A 29-year-old male visited our Dermatology Department with a complaint of a subcutaneous mass in the posterior cervical triangle. Because ultrasonography suggested that the mass was a lymph node in the superficial subcutaneous tissue, he underwent biopsy of the mass under local anesthesia. Soon after the biopsy, he suffered pain in the left upper arm and an inability to abduct the arm beyond 90°. Iatrogenic accessory nerve injury was diagnosed at the Orthopedic Department. Nerve suturing was performed 78 days after the biopsy, and the patient had fully recovered by seven months after the nerve repair. In order to avoid iatrogenic accessory nerve injury and its associated medical complications, it is important to understand that medical accidents can occur during surgery in the posterior cervical triangle. Medical practice on this area is mainly handled by otolaryngologists, and it is important to refrain from promptly scheduling any examinations or operations in the Dermatology Department. Before any surgery, informed consent should be obtained after providing a sufficient explanation of the potential complications of such surgery.
Herein we report a mycosis fungoides (MF) patient who did not show specific symptoms in the early stages of the disease but was finally diagnosed with MF. A 71-year-old woman, who had suffered from eruptions with itching on her trunk and extremities for 3 years, exhibited patches and papules symmetrically on the axilla, breast, and abdomen. Histological analysis revealed single lymphocytes scattered in the epidermis. However, the lymphocytes in both the epidermis and dermis showed no atypical features. Based upon the skin biopsy, she was diagnosed with prurigo or papuloerythroderma. However, seven years after her primary consultation, histopathology from the patient revealed Pautrier’s microabscesses and atypical lymphocytes, the characteristics of MF. Moreover, a T-cell receptor gene rearrangement from cells of the skin and blood of the patient showed clonality. We discuss the possibility of diagnosing this patient as early MF from the beginning of the symptoms.
The aim of this study was to evaluate whether copper is effective in preventing the spread of contamination with methicillin-resistant Staphylococcus aureus (MRSA) on the touch surfaces of equipment utilized in the hospital ward. First, we tested the bactericidal activity of copper against two type strains of MRSA and S. aureusin vitro. The bacterial counts of MRSA gradually decreased in proportion to the incubation time, as did those of S. aureus, and they fell below the level of detection by 180 minutes. These bactericidal effects of copper were completely inhibited by overlaying the surface with a Millipore membrane filter before starting the test. Our results indicate that copper can have a strong bactericidal effect against S. aureus, including MRSA, and that it is important that the bacteria directly touch the surface of copper for manifestation of its bactericidal activity. Subsequently, when a copper plate was installed on a floor that was highly contaminated with MRSA around the bed of a MRSA-carrying patient in the dermatology ward, the bacterial number of S. aureus, including MRSA and the other Staphylococcus, on the floor surface covered with copper plate significantly decreased when compared with that on unprotected areas as a control. These results suggest that the copper plate helped to prevent the spreading of MRSA contamination in the hospital.
The DLQI is the most frequently used questionnaire for evaluating the impact of dermatological diseases on patients’ QOL. Twelve hundred and two new Japanese outpatients from the Department of Dermatology, Kyushu University Hospital, were assessed for the influence of age, gender and diagnostic category on patients’ QOL using the Japanese version of the DLQI. We found that women had a worse QOL on the emotion scale than men and younger patients had a poorer QOL than older ones. Eczema patients had the highest mean scores throughout the various diagnostic categories, whereas patients with tumors had the lowest. We also compared the results of the DLQI with those from the Skindex16.