of this study was to clarify the nature of the bullous component of Kindler syndrome and to determine whether this inherited skin disorder represents a variant of dystrophic epidermolysis bullosa or a unique independent clinical entity. Two unrelated patients with Kindler syndrome were studied. Electron microscopy demonstrated marked duplication of the lamina densa, and clefts were observed in areas where the lamina densa was destroyed or obscured. Hemidesmosomes and anchoring fibrils showed normal features. Indirect immunofluorescence revealed normal linear labeling with antibodies against hemidesmosomal components (alpha 6 and beta 4 integrins, BPAG1, and BPAG2) and against anchoring filament components such as uncein, as detected by the 19-DEJ-1 monoclonal antibody. However, antibodies against the 3 respective laminin 5 chains, type IV collagen, and various type VII collagen epitopes (the aminoterminal NC1 domain, the central triple helical collagenous domain, and the carboxyterminal end of the triple helical collagenous domain) revealed a broad reticular staining pattern. Molecular screening of the type VII collagen gene (COL7A1) in the patients and their parents by heteroduplex analysis failed to detect any band shifts indicative of pathologic mutations. These results suggest that the bullous component of Kindler syndrome is distinct from dystrophic epidermolysis bullosa caused by mutations in the type VII collagen gene. Additionally, the differential distribution patterns of uncein and laminin 5 in the patients' skin samples support the hypothesis that uncein and laminin 5 are different molecules.
    Archives of Dermatology 10/1997; 133(9):1111-7. · 4.79 Impact Factor
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    ABSTRACT: We investigated the gene expression of a protein during the dimorphic transition from yeast to mycelial form of Sporothrix schenckii. Yeast cells were converted to mycelial cells in Sabouraud glucose broth at 25 degrees C. After 1, 3 and 5 days of culture, the intermediate form of cells between yeast and mycelium was obtained, and after 7 days these cells were morphologically similar to the mycelial cells. Proteins having the molecular weight of 45 kDa were found to by synthesized preferentially by intermediate form of day 7 and mycelial cells. On the other hand, the 45 kDa proteins were predominantly translated by the RNA isolated from the intermediate of day 7 and mycelial cells using in vitro cell-free translation assay. The 45 kDa proteins synthesized by mycelial cells were found to be identical with the 45 kDa translation products directed by the mRNA isolated from the intermediate and mycelial cells by V8 protease peptide mapping. The 45 kDa protein was considered to be actin by Western blot analysis using an anti-actin monoclonal antibody. These results suggest that the intermediate form of day 7 has the same phenotypes in the morphology and biosynthesis of actin as those of mycelial cells. The expression of the actin gene may be involved in the dimorphic transition of S. schenckii.
    Journal of medical and veterinary mycology: bi-monthly publication of the International Society for Human and Animal Mycology 01/1996; 34(3):175-80.
  • Journal of Dermatological Science 01/1996; 12(2):193-193. · 3.52 Impact Factor
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    ABSTRACT: We describe a case of a 53-year-old Japanese female suffering from Sjögren's syndrome, systemic lupus erythematosus, and Hashimoto's thyroiditis who developed pustules, erythema, and erosions on her fingers and toes. The histological specimen showed psoriatic changes. Indirect immunofluorescent study using anti-human IL (interleukin)-8 antibody produced positive staining patterns in the lesional epidermis. These findings suggested the diagnosis of acral pustular psoriasis. Diaminodiphenylsulfone at 75 mg orally daily for 20 days and the application of 0.12% betamethasone valerate ointment led to gradual improvement.
    The Journal of Dermatology 03/1995; 22(2):125-8. · 1.77 Impact Factor
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    ABSTRACT: The fungal elements observed by direct microscopic examination sometimes fail to grow on subsequent culture. To elucidate the cause of this discrepancy, the viability of dermatophytes and Candida in skin scales was evaluated by neutral red staining. Autoradiographic study using 3H-thymidine confirmed that grain-positive cells (viable cells) were stained with neutral red, whereas negative cells (non-viable cells) were not stained. Taking this as a baseline, the correlation between neutral red-positive fungal elements in scales taken from 211 patients with tinea and 27 patients with cutaneous candidosis and cultures on Sabouraud glucose agar was studied. Strong positive correlations were found in both mycoses. These findings suggest that neutral red staining provides a useful method for evaluating the viability of dermatophytes and Candida in human skin scales.
    Journal of medical and veterinary mycology: bi-monthly publication of the International Society for Human and Animal Mycology 02/1994; 32(1):31-5.
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    ABSTRACT: Primary localized cutaneous nodular amyloidosis (PLCNA) is a rare disease, and its pathogenesis of amyloid deposition is still unknown. The purpose of this study was to know the origin of amyloid in PLCNA. Water-soluble amyloid fibrils were isolated from the skin and resolved on SDS-PAGE, then subjected to immunoblot analysis. The major amyloid fibril protein was a 29-kD peptide which reacted with both anti-lambda- and anti-kappa-light-chain antibodies. Amyloids in this particular case of PLCNA are derived from the polyclonal immunoglobulin light chain and some cases of PLCNA could be reactive diseases rather than neoplastic ones.
    Dermatology 02/1994; 189(2):125-8. · 2.02 Impact Factor
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    ABSTRACT: We describe an 82-year-old man with CD8+ lymphoepithelioid lymphoma localized to the skin. The skin lesion had been present for 18 years. Histologically there was a dense infiltrate that consisted of atypical lymphoid cells and large epithelioid cells, thereby resembling the so-called Lennert's lymphoma. Local radiotherapy proved effective in reducing the size of the tumor. To the best of our knowledge, this is the first report of primary lymphoepithelioid lymphoma of the skin.
    Journal of the American Academy of Dermatology 12/1993; 29(5 Pt 2):871-5. · 4.91 Impact Factor

Publication Stats

342 Citations
75.40 Total Impact Points

Institutions

  • 1998–2008
    • Tokyo Women's Medical University
      • Department of Dermatology
      Edo, Tōkyō, Japan
  • 1978–1997
    • Keio University
      • Department of Dermatology
      Tokyo, Tokyo-to, Japan