To objectively evaluate the efficacy of moisturizers, we studied their effects on the artificially dried skin of healthy subjects in a randomized controlled trial (RCT) and also examined the effect of one moisturizer on the dry skin of patients with atopic dermatitis, using dermato-physiological parameters. A heparinoid preparation (Hirudoid®Soft), 20% urea preparation, or petrolatum was applied once daily for 3 days onto acetone/ether-water-dried skin of the medial forearm. The heparinoid preparation and the urea preparation significantly improved the water content of the stratum corneum. The heparinoid preparation was significantly more effective than petrolatum in improving the water content of the stratum corneum and was superior to the urea preparation in earlier recovery from dryness. Transepidermal water loss (TEWL) and dermatological findings significantly improved with all three drugs. The heparinoid preparation was also applied onto atopic dry skin twice daily for 3 weeks. The heparinoid preparation significantly improved the water content of the stratum corneum and dermatological findings, but TEWL and itching were not reduced. This study demonstrated the efficacy on dry skin of the heparinoid preparation, the urea preparation and petrolatum, all drugs being used for improvement of dermato-physiological dysfunction, as well as the efficacy of the heparinoid preparation for atopic dry skin.
We present 2 patients with clinically amyopatic dermatomyositis (C-ADM) with antibody against the 140 kDa protein antigen. Patient 1 is a 65-year-old woman who developed erythema on her face, back and chest with general fatigue and appetite loss. Her chest X-ray and CT scan showed interstitial pneumonia (IP). She was treated with steroid therapy. Patient 2 is a 75-year-old woman, who first noticed erythema on her palms. Her chest X-ray showed slight IP, which exacerbated rapidly with dyspnea after 4 months. She was treated with 50 mg/day of prednisolone and 150 mg/day of cyclosporine A. Laboratory examinations showed high levels of KL-6, without elevation of CPK, aldolase and myoglobin in both patients’ sera. In addition, antibody against 140 kDa protein antigen was detected in sera by immunoprecipitation. Based on these findings, a diagnosis of C-ADM with rapidly progressive interstitial pneumonia was made for both patients. Although C-ADM is rarely positive for antibody against the 140 kDa protein antigen, more attention should be paid, because positive patients often develop rapidly progressive interstitial pneumonia.
Both members of a married couple were found to suffer from Extramammary Paget’s disease. The husband, a 70-year-old man, had erythematous lesions on the penile and left scrotal skin. His wife, a 65-year-old woman, had similar lesions extending from both labia majora to the clitoris. Both were diagnosed with extramammary Paget’s disease by histopathological examination. Although rare cases of familial occurrence of extramammary Paget’s disease have been previously reported in the literature, there has been no such report of extramammary Paget’s disease in a married couple. Infectious or environmental etiology may be supposed to be operating, although this simultaneous occurrence of EMPD in a married couple may be coincidental.
Peripheral skin perfusion pressure (SPP) was measured in order to screen for peripheral vascular disorders of the lower extremities associated with diabetes, and the utility of this test was examined. The subjects were 110 patients with an average age of 65.3 years and a mean HbA1c value of 7.63%．Among these cases, 89 were clinically considered to have poor peripheral blood flow. This poor blood flow was complicated by ulcer or gangrene in 40 cases, and limb amputations became necessary during the observation period in 17 cases. The laboratory values obtained from SPP measurement were compared with those of the ankle brachial pressure index (ABPI) by single regression analysis. Then, using the ROC curve, the cases were grouped based on the presence of ischemia, ulceration, and limb amputation. The prevalence and specificity of SPP and ABPI were examined, and cutoff values were obtained for each item. The results showed comparatively good correlations between SPP and ABPI by regression analysis. According to the ROC curve, both the prevalence and specificity of SPP were superior to ABPI for all of the items. The SPP cutoff values were 60 mmHg for ischemia, 45 mmHg for ulceration, and 30 mmHg for limb amputation. Good correlations were observed between cutoff values and clinical findings.