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Livedoid vasculopathy secondary to high levels of lipoprotein(a)

fibrils were found around dermal fibroblasts in the culture with 25% serum (Fig. 2). We repeated these experiments three times and obtained similar results. In the skin, dermal fibroblasts, which are surrounded by dermal matrix, produce ECM including collagen, elastin and other matrix proteins, and also communicate with each other and other cell types such as epidermal keratinocytes, playing an important role in the regulation of skin physiology. Especially in cutaneous wound healing, the property of dermal fibroblasts to produce ECM is much more remarkable than in normal conditions. In vitro, dermal fibroblasts proliferate and synthesize ECM in response to several hormones or growth factors. Dermal fibroblasts grow well in the presence of FBS but are subject to density-dependent inhibition of growth when a confluent monolayer is formed. However, recently we found that post-confluent dermal fibroblasts alone in a special culture condition could form dermal equivalents in a culture dish. Moreover, epidermal growth factor (EGF) and insulin in a post-confluent culture of dermal fibroblasts alone produced a dermis-like tissue. In a preliminary study, we found that without serum EGF and insulin we could not induce a dermis-like tissue. Thus, in this study we hypothesized that serum may play an important role in the formation of a dermal equivalent. As a result, a high concentration of serum alone without exogenous materials produced a threedimensional tissue. Macroscopically and microscopically, the three-dimensional tissue induced by a high concentration of serum showed some features that were similar to those of normal human dermis in vivo. In addition, a dermis-like tissue was supported by immunohistochemical and ultrastructural studies. Serum is one of the most important factors that affect the growth and synthetic activities of cells. It is known to stimulate collagen production by fibroblasts. Serum is a mixture of numerous substances. The substances in the serum may together influence cell growth and ECM synthesis of dermal fibroblasts, resulting in the formation of the dermal matrix. Our results showed that a dermal equivalent could be formed by culturing dermal fibroblasts alone with a high concentration of serum, suggesting that serum plays an important role in the formation of a dermal equivalent without exogenous materials. Further study is necessary to evaluate what components in the serum are important for the formation of ECM. In addition, in order to prepare a xenobiotic-free substitute human serum will be necessary instead of FBS.