PUVA therapy has long been used to treat psoriasis vulgaris, and, in 1999, narrow-band UVB was introduced for various skin diseases in Japan. Although narrow-band UVB and suction blister treatment are commonly used to treat vitiligo vulgaris, we have experienced refractory cases in which the response to these modalities is relatively poor. In this study, autologous miniature punch grafting (1mm) was performed in 5 patients with segmental vitiligo, 4 with disseminated vitiligo, and 1 with localized vitiligo. Pigmentation was regained in an average of 62% of those with segmental vitiligo within 2 to 7 months and in 17.5% of those with disseminated vitiligo within 4 to 10 months. Our findings suggest that autologous miniature punch grafting should be considered for the treatment of segmental vitiligo, because it does not require postoperative rest or cause scar formation.
Bullous pemphigoid (BP) is an autoimmune blistering disease in which autoantibodies to BP antigens (BP 230 and/or BP180) are thought to be pathogenic. We report herein three cases of BP showing only anti-BP230 antibodies. All 3 cases (a 73-year-old male, a 54-year-old female, and a 59-year-old female) had generalized erythema, blisters and erosions, which immediately disappeared when treated with oral corticosteroids and/or double filtration plasmapheresis. In all 3 cases, immunoblot analysis failed to detect anti-BP180 antibodies, although antibodies to the C-terminus of BP230 were detected. The detailed roles and functions of anti-BP230 Ab in BP are still obscure. It remains necessary to clarify the pathogenicity of anti-BP230 antibodies by accumulating information about the relationship between clinical presentations and antibody profiles in more cases with BP.
We report patient with atopic dermatitis who had pigmentation resembling Laugier-Hunziker-Baran syndrome. The patient was a 66-year-old female hairdresser with pigmented macules on the lips, buccal mucosa, and hands. Histopathologically, hyperpigmentation was observed on the basal layer and melanophages were scattered in the upper dermis. The patient had neither a family history nor intestinal polyposis. We decided that these pigmented macules were postinflammatory pigmentation induced by broad chronic stimulation. The pigmented lesion on the lips corresponded to atopic labial melanosis (labial melanosis with atopic dermatitis). We feel that this case is instructive to demonstrate the correspondance between Laugier-Hunziker-Baran syndrome, labial melanotic macules, labial melanosis, and atopic labial melanosis.
We performed a clinicopathological study of 161 cases of sebaceoma, which had been diagnosed at the Sapporo Institute for Dermatopathology between May 2001 and August 2006. They included 67 male cases and 94 female cases. The average age at resection was 62.7±16.5 years. That of females (65.2±16.2 years) was a little higher than that of males (59.2±16.5 years). The lesions were most frequently located on the face (72 cases: 44.7%) and next most frequently on the scalp (51 cases: 31.7%). Only 10 cases (6.2%) were located on the eyelid. In male patients, 37 lesions (40.3%) were located on the scalp and 17 lesions (25.4%) the on face, but, in female patients, 55 lesions (58.5%) were located on the face and 24 lesions (25.5%) on the scalp. Only about 10% of the lesions were clinically diagnosed as sebaceous neoplasms. In 19 lesions (11.8%), a sebaceous nevus was associated. The average age at resection of the patients with sebaceous nevus (48.3±23.0 years) was significantly lower than that of the patients without sebaceous nevus (64.7±14.3 years). Trichoblastoma was associated in 13 cases (8.1%) and basal cell carcinoma in 5 cases (3.1%). Seven out of 13 cases (53.8%) of the lesions associated with trichoblastoma and all five cases of the lesions associated with basal cell carcinoma also showed an association with sebaceous nevus. Ten cases (7.0% of the cases without sebaceous nevus) were associated with seborrheic keratosis. These data reflect the characteristic clinicopathological data for sebaceoma in Japanese.