The Japanese Journal of Dermatology
Online ISSN : 1346-8146
Print ISSN : 0021-499X
ISSN-L : 0021-499X
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Volume 119, Issue 11
Displaying 1-9 of 9 articles from this issue
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Seminar for Medical Education
Review Articles
Original Articles
  • Four Cases of Drug Eruptions Caused by Blutal®, a Chondroitin Sulfate-iron Colloid
    Mari Iwasawa, Kazuhiko Yorifuji, Toshihiko Toida
    Article type: Original Articles
    2009 Volume 119 Issue 11 Pages 2165-2171
    Published: October 20, 2009
    Released on J-STAGE: November 28, 2014
    DOIhttps://doi.org/10.14924/dermatol.119.2165
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    Blutal®, a chondroitin sulfate-iron colloid, is a drug used for the treatment of iron deficiency anemia. Drug eruptions caused by Blutal® suddenly increased from 1–5 cases/year to 204 cases/year after the chondroitin sulfate source was changed from bovine to shark in November 2005. Blutal® was recalled in July 2006, and the number of sufferers has not increased since. However, the cause of the drug eruption has not previously been investigated. We encountered 4 cases of drug eruptions caused by Blutal® between March and May of 2006. In all the cases, we observed punctuate erythema and occasional diffuse erythema along with the presence of small-sized vesicles and pustules in severe lesions. A biopsy of the pustular lesions revealed intraepidermal pustules and spongiosis with perivascular lymphocytic infiltration. We analyzed the chondroitin sulfates sourced from cattle and sharks by 500-MHz proton nuclear magnetic resonance (1H NMR). Chondroitin sulfate originating in cattle was mainly composed of the H-4 of 4-O-sulfo-N-acetylgalactosamine (CSA), and the chondroitin sulfate originating in shark was mainly composed of the H-6 of 6-O-sulfo-N-acetylgalactosamine (CSC). It is known that the principal ingredient of human chondroitin sulfate is CSA. Therefore, it is possible that differences in structure with regard to sulfation, molecular weight, etc., caused the drug eruptions.
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  • The Efficacy of a 308-nm Monochromatic Excimer Lamp Targeted UVB Phototherapy for Various Skin Diseases
    Maki Yokogawa, Tomoya Takata, Yumie Nagano, Mitsunori Ikeda, Shigetosh ...
    Article type: Original Articles
    2009 Volume 119 Issue 11 Pages 2173-2180
    Published: October 20, 2009
    Released on J-STAGE: November 28, 2014
    DOIhttps://doi.org/10.14924/dermatol.119.2173
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    The xenon chloride excimer lamp emits 308-nm monochromatic UV with a 180-fold higher energy than conventional narrow-band UVB, offering a novel targeted phototherapy for treatment of various skin diseases. Here we evaluated its therapeutic efficacy in 31 cases, including seven patients with psoriatic erythemas, three with nail psoriasis, eleven with vitiligo, two with scleroderma, and eight with other problems. Most of psoriatic erythemas and vitiliginous lesions rapidly improved following irradiation, despite the fact that some of them had previously been resistant to narrowband UVB irradiation, suggesting that the excimer lamps had a therapeutic superiority. However, nail involvement in patients with psoriasis and lichen planus showed no favorable response. Interestingly, one patient with scleroderma and another with pretibial myxoedema showed remarkable improvements, respectively, with reduction of skin stiffness and flattened erythematous plaques associated with reduction of mucin deposition in the dermis. We conclude that treatment with 308-nm monochromatic excimer lamp represents an alternative UV therapy not only for psoriasis and vitiligo but also for lesions in the dermis.
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  • Analysis of Recurrent Cases of Keloids and Highly Hypertrophic Scars Treated with Postoperative Electron Beam Irradiation
    Takafumi Chin, Hiko Hyakusoku
    Article type: Original Articles
    2009 Volume 119 Issue 11 Pages 2181-2186
    Published: October 20, 2009
    Released on J-STAGE: November 28, 2014
    DOIhttps://doi.org/10.14924/dermatol.119.2181
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    Between 1988 and 2008, we followed 375 regions from patients with keloids or highly hypertrophic scars who were treated with surgical removal and postoperative electron beam irradiation for over 8 months after their operations. A statistical analysis was performed and therapeutic outcomes were evaluated. The overall recurrence rate was 29.0%. The results of analyzing the therapeutic outcomes clarified that it is important to consider not only sites but also causes. On the basis of medical records, the recurrence rate was high in cases of 3-pointed suture and poor adaptation of the suture. When usig the techniques of surgical removal and postoperative electron beam irradiation, our data indi cate that it is important to reduce skin tension, stitch the deep dermal layer, and avoid the 3-pointed suture.
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  • The Relationship between the Appearance of the Characteristic Skin Eruption and HHV-6 Reactivation in Drug-induced Hypersensitivity Syndrome (DIHS)
    Hidenori Okazaki, Mikiko Tohyama, Shinji Murakami, Manami Ishikawa, Na ...
    Article type: Original Articles
    2009 Volume 119 Issue 11 Pages 2187-2193
    Published: October 20, 2009
    Released on J-STAGE: November 28, 2014
    DOIhttps://doi.org/10.14924/dermatol.119.2187
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    We studied the relationship between the appearance of the characteristic skin eruption and HHV-6 reactivation in DIHS. Six patients with DIHS, who were treated in Ehime University Hospital from 2001 to 2007, exhibiteded the characteristic skin eruption pattern that included erythema and edema in the face and perioral red papules, pustules, vesicles and scales. HHV-6 reactivation was observed in all six patients. The exact date of HHV-6 reactivation was confirmed by quantitative real-time polymerase chain reaction assay of serial serum or whole blood samples. In all DIHS six patients, the characteristic skin eruptions in the face always preceded HHV-6 reactivation. This is the first time that this characteristic sequential response has been elucidated.
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