In the Sapporo Institute for Dermatopathology during the past 5 years, there have been 1,225 cases (1%) diagnosed as poroid cell neoplasms among a total of 122,506 specimens. Therefore, we consider poroid cell neoplasms to be a common disease. We reexamined the clinical data from the 421 cases. There were 199 men and 221 women (1:1.1). The average age was 63.9±15.0 years (12～98 years); 92.9% of patients were more than 40 years old at the time of exision. The tumors were mostly located on the lower extremities (43.4%), particularly on the foot (23.1%). The remainder were found on various regions. The average size was 8.2±5.0 mm (2～43 mm). Pedunculated lesions were the most common clinical form (47.3%). Clinically, this disease resembles seborrheic keratosis, pyogenic granuloma, and verruca vulgaris, so it is difficult to make an accurate clinical diagnosis. There is only 30 cases (7.3%), which made accurate diagnosis at the time of exision, difficult.
For 15 years from 1990 to 2004, 196 patients with Bowenʼs disease were seen at the Department of Dermatology, University of Occupational and Environmental Health, including 40 cases (20.4%) of the multiple type. The frequency of Bowenʼs disease among newly visiting outpatients was 0.61%, which was higher than those reported by other institutes. The average age of the patients at first visit was 73.0 years, and the male to female ratio was 0.77:1. The predilection sites of solitary Bowenʼs diseases were the lower extremities, followed by the trunk and upper extremities. The multiple type occurred on the fingers and palms, dorsa of feet, and legs. There were differences in the frequency of the multiple type among various areas in Kitakyushu City. In our retrospective search, tar was the most highly incident causative agent in the patients with multiple Bowenʼs disease; at least four patients had an occupational history of dealing with tar.
Objective: To establish the relationship between tumor thickness (TT) and metastatic rate of the sentinel lymph nodes (SLN) in Japanese patients with melanoma. Methods: A retrospective review of 259 patients who underwent successful SLN mapping and biopsy in 13 facilities in Japan from April of 2003 to June of 2006. The data were analyzed with the χ2 or Fisherʼs tests. Result: The metastatic rate of SLN in each T-classification category was as follows: pTis: 0% (0/36), pT1: 11.3% (6/56), pT2: 21.0% (13/63), pT3: 34.0% (35/103), and pT4: 62.4% (63/101). Two of T1 cases with SLN metastasis were T1b, and the remaining 4 cases with SLN metastasis were T1a, in which TT was 1.0, 0.8, 0.55, and 0.50 mm. Metastatic rates of SLN in patients with primary lesions over 4 mm in thickness were as follows: 4.01–5 mm: 40.0%, 5.01–6 mm: 57.9%, 6.01–7 mm: 53.8%, 7.01–8 mm: 62.5%, 8.01–9 mm: 87.5%, 9.01–10 mm: 87.5%, and 10 mm<: 72.0%. The metastatic rates of SLN were significantly higher in cases with ulcerated primary lesions than in those without ulceration in T1–T4 and T1–T3 groups (p<0.001). Conclusion: In melanoma patients with thicker primary lesions, the indication for SLN biopsy should be decided taking into consideration the predictive metastatic rates and locations of SLN. Further study is needed to define criteria for performing SLN biopsy in patients with melanomas less than 1.0 mm thick.
〔Methods〕Patients with toenail onychomycosis were divided into 2 groups; one group (250 mg group) was administered 250 mg terbinafine a day for 12 weeks, and the other group (125 mg group) was administered 125 mg a day for 24 weeks. The clinical features of the lesions had been classified into 2 clinical types; S-type (lateral edge, streak, spike, or lamellar splitting onychomycosis) or U-type (other onychomycosis). At 52 weeks, cure rates were calculated separately for each toe and for each clinical type. 〔Results〕Cure rates in the 250 mg group were 79.1% for the 1st toenails of U-type, 77.8% for the 1st toenails of S-type, 100% for the 2nd-5th toenails of U-type, and 94.4% for the 2nd-5th toenails of S-type. In the 125 mg group, the cure rates were 72.1%, 82.9%, 90.5%, and 100%, respectively. A comparison between the 2 dosage groups revealed no significant differences in cure rates (84.7% vs 82.6%). On the other hand, a sub-analysis based on patientsʼ characteristics revealed that the 1st toenails in both groups showed significantly lower cure rates compared with the extremely high cure rates of the 2nd-5th toenails and that there were no significant differences in cure rates between the different clinical types in either group. The cure rates of the 1st toenails were 78.6% (250 mg group) and 76.5% (125 mg group), while those of the 2nd-5th toenails were 98% (250 mg group) and 93% (125 mg group); there were no significant differences between the 2 dosage groups. There were no significant differences in occurrence rates of adverse events between the 2 groups, although the rate of liver dysfunction was significantly higher in the 250 mg group. 〔Conclusion〕Continuous oral administration of 125 mg terbinafine seems equally useful to that of 250 mg terbinafine for treatment of toenail onychomycosis, and the cure rate for the 1st toenail is significantly lower than that for the 2nd-5th toenails.