Papers - UHARA Hisashi

ニボルマブによってリウマチ性多発筋痛症様症状を呈した1例

執行 延明, 西田 彩華, 菅野 莉英, 箕輪 智幸, 藤岡 茉生, 堀本 浩平, 加藤 潤史, 肥田 時征, 宇原 久, 津田 玲子, 高橋 裕樹

日本皮膚科学会雑誌 ( (公社)日本皮膚科学会 )  129 ( 11 ) 2336 - 2336  2019.10

体温上昇により誘発された血管浮腫の2例

箕輪 智幸, 澄川 靖之, 宇原 久

アレルギーの臨床 ( (株)北隆館 )  39 ( 11 ) 915 - 918  2019.10

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[症例1]は18歳女性。アトピー性皮膚炎。体温上昇によって眼瞼腫脹が出現した。[症例2]は20歳女性。アトピー性皮膚炎。体温上昇によって眼瞼腫脹、アナフィラキシーが出現した。2症例とも補体は正常で、血管浮腫の家族歴はなく、蕁麻疹の合併もなかったため、体温上昇によって誘発された血管浮腫と考えた。入浴や運動による血管浮腫、アナフィラキシー、コリン性蕁麻疹はアトピー性皮膚炎を有する若年女性に好発するとされている。我々の症例はコリン性蕁麻疹の合併がなかったが経過を追いたい。(著者抄録)

自己免疫性水疱症例における免疫グロブリン大量療法後の血小板減少についての検討

小林 英理, 菅 裕司, 細川 夕菜, 箕輪 智幸, 米田 大介, 熊谷 綾子, 神谷 崇文, 澄川 靖之, 宇原 久

日本皮膚科学会雑誌 ( (公社)日本皮膚科学会 )  129 ( 11 ) 2335 - 2335  2019.10

メラノーマにおける抗PD-1抗体治療中止後の効果持続について

加藤 潤史, 半田 稔也, 松井 馨之, 箕輪 智幸, 藤岡 茉生, 澤田 匡秀, 佐藤 さゆり, 堀本 浩平, 肥田 時征, 澄川 靖之, 宇原 久

日本癌治療学会学術集会抄録集 ( (一社)日本癌治療学会 )  57回   P160 - 2  2019.10

腹部に生じた巨大尖圭コンジローマの1例

石田 倫子, 中原 真希子, 内 博史, 和田 尚子, 宮崎 玲子, 辻 学, 中原 剛士, 三苫 千景, 肥田 時征, 黄倉 真恵, 宇原 久, 古江 増隆

西日本皮膚科 ( 日本皮膚科学会-西部支部 )  81 ( 5 ) 438 - 438  2019.10

放射線治療を行った基底細胞癌症例の検討

西田 彩華, 堀本 浩平, 加藤 潤史, 執行 延明, 菅野 莉英, 藤岡 茉生, 大橋 隆宏, 肥田 時征, 宇原 久

日本皮膚科学会雑誌 ( (公社)日本皮膚科学会 )  129 ( 9 ) 1909 - 1909  2019.08

Blastic plasmacytoid dendritic cell neoplasm(BPDCN)の1例

執行 延明, 西田 彩華, 菅野 莉英, 藤岡 茉生, 大橋 隆宏, 堀本 浩平, 加藤 潤史, 肥田 時征, 宇原 久, 井山 諭, 前田 和男, 須釜 佑介

日本皮膚科学会雑誌 ( (公社)日本皮膚科学会 )  129 ( 9 ) 1910 - 1910  2019.08

尋常性天疱瘡の治療中に腸管気腫症をきたした1例

小林 英理, 菅 裕司, 半田 稔也, 松井 馨之, 細川 夕菜, 箕輪 智幸, 熊谷 綾子, 神谷 崇文, 澄川 靖之, 宇原 久

日本皮膚科学会雑誌 ( (公社)日本皮膚科学会 )  129 ( 9 ) 1909 - 1909  2019.08

末梢血中の腫瘍由来DNAを用いた悪性黒色腫に対するニボルマブの治療効果の評価

芦田 敦子, 境澤 香里, 奥山 隆平, 宇原 久

日本皮膚科学会雑誌 ( (公社)日本皮膚科学会 )  129 ( 8 ) 1647 - 1647  2019.07

転移性悪性黒色腫のNivolumab治療における血清5-S-CDの有用性

面高 俊和, 皆川 茜, 古賀 弘志, 奥山 隆平, 若松 一雅, 宇原 久

日本皮膚科学会雑誌 ( (公社)日本皮膚科学会 )  129 ( 8 ) 1648 - 1648  2019.07

局所麻酔薬アレルギー疑い患者の皮膚テスト陽性率と発作時の症状の検討

澄川 靖之, 江畑 加奈子, 神谷 崇文, 菅 裕司, 石井 泰江, 肥田 時征, 加藤 潤史, 堀本 浩平, 宇原 久

西日本皮膚科 ( 日本皮膚科学会-西部支部 )  81 ( 3 ) 253 - 253  2019.06

Docetaxel therapy for classic Kaposi's sarcoma.

Yuna Hosokawa, Junji Kato, Tokimasa Hida, Kohei Horimoto, Sayuri Sato, Masahide Sawada, Hiroshi Sasaki, Yoshiyuki Matsui, Toshiya Handa, Hisashi Uhara

Asia-Pacific journal of clinical oncology   15 ( 3 ) 181 - 182  2019.06  [Refereed]  [International journal]

DOI PubMed

Long-term follow up of nivolumab in previously untreated Japanese patients with advanced or recurrent malignant melanoma.

Naoya Yamazaki, Yoshio Kiyohara, Hisashi Uhara, Jiro Uehara, Yasuhiro Fujisawa, Tatsuya Takenouchi, Masaki Otsuka, Hiroshi Uchi, Hironobu Ihn, Masahiro Hatsumichi, Hironobu Minami

Cancer science   110 ( 6 ) 1995 - 2003  2019.06  [Refereed]  [International journal]

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The immune checkpoint inhibitor nivolumab inhibits the programmed death 1 receptor and suppresses the immune resistance of cancer cells. This is a long-term follow up of a single-arm, open-label, multicenter, phase II study of nivolumab in untreated Japanese patients with stage III/IV or recurrent melanoma. In addition, a post-hoc subgroup analysis stratified by melanoma types was performed. Nivolumab was administered intravenously at a dose of 3 mg/kg every 2 weeks. The primary endpoint was the overall response rate (ORR), and secondary endpoints included overall survival (OS), progression-free survival (PFS), best overall response, the disease control rate and change in tumor diameter. Safety was assessed by recording treatment-related adverse events (TRAE), including select immune-related adverse events. Of the 24 patients initially included in the primary phase II study, 10 survived for over 3 years (41.7%). The ORR was 34.8% (90% confidence interval [CI]: 20.8, 51.9) for all patients. When analyzing by melanoma type, the ORR was 66.7% (90% CI: 34.7, 88.3) for superficial spreading, 33.3% (90% CI: 11.7, 65.3) for mucosal, and 28.6% (90% CI: 10.0, 59.1) for acral lentiginous tumors. The median OS was 32.9 months, the 3-year OS rate was 43.5%, and the 3-year PFS rate was 17.2%. A long-term response was observed in all the tumor types. The most common TRAE included skin toxicity (45.8%) and endocrine disorders (29.2%). This study demonstrated the long-term efficacy and tolerability of nivolumab in patients with advanced or recurrent melanoma, irrespective of melanoma type.

DOI PubMed

Clinical and Histopathologic Characteristics of Melanocytic Lesions on the Volar Skin Without Typical Dermoscopic Patterns.

Yasutomo Mikoshiba, Akane Minagawa, Hiroshi Koga, Yoshiharu Yokokawa, Hisashi Uhara, Ryuhei Okuyama

JAMA dermatology   155 ( 5 ) 578 - 584  2019.05  [International journal]

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Importance: It is challenging to differentiate melanoma from melanocytic nevus on the volar skin in the absence of typical dermoscopic patterns. Objective: To identify the frequency and clinical and dermoscopic characteristics of melanocytic lesions on the volar skin not displaying a parallel furrow pattern, lattice-like pattern, fibrillar pattern, or parallel ridge pattern on results of dermoscopy. Design, Setting, and Participants: In this retrospective cohort study, a total of 504 melanocytic lesions on the volar skin were evaluated in the Shinshu University Hospital department of dermatology between January 1, 2000, and December 31, 2012. Dermoscopic images were independently assessed by 3 dermoscopists for the presence of established dermoscopic criteria. Statistical analysis was performed from October 1, 2017, to April 30, 2018. Main Outcomes and Measures: Frequency of dermoscopic criteria and corresponding clinical (patient age and size and location of lesion) and histopathologic features. Results: Of 504 lesions, 110 (21.8%) (melanocytic nevus, 97; melanoma, 8; and equivocal melanocytic lesion, 5) from 108 patients (68 female and 40 male patients; mean age, 40.1 years [range, 1-86 years]) did not show a parallel furrow pattern, lattice-like pattern, fibrillar pattern, or parallel ridge pattern. Among them, the mean patient age was significantly higher for melanoma than for melanocytic nevus (65.3 vs 38.0 years; P < .001), as was mean maximum lesion diameter (11.8 vs 5.7 mm; P < .001). Melanomas and equivocal melanocytic lesions tended to be distributed on weight-bearing areas of the foot sole, such as the heel, while nevi were spread over non-weight-bearing regions. Dermoscopically, 95 melanocytic nevi (97.9%) were symmetrical in 1 or 2 axes while melanomas were not. A total of 91 melanocytic nevi (93.8%) had 1 or 2 colors per lesion, and 4 melanomas (50.0%) had more than 2 colors. Vascular structures were seen in 3 melanocytic nevi (3.1%) and 3 melanomas (37.5%). Blue-white structures were seen in 18 melanocytic nevi (18.6%) and 3 melanomas (37.5%). Dots and globules were seen in 22 melanocytic nevi (22.7%) and 4 melanomas (50.0%). Vascular structures, blue-white structures, and dots and globules were irregularly distributed in the melanomas. Ulcer, hyperkeratosis, and irregular streaks were observed only in melanomas. Conclusions and Relevance: More than one-fifth of melanocytic lesions on the volar skin did not display typical dermoscopic patterns. Asymmetry, numerous colors (≥3), and other melanoma-specific dermoscopic findings were more frequently observed for melanomas. Clinical information, including patient age and lesion size and location, was helpful in differentiating melanoma from melanocytic nevus. Further prospective clinical studies are warranted to clarify the diagnostic accuracy of dermoscopy combined with clinical information.

DOI PubMed

悪性黒色腫における抗PD-1抗体と放射線治療

加藤 潤史, 肥田 時征, 堀本 浩平, 佐藤 さゆり, 澤田 匡秀, 藤岡 茉生, 箕輪 智幸, 松井 馨之, 宇原 久

日本皮膚科学会雑誌 ( (公社)日本皮膚科学会 )  129 ( 5 ) 1177 - 1177  2019.05

ペムブロリズマブの投与にて完全奏功を維持している陰部悪性黒色腫の1例

堀本 浩平, 加藤 潤史, 松井 馨之, 佐々木 洋, 細川 夕菜, 澤田 秀匡, 佐藤 さゆり, 肥田 時征, 宇原 久

日本皮膚悪性腫瘍学会学術大会プログラム・抄録集 ( (一社)日本皮膚悪性腫瘍学会 )  35回   116 - 116  2019.04

小児期発症の病歴を持つメラノーマの病理組織学的検討

皆川 茜, 宇原 久, 芦田 敦子, 境澤 香里, 古賀 弘志, 奥山 隆平

日本皮膚病理組織学会抄録集 ( 日本皮膚病理組織学会 )  35回   50,31 - 50,31  2019.04

Efficacy of combined radiotherapy and anti-programmed death 1 therapy in acral and mucosal melanoma.

Junji Kato, Tokimasa Hida, Masanori Someya, Sayuri Sato, Masahide Sawada, Kohei Horimoto, Mao Fujioka, Tomoyuki Minowa, Yoshiyuki Matsui, Takaaki Tsuchiya, Mio Kitagawa, Kensei Nakata, Koh-Ichi Sakata, Toshihiko Torigoe, Hisashi Uhara

The Journal of dermatology   46 ( 4 ) 328 - 333  2019.04  [Refereed]  [International journal]

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Some studies showed that clinical response to immune check point inhibitors is lower in acral and mucosal melanoma than in cutaneous melanoma. Although the synergistic effect of radiotherapy (RT) and ipilimumab has been reported in patients with brain metastasis, the efficacy of combined RT and anti-programmed death 1 (PD-1) therapy for acral and mucosal melanoma is unclear. The present study aimed to evaluate the efficacy of combined RT and anti-PD-1 therapy for acral and mucosal melanoma. We retrospectively analyzed patients with acral or mucosal melanoma who were treated with anti-PD-1 and RT at Sapporo Medical University Hospital. In 10 patients (acral, 3; mucosal, 7), the response rate (RR) and the disease control rate (DCR) were 40% and 60%, respectively. As regards mucosal melanoma, four of the seven patients had achieved complete response + partial response, and three had progressive disease (RR = 57.1%). Meanwhile, two of the three patients with acral melanoma had stable disease and one had progressive disease (RR and DCR were 0% and 66.6%, respectively). Except for the patients treated with palliative RT for bone metastasis in the present study, the RR was 50% (4/8 patients), and the DCR was 75% (6/8 patients). Vitiligo developed after RT in five (50%) patients at a median duration of 2 months after RT. The clinical response and the high occurrence of vitiligo suggest that the combination of RT and anti-PD-1 therapy could be effective in some patients with mucosal melanoma.

DOI PubMed

Bowen病に合併したMerkel細胞癌の1例

辻 あすか, 大橋 敦子, 三宅 知美, 上條 史尚, 古賀 弘志, 宇原 久, 奥山 隆平

日本皮膚科学会雑誌 ( (公社)日本皮膚科学会 )  129 ( 4 ) 560 - 560  2019.04

根治切除不能な化学療法未治療の悪性黒色腫に対するニボルマブとイピリムマブ併用第II相試験(最終報告)

内 博史, 清原 祥夫, 竹之内 辰也, 宇原 久, 古賀 弘志, 山崎 直也

日本皮膚悪性腫瘍学会学術大会プログラム・抄録集 ( (一社)日本皮膚悪性腫瘍学会 )  35回   114 - 114  2019.04