We analyzed the clinical and histopathological features and therapeutic outcomes of 30 lesions treated by cryosurgery and 19 lesions by topical therapy with imiquimod among the 80 lesions pathologically diagnosed as actinic keratosis and treated at the Dermatology Department of Sapporo Medical University Hospital from January 2006 through September 2012. The clinicopathological characteristics, including age and clinical and pathological features of the lesions of the two treatment groups, showed no statistically significant differences. The cryosurgery resulted in a complete response (clearance) in 83.3% (25/30) of the patients, and the imiquimod treatment clearance rate was 100% (19/19). In the present study, we discuss in detail the relationships between histopathological features such as acanthosis, atypical keratinocytes, follicle invasions, and solar elastosis and clinical outcomes.
We report the results of skin biopsies of normal-looking axilla in 30 patients with genital extramammary Paget’s disease. Among all of the cases, only one exhibited intraepidermal clear cells at one side of the axilla. In this case, the clear cells had only a sparse and limited distribution, as in most of other previous case reports dealing with axillary occult Paget’s disease. We suggest that so-called occult Paget’s disease may include Toker cells or clinically overlooked Paget’s disease with subtle skin changes. We conclude that careful inspection is crucial rather than unnecessary random axillary skin biopsies.
To evaluate the possible difference in efficacy between brand name and generic formulations of 10% urea moisturizers, we examined their effects on dried skin models in fifteen healthy subjects. Each urea cream, either brand name and generic, was applied twice daily for 10 days, and the water content of the stratum corneum was compared. Among the results, one of the generic creams showed a significant increase in water content compared to other moisturizers. In general, if generic substitutions are used for brand name formulations, physicians must be aware that there might be a significant reduction in therapeutic effectiveness. However, one of the generic urea moisturizers had a higher moisturizing capacity than the brand name.
Evidence has been accumulating for the use of negative pressure wound therapy (NPWT) to treat chronic wounds. There are various types of devices for NPWT available in many countries, so that a selection can be based upon the symptoms and patient needs; however, this range of selections is not yet available in Japan. We report here a case with a chronic pressure sore which we successfully treated with the SNaP® Wound Care System, an ultraportable device that delivers NPWT without the use of an electrically-powered pump. A prompt introduction of such devices is awaited in Japan.