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Volume 66 (2004)
- Issue 6 Pages 551-
- Issue 5 Pages 435-
- Issue 4 Pages 329-
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- Issue 2 Pages 113-
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Volume 66, Issue 5
Displaying 1-19 of 19 articles from this issue
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Clinical Case Reports
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Takahiko TSUNODA, Hiroko KOIZUMI, Takashi MASU, Hiroyuki ENDOH, Takash ...2004 Volume 66 Issue 5 Pages 435-438
Published: 2004
Released on J-STAGE: October 21, 2005
JOURNAL RESTRICTED ACCESSA 73-year-old woman with diabetes mellitus developed a deep ulcer after treatment for severe cellulitis on the dorsal region of her foot. After debridement, the ulcer was treated every day with topical hemotherapy by soaking with the patient's own fresh heparinized blood. Soaking was necessary because the ulcer, having an irregular margin, extended over a wide area. After 2 weeks of topical hemotherapy, new granulation tissue developed on the surface of the ulcer. Then trafermin spray was applied to the ulcer for 3 weeks. After 2 months, the ulcer was healed.View full abstractDownload PDF (3501K) -
Maiko SASAE, Takaaki AIKOH, Syunsuke SASAOKA, Makoto INAOKI, Wataru FU ...2004 Volume 66 Issue 5 Pages 439-443
Published: 2004
Released on J-STAGE: October 21, 2005
JOURNAL RESTRICTED ACCESSWe describe a 23-year-old man with cutaneous lupus erythematosus presenting with reticular erythematosus mucinosis (REM) on his back. Approximately a year ago, the patient had noticed development of violaceous erythema on the nose and left cheek, annular erythema on the chest and reticular erythema on the back. Histopathologic examination of the reticular erythema on his back revealed deposits of mucin throughout the upper and mid-dermis, no liquefaction degeneration and no immunoglobulin deposits in the basement membrane zone. These findings were compatible with REM. A biopsy specimen revealed lymphocytic infiltration and immunoglobulin deposits in the basement membrane zone. Results of laboratory tests were unremarkable except for mild leukocytopenia and positive anti-nuclear antibody and positive anti-SS-A antibody. The relationship between REM and lupus erythematosus was reviewed. REM should be regarded as a characteristic skin lesion associated with various underlying diseases but not as a single clinical entity.View full abstractDownload PDF (3832K) -
Shuko MISUMI, Koji MAKINO, Yoshihiro MAEKAWA2004 Volume 66 Issue 5 Pages 444-446
Published: 2004
Released on J-STAGE: October 21, 2005
JOURNAL RESTRICTED ACCESSA 28-year-old Japanese woman in the 27th week of pregnancy (G1P0) presented at our hospital. In the 25th week of pregnancy, she had developed red plaques and iris lesions on her forearms, dorsal hands, trunk and legs. Only the palms of both hands had vesicles. Histopathology revealed no subepidermal bulla, but spongiosis, bulla and numerous infiltrations of eosinophils were evident. Direct immunofluorescence study revealed C3 deposits along the basement membrane zone. Results of an indirect immunofluorescence study showed positivity for HG factor. Serum immunoblot methodology produced a reaction to the Nc16a domain of BP180kDa. These immunological findings were consistent with herpes gestationis. The patient responded well to treatment with oral corticosteroids. She gave birth to a girl with low body weight (2,422g). Evaluation of cord serum resulted in no abnormal immunological findings.View full abstractDownload PDF (2439K) -
Minako HIRAYAMA, Katsutaro NISHIMOTO, Ichiro KATAYAMA, Norito ISHII, T ...2004 Volume 66 Issue 5 Pages 447-450
Published: 2004
Released on J-STAGE: October 21, 2005
JOURNAL RESTRICTED ACCESSCase 1 was an 86-year-old Japanese male who noticed tense vesicles on his palms and soles accompanied by severe itching. Histopathology revealed subepidermal blisters with cell infiltration composed of eosinophils and lymphocytes. A linear C3 deposit at the basement membrane zone was seen by direct immunofluorescence. Indirect immunofluorescence detected anti-basement membrane zone IgG antibodies at a titer of 1 : 160. Indirect immunofluorescence using 1M NaCl split skin detected both IgG and IgA antibodies reacting with the epidermal side of the split. Immunoblotting studies showed that the IgG antibodies reacted with BP180. Case 2 was an 85-year-old Japanese male who noticed tense vesicles on his soles. New vesicles developed on his palms and trunk. Histopathology revealed subepidermal blisters with cell infiltration composed of eosinophils and lymphocytes. Linear IgG and C3 deposits at the basement membrane zone were seen by direct immunofluorescence. Indirect immunofluorescence detected anti-basement membrane zone antibodies at a titer of 1 : 160. Indirect immunofluorescence using 1M NaCl split skin detected both IgG and IgA antibodies reacting with the epidermal side of the split. Immunoblotting studies showed that IgG antibodies reacted with BP180. Both patients responded well to oral corticosteroid treatment.View full abstractDownload PDF (4481K) -
Mariko HOKOISHI, Misuzu MARUYAMA, Shinji MURAKAMI, Koji HASHIMOTO2004 Volume 66 Issue 5 Pages 451-453
Published: 2004
Released on J-STAGE: October 21, 2005
JOURNAL RESTRICTED ACCESSA 63-year-old Japanese female complained of a 9-month history of multiple subcutaneous nodules on her lower legs. She had been treated with oral betamethasone (3mg/day, total dose 7g, maximum dose 6 mg/day) for pemphigus vulgaris. Physical examination revealed multiple mobile subcutaneous nodules, 46 on the right leg and 38 on the left leg. The nodules were less than 5 mm in diameter. Several nodules were extirpated under local anesthesia. Histopathologically, the nodules were composed of mature fat tissue with various degrees of degeneration and membranocystic fat necrosis, and they were encapsulated by thick collagen. To our knowledge, 23 cases (including the present case) of multiple encapsulated fat necrosis have been reported. Fourteen cases had serious complications, seven cases received oral glucocorticoids, and one suffered from Cushing's syndrome. These reports implicate glucocorticoids in the pathogenesis of the development of multiple encapsulated fat necrosis.View full abstractDownload PDF (2637K) -
Ryoko SAKAMOTO, Akira GUSHI, Takuro KANEKURA, Tamotsu KANZAKI2004 Volume 66 Issue 5 Pages 454-457
Published: 2004
Released on J-STAGE: October 21, 2005
JOURNAL RESTRICTED ACCESSWe reported three cases of oral lichen planus. The one was a 78-year-old woman who had enlarging ulcer with hemorrhagic crust on the lower lip. The others were a 64-year-old and a 72-year-old woman who had painful and shallow ulcer in the oral mucosa. Oral administration of etretinate had no effect on them. All patients showed dramatic improvement with topical tacrolimus ointment within 1 to 3 weeks. Topical tacrolimus appears to be effective in controlling painful and recalcitrant oral lichen planus.View full abstractDownload PDF (3504K) -
Atsushi FUJITA, Joji TADA, Kenji IMAJO, Sae WADA2004 Volume 66 Issue 5 Pages 458-461
Published: 2004
Released on J-STAGE: October 21, 2005
JOURNAL RESTRICTED ACCESSA 56-year-old woman who had a large mass in the abdomen and had a high fever was referred to our hospital for further evaluation. A diagnosis of mantle cell lymphoma was made based on immunohistological examination of biopsy specimens obtained both from the left cervical lymph nodes and from bone marrow. During hospitalization many dark red papules with a keratotic plug and central umbilication had developed and were accompanied by severe itching on the entire body, excluding the scalp, face, palms and soles. Histopathological examination of skin biopsy specimens from one of the papules revealed vertically oriented, shallow, cup-shaped invagination of the epidermis forming a short canal. Within the canal, there were densely packed degenerated basophilic staining and basophilically-altered collagen bundles. These were detected by elastica van Gieson staining that extended with elastic fibers in the necrotic substances from the dermis. Based on these findings, acquired reactive perforating collagenosis with mantle cell lymphoma was diagnosed. Just after combination chemotherapy was started, the underlying original disease, the lymphoma, went into remission, and the pruritic skin eruptions subsided concurrently. The pathogenesis of the skin lesions is believed to be related to the severe pruritus and excoriation brought about by scratching to relieve the severe itching that accompanies mantle cell lymphoma.View full abstractDownload PDF (3437K) -
Minako YASUMOTO, Tsuyoshi MITSUISHI, Seiji KAWANA2004 Volume 66 Issue 5 Pages 462-465
Published: 2004
Released on J-STAGE: October 21, 2005
JOURNAL RESTRICTED ACCESSWe described two patients with acquired reactive perforating collagenosis arising on the extremities and trunk. These patients, with a history of diabetes mellitus for many years, developed multiple pruritic papules with a central adherent keratotic plug on the legs and trunk. Microscopic examination indicated marked transepidermal elimination surrounded by lymphocytic infiltrates in the epidermal-dermal junction. A plug consisting of a mixture of parakeratotic material within a cup-shaped epidermal depression was revealed. Immunohistochemical staining showed numerous fibroblasts around the perforating lesion that were strongly positive for Transforming Growth Factor-β3.View full abstractDownload PDF (5016K) -
Chikage TAKEO, Chiharu WATANABE, Ryokichi IRISAWA, Tsunao OH-I, Takuya ...2004 Volume 66 Issue 5 Pages 466-469
Published: 2004
Released on J-STAGE: October 21, 2005
JOURNAL RESTRICTED ACCESSThe present case concerns a 63-year-old male with zinc deficiency syndrome caused by a zinc-poor enteral diet. Four months after a total esophagectomy for treatment of advanced esophageal cancer, the method of feeding the patient was changed from intravenous hyperalimentation to enteral feeding. Some 20 days following the commencement of enteral nutrition, the patient began exhibiting erosions and scaly erythema accompanied by itchiness and sharp pain in the scrotum. The condition resisted treatment with various types of topical medication and gradually spread to other areas of the body, including the face, scalp, abdomen, extremities, and the perianal area, and was accompanied by alopecia and severe diarrhea. The serum zinc level showed a marked drop to 9 μg/dl. It was subsequently found that the enteral diet formula, Hinex R, contained no zinc. Supplementation of the patient's diet with zinc sulfate resulted in a normalization of serum zinc concentrations and the rapid remission of symptoms over the entire body.View full abstractDownload PDF (3511K) -
Shinya YAMANAKA, Makiko ODA, Mariko SEISHIMA2004 Volume 66 Issue 5 Pages 470-473
Published: 2004
Released on J-STAGE: October 21, 2005
JOURNAL RESTRICTED ACCESSWe report here basal cell carcinoma in two white women in their thirties. Case 1 : A 34-year-old white woman from New Zealand had two light red nodules, one on the left forearm and the other on the right chest. Case 2 : A 35-year-old white woman from U.S.A. had two light red nodules, one on the right shoulder and the other one on the left forearm. Histopathological diagnosis of these four nodules was basal cell carcinoma. We examined the differences in basal cell carcinoma between overseas patients and Japanese patients, including the 143 cases at our hospital during the past 15 years. There was a peak of onset in patients in their sixties, in both oversea patients and Japanese patients. The two cases described here are rare because the patients were only in their thirties at onset. Multiple basal cell carcinomas were found in 1.6-3.0% of Japanese and in 6.6% of U.S.A. patients. Approximately 80% of basal cell carcinomas are pigmented in Japanese patients and about 70% in Korean patients, while only about 10% are pigmented according to an overseas report from U.S.A. The high incidence of pigmentation in basal cell carcinoma is one of the characteristic features of basal cell carcinoma in Japanese and also in Korean patients.View full abstractDownload PDF (3105K) -
Tomoko NAGATA, Shigeo NONAKA, Hajime MIYASATO2004 Volume 66 Issue 5 Pages 474-478
Published: 2004
Released on J-STAGE: October 21, 2005
JOURNAL RESTRICTED ACCESSWe report a case involving leiomyosarcoma of the skin in a 44-year-old Japanese male. He visited our hospital complaining of a brown tumor on his right back. The lesion was considered to represent a benign tumor, such as nevus cell nevus, calcifying epithelioma, and dermatofibroma. The decision was made to continue observation without skin biopsy. However, the patient canceled follow-up without consultation. When he next visited the hospital, 2 years later, the lesion comprised an erythematous tumor with smooth surface, 56×42×30 mm in size. Dermatofibrosarcoma protuberance was suspected, and total excision was performed. Histologic examination revealed spindle cells with eosinophilic cytoplasm. Gitter staining revealed a so-called encased picture. Immunohistopathological staining for desmin and smooth muscle actin both yielded positive results. A diagnosis of leiomyosarcoma was made based on these findings, suggesting a muscle cell origin. As of 4 years post-operatively, no recurrence has developed. Only 60 cases of leiomyosarcoma of the skin have been reported in Japan.View full abstractDownload PDF (2319K) -
Susumu TAKAYASU, Nobuyoshi NASU, Tetsuji HOSHINO, Yutaka HATANO2004 Volume 66 Issue 5 Pages 479-481
Published: 2004
Released on J-STAGE: October 21, 2005
JOURNAL RESTRICTED ACCESSA 50-year-old man who had been administered allopurinol and several other drugs over a period of two years presented with erythematous maculopapular eruptions on the trunk and extremities. In addition, he had been administered vancomycin intravenously for 15 days concomitantly because of MRSA infection on the abdominal wall around the catheter for CAPD. A few days after the development of the skin eruptions, he developed a high fever, moderate liver dysfunction and marked neutropenia. Although he recovered upon withdrawal of all of these drugs, he again developed a similar skin rash, eosinophilia (35.5%) and low-grade fever when allopurinol and four other drugs were readministered orally. The condition rapidly resolved following withdrawal of allopurinol alone. From these findings, the eruptions, which appeared twice, were considered to be due to allopurinol hypersensitivity. Perhaps the high fever and neutropenia that accompanied the first episode were caused by vancomycin, which was detectable even six days after discontinuation of the drug. Adjuvant effects of skin infection and high fever and neutropenia caused by vancomycin might be associated with hypersensitivity to allopurinol, which had been used safely in this patient for two years.View full abstractDownload PDF (1640K) -
Tomotaka MABUCHI, Yoshinori UMEZAWA, Yukinori OHTA, Mariko IIZUKA, Tak ...2004 Volume 66 Issue 5 Pages 482-484
Published: 2004
Released on J-STAGE: October 21, 2005
JOURNAL RESTRICTED ACCESSWe report a case of benign symmetric lipomatosis (BSL) in a 56-year-old man. At the age of 50, the patient had noticed a soft mass on his neck. The mass progressively enlarged and spread over his shoulders and reached the upper arms. During this period, he gained 6 kilograms. The patient had been alcoholic for almost 35 years, and stopped drinking at the age of 55. Physical examination revealed soft, massive, symmetric, subcutaneous masses on the back of his body. These palpable masses eventually extended to the upper back, shoulders, neck and abdomen. The patient was diagnosed as having BSL. Liposuction was performed by our plastic surgical team twice and was very successful.View full abstractDownload PDF (3385K) -
Akio KONDOH, Yoshinori UMEZAWA, Yukinori OHTA, Mariko IIZUKA, Takashi ...2004 Volume 66 Issue 5 Pages 485-489
Published: 2004
Released on J-STAGE: October 21, 2005
JOURNAL RESTRICTED ACCESSCase 1 : A 69-year-old male presented with erosion in the right lower lip that appeared 10 years ago. The lesion showed erythema of 1.5×0.8 cm in diameter and erosion of 5 mm in diameter, respectively. Case 2 : A 59-year-old male presented with erosion in the left lower lip that appeared about 4 months ago. That lesion showed erythema of 1.2×0.7 cm in size and a shallow ulcer about 5 mm in diameter in the center. Histopathologically, both cases were diagnosed as plasmocytosis circumorificialis with a dense infiltration of plasmacytes found in the corium. Case 1 was almost cured with topical injection of triamcinolone acetonide. Case 2 was almost cured with topical administration of 0.1% triamcinolone acetonide. The treatment of plasmocytosis circumorificialis was studied in 73 cases reported in Japan. Topical administration of steroid preparations is given most frequently but its efficacy rate was low at about 40%. On the other hand, the efficacy rate of local steroid injection therapy, oral administration of griseofulvin and total resection was high at 82.3%, 50.0% and 85.7% respectively, although the number of cases reported was small. When the lesion is incurable with topical steroid therapy, other therapies should be tried.View full abstractDownload PDF (3955K)
Clinical and Investigative Report
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Tamotsu KANZAKI, Shimako MIZOGUCHI2004 Volume 66 Issue 5 Pages 490-493
Published: 2004
Released on J-STAGE: October 21, 2005
JOURNAL RESTRICTED ACCESSCoix seed extract tablets (18T/day) was administered to healthy volunteers (n=8), patients with malignant melanoma (MM) (n=5) or with adult T-cell leukemia (ATL) (n=11) for more than 2 months and natural killer (NK) cell activities and levels of interferon (IFN)-γ were examined in the peripheral blood before, during and after administrations. NK activity was enhanced from 49.6±7.50 to 58.4±7.32 (p<0.05) by Coix seed in healthy volunteers. IFN-γ levels did not change with Coix seed in healthy volunteers. NK cell activities did not change significantly in patients with MM or ATL although these activities were thought to decrease by diseases themselves and strong anticancer chemotherapies. IFN-γ levels were below the detection levels in these patients. These results suggest that Coix seed may be useful for cancer therapies and intractable verruca vulgaris as well.View full abstractDownload PDF (294K)
Statistics
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Makoto HASHIMOTO, Hajime IIZUKA, Hitoshi KUBO2004 Volume 66 Issue 5 Pages 494-503
Published: 2004
Released on J-STAGE: October 21, 2005
JOURNAL RESTRICTED ACCESSDermatophytes isolated from patients at the Division of Dermatology of Fukagawa Municipal Hospital during the 10-year period from April 1990 to March 2000 were analyzed. A total of 3563 patients with dermatophytoses were documented, accounting for 6.8% of all outpatients. Male/female ratio was 0.96, and the greatest incidence was observed in the age of sixties. Clinically, the most frequent dermatophyte infection was tinea pedis (61.5%), followed by tinea corporis (15.5%), tinea unguium (12.5%), tinea cruris (7.2%), tinea manus (2.7%), tinea capitis (0.3%), sycosis trichophytica (2 cases), trichophytia profunda acuta of the glabrous skin (2 cases), trichophytia profunda acuta of the terminal hair (1 case) and kerion celsi (1 case). Granuloma trichophyticum was not observed. Dermatophytes were successfully isolated in 51.7% of cases. The isolates consisted of 1252 strains (68.0%) of Trichophyton rubrum, 515 (28.0%) of T. mentagrophytes, 54 (2.9%) of Microsporum canis, 8 (0.4%) of T. verrucosum, and 6 (0.3%) of Epidermophyton floccosum.View full abstractDownload PDF (1555K) -
Tokuya OHSAWA, Kyoko HATTORI, Nanako YAMADA, Makoto KAWAKAMI, Masahiko ...2004 Volume 66 Issue 5 Pages 504-509
Published: 2004
Released on J-STAGE: October 21, 2005
JOURNAL RESTRICTED ACCESSA total of 47 cases of “mamushi” viper bite for which the Division of Dermatology, Matsue Red Cross Hospital was consulted from 1993 to 2000 were clinically evaluated. The incidence was about 6 cases per year and the most prevalent season was between July and September. Most of the patients were in their sixties. Most were bitten while working on a farm and were admitted to the emergency room of our hospital within 40 minutes after the bite. Bites were predominantly on the fingers and feet. Of the 47 cases of mamushi bites, 4 were treated with antivenin alone, 4 with cepharanthin alone and 39 were treated by a combination of these agents. Nine patients had a positive intracutaneous test for antivenin, and therefore were treated with cepharanthin. However, only 3 were cured and the remainder (6 patients) had exacerbations, both clinically (i.e. swelling) and with regard to results of laboratory tests (i.e. LDH, GOT and CPK.) Therefore, these 6 patients were given antivenin again after being desensitized for antivenin, and all were cured without any severe side effects.View full abstractDownload PDF (703K)
Therapy
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Juichiro Nakayama, Masutaka Furue, Kazutaka Makino2004 Volume 66 Issue 5 Pages 510-514
Published: 2004
Released on J-STAGE: October 21, 2005
JOURNAL RESTRICTED ACCESS -
Yoshihiro KATO, Yoichi SHINTANI, Akimichi MORITA2004 Volume 66 Issue 5 Pages 515-518
Published: 2004
Released on J-STAGE: October 21, 2005
JOURNAL RESTRICTED ACCESSVitiligo is a refractory skin disease that is resistant to oral and topical steroid, topical vitamin D3 and PUVA therapy. In recent foreign studies, narrow-band UVB was shown to be highly effective for the treatment of vitiligo. We treated 4 patients with generalized vitiligo (mean age 51 years). The mean duration of disease was 12 years. We initiated exposure from 50% of the minimal erythema and gradually increased the dose by 10% with each exposure. Maximum exposure dose was achieved when pigmentation was found in the lesion. Average exposure rate was 10 to 39 (9.8-38.4 J/cm2). Complete repigmentation was achieved in all cases with facial lesions, and one case of a truncal lesion. For another case of truncal lesions, slight repigmentation was noted. However, there was no repigmentation in hand lesions. These results indicated that narrow-band UVB should be very effective for treatment of generalized vitiligo, especially for facial and truncal lesions.View full abstractDownload PDF (2392K)
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