Recently we treated three patients who were more than 90 years old and had hemangiosarcoma of the scalp. They had no distant metastasis. Considering their extreme ages, we treated them only with massive electron-beam fractionated radiotherapy (2.5 Gy per day×28 times, total 70 Gy), which was completed within 6 weeks. All the cases responded very well to this treatment without any radiodermatitis or systemic side effects. This treatment shortened their admission time and allowed easy care after discharge. They have had no recurrences in the follow-up terms of six months, one year five months, and two years, respectively. We suggest that this radiotherapy can supply a high QOL for extremely old patients with hemangiosarcoma.
We studied the clinicopathological data from 691 cases of primary cutaneous squamous cell carcinoma (SCC) selected from the cases diagnosed at Sapporo Institute for Dermatopathology between May of 2001 and December of 2005. We divided these cases into four categories: Solar keratosis type, Bowen type, Keratoacanthoma type, and others, according to the classification of Ackerman and co-workers. The patient group was comprised of 325 men (47.0%) and 366 women (53.0%). Average age at resection was 80.1 years (men: 75.2 years ; women: 84.4 years). SCC occurred the most frequently on the face (59.0%). The cases of solar keratosis type (322 cases: 48.0%) were the most frequent, followed by Bowen type (114 cases: 20.8%), and Keratoacanthoma type (87 cases: 12.6%). On the face, the solar keratosis type was dominant, although the Bowen type was dominant in trunk and extremities. In 19 cases, we decided that the lesions arose on traumatic scars, including burn scars. Our data revealed that primary cutaneous SCC in Japan occurs most frequently on the face and arises especially on solar keratosis. We proved that SCC caused by ultra-violet irradiation has increased in Japan. Therefore, it is important to encourage ultra-violet protection and to diagnose and treat solar keratosis, conclusively.
There are only a paucity of data and information on the prevalence and natural history of nevi on the hands and feet, especially among young children. We examined the prevalence of nevi on four regions of the skin, including the palms, dorsa of hands, soles, and dorsa of feet on children aged 0–6 years old who participated in a cohort study. Fifty-eight of 1,011 children (5.7%) had nevi on the dorsa of their hands, 33 (3.3%) on their soles, 26 (2.5%) on their palms, and 23 (2.3%) on the dorsa of their feet. The prevalence of nevi was highest on the dorsa of the hands, indicating a plausible influence of frequent exposure to ultraviolet rays. The prevalence of nevi increased gradually until the age of 3 years old and then plateaued. Nevi on the soles were likely to be larger than those on other areas, but there werenʼt any statistical differences. There was no correlation between the size of nevi and age. In our cohort study, 89 children had skin examinations in both 2004 and in 2006. Interestingly, 6 out of 11 (54.4%) nevi which had been present in 2004 had disappeared by 2006. Furthermore, 13 of the 78 children who had had no nevi on any of the 4 areas in 2004 had developed new nevi by 2006.
Royal jelly (RJ) is contained in health supplements, health food products, and cosmetics. We reported two cases of immediate hypersensitivity to RJ. In the skin prick test, a positive reaction was observed in response to two commercial RJ extracts in both cases. In immunoblotting, we detected bands at MW 47 kDa, 55 kDa, and 65–70 kDa. Among these proteins, no component of MW 65–70 kDa has previously been reported. From these findings, we suspect that this component may be a new and important allergen to RJ. However, this has not yet been proven by the skin prick test or the oral provocation test for the ethical problem.