Faculty Profiles - HIRAI Youji

Papers - HIRAI Youji

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Cutaneous Pseudolymphoma Caused by an Injury with a Metallic Piece of a Mowing Machine Containing Tungsten. International journal

Mayu Tokuda, Yoshio Kawakami, Yoji Hirai, Kota Tachibana, Yuki Nakagawa, Satoru Sugihara, Tomoko Miyake, Osamu Yamasaki, Keiko Manabe, Shin Morizane

Indian journal of dermatology 68 ( 4 ) 468 - 470 2023

A case of generalized allergic contact dermatitis due to sodium lauroyl methylaminopropionate in a shampoo. International journal

Azusa Hirose, Yoshio Kawakami, Tomoko Miyake, Yoji Hirai, Shin Morizane

Contact dermatitis 87 ( 6 ) 546 - 548 2022.12

シャンプーに含まれるN-ラウロイル-N-メチル-β-アラニンNaによる接触皮膚炎症候群の1例

廣瀬梓, 川上佳夫, 三宅智子, 平井陽至, 森実真

日本皮膚免疫アレルギー学会総会学術大会プログラム・抄録集 52回 201 - 201 2022.12

Cutaneous toxicity with suprabasal blisters and dyskeratosis following administration of enfortumab vedotin. International journal

Ken-Ichi Hasui, Yoshio Kawakami, Tomoko Miyake, Yoji Hirai, Hayato Nomura, Kohei Edamura, Motoo Araki, Shin Morizane

The Journal of dermatology 50 ( 4 ) e115-e116 2022.11

Novel homozygous missense mutation c.1654G>T in the ALOX12B gene causing congenital ichthyosiform erythroderma. International journal

Kotoe Mae, Yoshio Kawakami, Ai Kajita, Takuya Takeichi, Tatsuhiro Noda, Yoji Hirai, Masashi Akiyama, Shin Morizane

The Journal of dermatology 50 ( 1 ) e37-e38 2022.10

Rituximab therapy for intractable pemphigus: A multicenter, open-label, single-arm, prospective study of 20 Japanese patients. International journal

Jun Yamagami, Yuichi Kurihara, Takeru Funakoshi, Yasuko Saito, Ryo Tanaka, Hayato Takahashi, Hideyuki Ujiie, Hiroaki Iwata, Yoji Hirai, Keiji Iwatsuki, Norito Ishii, Jun Sakurai, Takayuki Abe, Ryo Takemura, Naomi Mashino, Masahiro Abe, Masayuki Amagai

The Journal of dermatology 50 ( 2 ) 175 - 182 2022.10

Language：English Publishing type：Research paper (scientific journal)

This was a multicenter clinical trial of rituximab, a chimeric monoclonal IgG antibody directed against CD20, for the treatment of refractory pemphigus vulgaris and pemphigus foliaceus. In total, 20 patients were treated with two doses of rituximab (1000 mg; 2 weeks apart) on days 0 and 14. The primary end point was the proportion of patients who achieved complete or partial remission on day 168 following the first rituximab dose. Of the 20 enrolled patients, 11 (55%) and four (20%) achieved complete and partial remission, respectively; therefore, remission was achieved in a total of 15 patients (75.0% [95% confidence interval, 50.9%-91.3%]). It was demonstrated that the remission rate was greater than the prespecified threshold (5%). In addition, a significant improvement in clinical score (Pemphigus Disease Area Index) and decrease in serum anti-desmoglein antibody level were observed over time. Four serious adverse events (heart failure, pneumonia, radial fracture, and osteonecrosis) were recorded in two patients, of which only pneumonia was considered causally related with rituximab. The level of peripheral blood CD19-positive B lymphocytes was decreased on day 28 after rituximab treatment and remained low throughout the study period until day 168. Our results confirm the efficacy and safety of rituximab therapy for refractory pemphigus in Japanese patients.

DOI： 10.1111/1346-8138.16597

PubMed

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【(新規)抗腫瘍薬～光と影～】二次感染を契機に皮膚症状が増悪しモガムリズマブが奏効したSezary症候群

赤松由規, 平井陽至, 三宅智子, 森実真

皮膚病診療 44 ( 5 ) 410 - 413 2022.5

水疱性類天疱瘡に合併した偽性低アルドステロン症の乳児例

宮原宏幸, 村上美智子, 二川奈都子, 長谷川高誠, 茂原研司, 宇田和宏, 津下充, 八代将登, 平井陽至, 森実真, 塚原宏一

日本小児科学会雑誌 126 ( 4 ) 728 - 728 2022.4

特異疹が緊満性水疱を呈したATLLの1例

山口春佳, 橋本倫子, 神野泰輔, 川上佳夫, 平井陽至, 谷口恒平, 松岡賢市, 山崎修, 森実真

西日本皮膚科 84 ( 2 ) 134 - 139 2022.4

Language：Japanese Publisher：日本皮膚科学会-西部支部

69歳,女性。右前腕部の緊満性水疱を伴う紅斑の精査加療目的に当科を紹介され受診した。1ヵ月前より右前腕部に自覚症状のない紅斑が出現し,次第に緊満性水疱が多発し,右上肢全体の発赤や腫脹,灼熱感および疼痛を伴うようになった。臨床像より水疱性類天疱瘡や蜂窩織炎が鑑別に挙がり血液検査をしたところ,大型な異型リンパ球の増加,好酸球増加,sIL-2R上昇,抗HTLV-1抗体陽性を認めた。水疱部からの病理組織像では,表皮直下に水疱が形成され,真皮から脂肪織に異型リンパ球と好酸球が密に浸潤し,免疫組織化学染色ではCD3,CD4,CD25,CD30陽性,CD20陰性であり,蛍光抗体直接法は全て陰性であった。皮疹部よりサザンブロット法でHTLV-IプロウイルスDNAのモノクローナルな取り込みを認め,Adult T-cell leukemia/lymphoma(ATLL)の特異疹と診断した。皮疹はステロイド全身投与と化学療法開始後に速やかに消退した。臨床経過と検査所見から好酸球性脂肪織炎を併発していると考えた。水疱を呈するATLLの特異疹は稀であり,また,好酸球性脂肪織炎を併発したATLLの報告例はこれまでになく,自験例が初めてである。自験例は血液検査および皮膚生検により診断が明らかとなった。難治性の水疱を呈する皮疹を認めた際はATLLの特異疹の可能性も考え,精査することが重要である。(著者抄録)

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Other Link： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2022&ichushi_jid=J01003&link_issn=&doc_id=20220517220013&doc_link_id=10.2336%2Fnishinihonhifu.84.134&url=https%3A%2F%2Fdoi.org%2F10.2336%2Fnishinihonhifu.84.134&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_2.gif

金属異物によって生じた前頸部pseudolymphoma

徳田真優, 平井陽至, 川上佳夫, 立花宏太, 中川裕貴, 杉原悟, 三宅智子, 山崎修, 森実真, 眞部恵子, 浅越健治

日本皮膚科学会雑誌 132 ( 3 ) 506 - 506 2022.3

特異疹が緊満性水疱を呈したATLLの1例

妹尾春佳, 橋本倫子, 神野泰輔, 川上佳夫, 平井陽至, 山崎修, 森実真, 谷口恒平, 松岡賢市

日本皮膚科学会雑誌 132 ( 1 ) 99 - 99 2022.1

Efficacy and Safety of Oral Bexarotene for Japanese Patients with Mycosis Fungoides : A Retrospective Case-Series Study of a Single Medical Center in Japan

NAKAGAWA Yuki, HAMADA Toshihisa, HIRAI Yoji, MIYAKE Tomoko, YAMASAKI Osamu, IWATSUKI Keiji, MORIZANE Shin

Nishi Nihon Hifuka 83 ( 6 ) 549 - 553 2021.12

咽頭浮腫や腸管浮腫を来した正補体性蕁麻疹様血管炎の1例

川上大輔, 岡優美, 竹内杏奈, 藤井翔太郎, 織田好子, 福永淳, 錦織千佳子, 森田安里, 黒田桂子, 平井陽至

皮膚の科学 20 ( 4 ) 373 - 373 2021.12

Safety and efficacy of bexarotene for Japanese patients with cutaneous T-cell lymphoma: Real-world experience from post-marketing surveillance. International journal

Toshihisa Hamada, Akimichi Morita, Hiraku Suga, Hikari Boki, Taku Fujimura, Yoji Hirai, Takatoshi Shimauchi, Chiharu Tateishi, Eiji Kiyohara, Ikko Muto, Hideki Nakajima, Riichiro Abe, Kazuyasu Fujii, Chikako Nishigori, Eiji Nakano, Kentaro Yonekura, Takeru Funakoshi, Masahiro Amano, Tomomitsu Miyagaki, Noriko Makita, Katsunori Manaka, Yoshihito Shimoyama, Makoto Sugaya

The Journal of dermatology 49 ( 2 ) 253 - 262 2021.10

Language：English Publishing type：Research paper (scientific journal)

To establish real-world evidence about the safety and efficacy of bexarotene for Japanese patients with cutaneous T-cell lymphoma, we conducted a nationwide cohort study using data from post-marketing surveillance for bexarotene treatment. In total, 294 patients with cutaneous T-cell lymphoma were identified between June 2016 and June 2018. Of these, 267 patients were included as the safety analysis set. Of the 267 patients, 175 were included in the efficacy analysis set. Of these, 139 patients had mycosis fungoides, including 46 with early stage disease and 93 with advanced stage disease. Among the 139 patients with mycosis fungoides, the objective response rate was 46.8%. A significant difference in objective response rate was detected between patients who started with bexarotene at 300 mg/m2 (61.6%) and patients who started with bexarotene at less than 300 mg/m2 (22.6%, p < 0.001). Of the 139 patients with mycosis fungoides, 92 were treated with a combination of bexarotene plus photo(chemo)therapy. A significant difference in objective response rate was seen between bexarotene with a combination of photo(chemo)therapy (57.6%) and bexarotene without a combination of photo(chemo)therapy (25.5%, p < 0.001). Starting bexarotene at 300 mg/m2 and combination with photo(chemo)therapy were detected as independent factors influencing response. Common treatment-related adverse events included hypothyroidism (85.8%), hypertriglyceridemia (68.5%), hypercholesterolemia (43.8%), and neutropenia (21.3%). Hypertriglyceridemia, hypercholesterolemia, and neutropenia occurred more frequently in patients who started with bexarotene at 300 mg/m2 than patients who started with bexarotene at less than 300 mg/m2 (hypertriglyceridemia, 76.4% vs. 57.0%, p = 0.001; hypercholesterolemia, 49.0% vs. 36.4%, p = 0.045; neutropenia, 28.0% vs. 12.1%, p = 0.002; respectively). The present study indicates that starting bexarotene at 300 mg/m2 and combination of photo(chemo)therapy offer a promising efficacy for the treatment of patients with mycosis fungoides. Efficacy of low-dose bexarotene plus photo(chemo)therapy should be evaluated in future.

DOI： 10.1111/1346-8138.16201

PubMed

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皮膚T細胞性リンパ腫における皮膚FCMの有用性の検討

中川裕貴, 三宅智子, 平井陽至, 山崎修, 岩月啓氏, 森実真, 高橋孝英, 濱田利久

日本皮膚科学会雑誌 131 ( 11 ) 2446 - 2446 2021.10

Analysis of clonality in cutaneous B-cell lymphoma and B-cell pseudolymphoma using skin flow cytometry: Comparison of immunophenotyping and gene rearrangement studies. International journal

Yuki Nakagawa, Toshihisa Hamada, Takahide Takahashi, Tomoko Miyake, Yoji Hirai, Keiji Iwatsuki, Shin Morizane

The Journal of dermatology 49 ( 2 ) 246 - 252 2021.7

Language：English Publishing type：Research paper (scientific journal)

To identify clonal neoplastic cells in skin affected by B-cell lymphoma using skin flow cytometry (FCM) techniques, we investigated light-chain restriction using skin FCM with clonality assessed by polymerase chain reaction and light-chain restriction by in situ hybridization (ISH). We retrospectively analyzed 16 cases of B-cell lymphoma with cutaneous involvement: primary cutaneous diffuse large B-cell lymphoma, leg type (pcDLBCL-LT) (n = 7), DLBCL-not otherwise specified (DLBCL-NOS) (n = 6), primary cutaneous follicle center lymphoma (pcFCL) (n = 1), and follicular lymphoma (n = 2), as well as cutaneous B-cell pseudolymphoma (n = 9). Results of skin FCM light-chain restriction analyses were compared with immunoglobulin H (IgH) gene rearrangement and κ/λ ISH findings. Skin FCM detected light-chain restriction in 11 of 14 B-cell lymphoma patients but none of the B-cell pseudolymphoma patients. The sensitivity of skin FCM for distinguishing B-cell lymphoma and B-cell pseudolymphoma was 79%, and the specificity was 100%. Eleven of 13 B-cell lymphoma patients exhibited gene rearrangement (sensitivity 85%), whereas six of seven pseudolymphoma patients were negative (specificity 86%). ISH was positive in three of 16 B-cell lymphoma cases (sensitivity 19%) but none of the B-cell pseudolymphoma cases (specificity 100%). ISH sensitivity was 29% for pcDLBCL-LT, 17% for DLBCL-NOS, and 0% for pcFCL and follicular lymphoma. Skin FCM therefore appears to be more sensitive than ISH in detecting light-chain restriction in DLBCL and follicular lymphoma, and as sensitive as IgH gene rearrangement analysis in detecting clonality. Skin FCM is thus a promising diagnostic tool for identifying monoclonal neoplastic B-cell populations.

DOI： 10.1111/1346-8138.16057

PubMed

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Cutaneous adult T-cell leukemia/lymphoma with granulomatous reaction. International journal

Yuki Nakagawa, Yoshio Kawakami, Tomoko Kawamoto, Tomoko Miyake, Yoji Hirai, Osamu Yamasaki, Shin Morizane

The Journal of dermatology 48 ( 6 ) e273-e274 2021.6

Staphylococcal enterotoxin B- and lipopolysaccharide-induced toxic shock syndrome in a burn patient. International journal

Osamu Yamasaki, Satoru Sugihara, Ai Kajita, Emi Yokoyama, Tomoko Miyake, Yoji Hirai, Shin Morizane

The Journal of dermatology 48 ( 4 ) 547 - 550 2021.4

Language：English Publishing type：Research paper (scientific journal)

Toxic shock syndrome (TSS) is caused by toxic shock syndrome toxin 1 or enterotoxins secreted by Staphylococcus aureus. Lipopolysaccharide (LPS) has also been shown to play a major role in the development of sepsis. Staphylococcal superantigens and LPS operate synergistically in conditioning cytokine release and lethal shock in mice. An 80-year-old woman was admitted because of a 20% mixed-depth flame burn. Despite two excisions and grafts, necrotic ulcers with methicillin-resistant Staphylococcus aureus (MRSA) colonization remained. On the 7th day after the operation, she developed shock with an erythematous rash. Blood examination revealed evidence of disseminated intravascular coagulation, and liver and renal dysfunction. A blood culture revealed a staphylococcal enterotoxin B (SEB)-producing strain of MRSA and Klebsiella pneumoniae. The septic symptoms were prolonged, but the condition gradually improved with extensive treatment. T-cell receptor analysis demonstrated a marked accumulation of SEB-mediated Vβ T cells. Stimulation of peripheral blood mononuclear cells in the recovery phase with SEB and LPS induced additive effects on tumor necrosis factor-α, interferon-γ, and interleukin-6 production. Although the present case did not fulfill the clinical criteria for TSS, the additive effects of SEB and LPS might have caused the severe septic shock.

DOI： 10.1111/1346-8138.15729

PubMed

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A case of allergic contact dermatitis due to 3-glyceryl ascorbate in a skin-lightening lotion. International journal

Yoshio Kawakami, Takatsune Umayahara, Yoji Hirai, Shin Morizane

Contact dermatitis 2021.2

Case of tufted angioma treated successfully with tranilast, topical steroids and tacrolimus ointment. International journal

Yuki Nakagawa, Yoji Hirai, Masatoshi Jinnin, Shin Morizane

The Journal of dermatology 48 ( 2 ) e84-e85 2021.2

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