The infiltrating pattern of either nevocellular cells or melanin-laden nevocellular cells and the relationship between this and the size of the nevus were examined. Age-related changes in the infiltrating patterns of these nevocellular cells were also examined. The nevi were classified into 3 types according to the depth of infiltration and into 2 types according to the infiltration pattern of nevocellular cells. Furthermore, each nevus was also classified into 3 types by the location of the melanin-laden nevocellular cells. The relationship between the size of the nevus (small, middle-sized, large) and the infiltrating patterns of nevocellular cells was positive; the larger the nevus becomes, the deeper the infiltration of the nevocellular cells. In the small nevi located only in the head and neck region, the melanin-laden nevocellular cells locate in the papillary dermis in the young and gradually proceed deeper into the dermis with age. This phenomenon was not seen in the nevi on other parts of the body. These obsevations suggest that early dermabrasion of the small nevi located on the head and neck with a laser, may remove the pigmentation caused by the melanin-laden nevocellular cells.
We performed a clinicopathological study of mixed tumor of the skin (MTS) in 130 cases. These included 78 male and 52 female cases ; the average age at resection was 54.6 years. Most cases arose on the face (119 cases: 92%). Histopathological examination revealed that the apocrine type of MTS contains glandular structures with decapitation secretion and ductal structures consisting of poroid and cuticular cells. We comfirmed the histopathological findings as follows: 1) 126 cases (97%) were apocrine type and only 4 cases (3%) were eccrine type, 2) cells with myoepithelial differenatiation (plasmacytoid cells), were observed in 114 cases (88%), 3) keratinous cysts were observed in 61 cases (47%), and aggregations of follicular germinative cells were seen in 54 cases (42%), 4) sebaceous differentiation was seen in 5 cases (4%), 5) connection to the epidermis was confirmed in 9 cases (7%), 6) the solid portion occupied a large area, in 55 cases (42%) and a solid portion was not confirmed in 8 cases (6%), 7) myxoid change were seen in 125 cases (96%), chondroid changes, in 43 cases (33%), osteoid changes, in 11 cases (8%), and adipotic changes, in 46 cases (35%).
In order to evaluate the clinical validity of the self-administered Psoriasis Area and Severity Index (Self-PASI)，the patient’s self-reported index for psoriasis severity, we examined associations between Self-PASI and Self-BSA scores with PASI and BSA scores, the physician’s reported index, in 200 Japanese psoriasis patients. Furthermore, we examined the associations between those indices and the psoriasis-specific QOL related index (the Psoriasis Disability Index, PDI) and the comprehensive health-related QOL index (Short Form-36, SF-36). In a results, the correlation coefficients were found to be significant between the patients’ and physicians’ reported indices (0.65 for SAPASI and PASI, 0.69 for Self-BSA and BSA). The correlation coefficients for Self-BSA and BSA were high for the trunk, upper extremities, and lower extremities, but were low for the head. The PDI score has a higher association with Self-PASI and Self-BSA scores than did the PASI and BSA scores. However, compared to the PDI score, the SF-36 score had a lower association with SA-PASI and Self-BSA. In conclusion, the Self-PASI has been shown to be valid and useful in clinical practice for Japanese psoriasis patients.
In 2006, questionnaire surveys related to surveillance, recognition, and reporting of Tsutsugamushi disease and Japanese spotted fever were conducted with dermatologists in Kumamoto and Miyazaki prefecture. The response rate was 60% (73/121) in Kumamoto and 53% (27/51) in Miyazaki. Of the dermatologists in Kumamoto, 74% and 51% knew that Tsutsugamushi disease and Japanese spotted fever were notifiable diseases, respectively. Recognition of these surveillance systems among Miyazaki dermatologists was at almost the same level as Kumamoto. However, in the survey in 2001, only 26% of Kumamoto dermatologists had known that Tsutsugamushi disease was notifiable. In 2005, 7 Tsutsugamushi disease cases were clinically diagnosed. Among them, 3 were laboratory confirmed and 2 were reported by a Kumamoto dermatologist. Among the dermatologists in Miyazaki, 2 Tsutsugamushi disease cases were clinically diagnosed and 1 case was confirmed and reported. One Japanese spotted fever case was clinically confirmed and reported by a dermatologist in Miyazaki. Facilities for laboratory confirmation of these diseases are limited in these areas. A larger survey is needed for surveillance evaluation of laboratory confirmation and reporting.