Nerve block is a favored local anesthetic technique, particularly in cases for which general, epidural, or spinal anesthesia cannot be employed. It is also useful for perioperative pain management. Recently, we sometimes encounter situations in which it is difficult to locate an anesthesiologist even in key hospitals, so it is also an advantage that unassisted dermatologists can safely carry out nerve blocks, especially in emergency cases. We have achieved favorable outcomes using nerve block techniques for skin surgery in our department. In this report, we review 34 surgical cases operated under nerve block anesthesia on the lower extremities from April 2012 to March 2013.
In this study, we examined the clinical characteristics of 12 systemic sclerosis (SSc) patients (5 males and 7 females) with anti-RNA polymerase antibodies (anti-RNAP) among the 200 SSc patients who presented to our hospital from 1992 to 2013. The mean mRSS (modified Rodnan total skin thickness score) was 14.2. 6 patients (50%) met the SRC (Scleroderma renal crisis) criteria, and 5 patients (41%) had a history of cancer. The duration of scleroderma at the time of the cancer diagnosis was from -0.5 years to +8 years. It has been reported that anti-RNAP positive SSc patients have a greater risk for SRC, and recently reported that they increase the risk for cancer in a Caucasian population. Our study confirmed that Japanese patients with anti-RNAP antibodies were associated with a significantly increased risk of cancer.
We present the case of a patient diagnosed with adult T-cell leukemia/lymphoma (ATLL) with multiple molluscum contagiosum. Her cutaneous symptoms rapidly disappeared after she developed a non-tuberculous mycobacterial infection. Patients with ATLL are immunodeficient due to lowering of both cellular and innate immunity. In this case, we believe that the immunodeficiency supported multiple molluscum contagiosum. When the mycobacterial infection occurred, the Th1/2 balance switched to Th1 and cellular immunity was activated, along with the innate immunity. The patient's immunity thus improved and the refractory molluscum contagiosum disappeared.