The Japanese Journal of Dermatology
Online ISSN : 1346-8146
Print ISSN : 0021-499X
ISSN-L : 0021-499X
Volume 120 , Issue 14
Showing 1-8 articles out of 8 articles from the selected issue
Seminar for Medical Education
Special Report
Original Articles
  • Ryoko Shimada, Katsuko Kikuchi, Tomoyuki Ohtani, Masato Mizuashi, Taka ...
    Type: Original Articles
    2010 Volume 120 Issue 14 Pages 3097-3101
    Published: December 20, 2010
    Released: November 28, 2014
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    “Stomahesive” powder is used as a skin-care product for the management of stomas. We successfully treated a 3-month-old boy who had an intractable skin ulcer on his buttocks with this skin-protection powder. His ulcer emerged on the left sacral region where he had an erythematous patch from birth. Although he had been treated with various ointments, the ulcer rapidly expanded after the onset of diarrhea. We implaced a urine catheter and started daily application of the skin-protection powder “Stomahesive” on the ulcer after washing. A gel formed from the powder and wound discharge covered the wound and moistened it like a hydrocolloid dressing and prevented skin irritation from the feces due to its pH buffering system and absorption of excess water. After each evacuation, we removed the feces and gel and then re-applied the skin-protection powder without re-washing the wound. The “Stomahesive” powder may be considered as one of the useful therapeutic option for intractable ulcers, especially on the buttocks or vulva, where there is often irritation from feces or vaginal discharge.
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  • Saori Watanuki (Kudo), Juria Miyamoto, Masafumi Ishibashi, Ko-Ron Chen
    Type: Original Articles
    2010 Volume 120 Issue 14 Pages 3103-3108
    Published: December 20, 2010
    Released: November 28, 2014
    JOURNALS RESTRICTED ACCESS
    A 72 year-old Japanese male had asymptomatic erythematous plaques with erosions on both dorsal hands and fingers. Histopathological features included dense dermal neutrophilic infiltration with collagen fibrolysis and absence of vasculitis. Four weeks later, concurrently with ulceration of the lesions on the hands, varied eruptions appeared on the other sites, including erythematous plaques and folliculitis, purpuric papules on the legs, and pustulosis palmoris et plantaris-like eruptions on both palms. Histopathological features of the purpuric papules included vasculitis with neutrophilic and lymphocytic infiltration. All the eruptions improved after 3 weeks of treatment with minocycline and topical steroid, and no scars remained. Based on the clinical and histopathologic findings, our case fits into the category of neutrophilic dermatoses. The various histopathological patterns of neutrophilic infiltration in the epidermis and dermis account for the diverse eruptions. Physicians should be aware that pyoderma gangrenosum-like lesions occurring on the dorsal hands that are similar to lesions of atypical mycobacterium may present as the initial manifestation of a neutrophilic dermatosis.
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  • Yukari Urabe, Mikiko Tohyama, Yuji Shirakata, Shinji Murakami, Koji Ha ...
    Type: Original Articles
    2010 Volume 120 Issue 14 Pages 3109-3114
    Published: December 20, 2010
    Released: November 28, 2014
    JOURNALS RESTRICTED ACCESS
    In 1998, a 31-year-old man visited us with a 7 year history of recalcitrant psoriasis. He was treated with topical corticosteroid, vitamin D3, oral etretinate, methotrexate, and PUVA. In 2004, without any prodromal symptoms, high fever and painful pustules developed within psoriatic plaques with erosions of oral mucosa. A diagnosis of Kaposiʼs varicelliform eruption was made and followed by an intravascular administration of acyclovir. The fever subsided in a few days. However, bullae and erosions developed at the margin of the psoriatic plaques. A skin biopsy of a bulla revealed acantholytic blister, and a direct immunofluorescence test showed intercellular depositions of IgG and C3 in the epidermis. A diagnosis of pemphigus vulgaris was made, and the patient was treated with oral prednisolone 60 mg/day and methylprednisolone pulse therapy (1 g/day, three days). The coincidence of pemphigus vulgaris with psoriasis vulgaris is a rare phenomenon, and the development of psoriasis vulgaris precedes that of pemphigus vulgaris in most cases. According to some previous case reports, a herpes simplex virus infection can provide a clue to a diagnosis of pemphigus.
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  • Rie Nakamura, Kenichi Morimoto, Ikuko Hori, Shuji Yonehara, Keiko Hana ...
    Type: Original Articles
    2010 Volume 120 Issue 14 Pages 3115-3120
    Published: December 20, 2010
    Released: November 28, 2014
    JOURNALS RESTRICTED ACCESS
    A sixty-year-old Japanese female with severe articular contracture caused by a brain tumor and infarction had an erythematous plaque on her right labina major and perianal region. Biopsy revealed Pagetʼs cells in the epidermis. Using immunostaining, carcinoembryonic antigen (CEA) and cytokeratin 7 (CK7) were positive in the tumor cells. No abnormal findings were observed in urethral, vaginal, or intestinal epithelium. Computed tomography showed no lymph-node swelling or distant metastasis. Thus the tumor was diagnosed as extramammary Pagetʼs disease of T1N0M0, stage IA. Neither surgery nor radiation therapy could be applied because of severe contracture of the hip and knee joint, so topical imiquimod 5% cream was applied topically and washed out 7 hours later. The treatment was repeated three times per week. The lesion resolved after 6 weeks of treatment. Rebiopsy showed no residual tumor, and both CEA and CK7 were negative. The patient was free from recurrence during five months of observation. She complained of irritation, but the problem was resolved by topical application of steroid ointment. No severe adverse effects were was observed. We conclude that topical imiquimod therapy is worth trying for the treatment of an early stage of extramammary Pagetʼs disease, when surgery is not a viable option.
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