The Japanese Journal of Dermatology
Online ISSN : 1346-8146
Print ISSN : 0021-499X
ISSN-L : 0021-499X
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Volume 130, Issue 9
Displaying 1-11 of 11 articles from this issue
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Guidance
Seminar for Medical Education
Original Articles
  • Retrospective Study of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis in 132 Patients
    Tomoya Watanabe, Naoko Takamura, Yuko Watanabe, Yumiko Yamane, Michiru ...
    2020 Volume 130 Issue 9 Pages 2059-2067
    Published: August 20, 2020
    Released on J-STAGE: August 21, 2020
    DOIhttps://doi.org/10.14924/dermatol.130.2059
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    We retrospectively investigated 132 patients with Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) treated at two university hospitals between January 2000 and March 2019. The mortality rates for SJS and TEN were 1.3% and 12.5%, respectively. Interestingly, over the last 7 years (between 2012 and 2019), the mortality rate for TEN was 3.8%. These results suggest that steroid administration in combination with plasma exchange and/or immunoglobulin therapy has contributed to an improved prognosis of patients with TEN. In addition to these treatments, the significantly short interval between disease onset and treatment initiation at our hospitals may have contributed to reduced mortality rates associated with TEN. This study reaffirms the importance of early diagnosis and prompt initiation of intensive medical treatment for TEN.

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  • A Case of Death with Multiple Organ Failure Due to Vespa mandarinia Stings
    Hitomi Morisaki, Erika Higashi, Motoi Takenaka, Hiroyuki Murota
    2020 Volume 130 Issue 9 Pages 2069-2075
    Published: August 20, 2020
    Released on J-STAGE: August 21, 2020
    DOIhttps://doi.org/10.14924/dermatol.130.2069
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    A 68 years old male suffered from anaphylactic shock after getting stung more than 50 times by hornets (Vespa mandarinia) when he climbed a mountain. He was treated with adrenaline and methylprednisolone about one and a half hours later and rushed to our hospital by hospital-dispatched helicopter about three and a half hours after the attack. Systemic administration of adrenaline and corticosteroid resulted in his hemodynamic stability, and he referred to our dermatology clinic. His painfully lesional skin had erythema with subcutaneous hemorrhage. He suffered rapidly progressive rhabdomyolysis, liver damage, and renal failure, and then multiple organ failure with a rapid onset about fifteen hours after the attack. He was transferred to a Nagasaki university hospital, and treated with multidisciplinary therapy. Unfortunately, he died of multiple organ failure 36 hours after the hornet stings. In this case report, we would like to emphasize the importance of extensive systemic treatment for such cases of multiple bee stings. High serum creatine kinase levels may have potentially severe cinsequences.

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Case Reports
  • A Case of Multiple Basal Cell Carcinoma with a History of Treatment for Chronic Myeloid Leukemia
    Kana Ueda, Daisuke Yokoyama, Yumiko Kawata, Toshihiro Takai, Masayoshi ...
    2020 Volume 130 Issue 9 Pages 2077-2081
    Published: August 20, 2020
    Released on J-STAGE: August 21, 2020
    DOIhttps://doi.org/10.14924/dermatol.130.2077
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    The patient is a 28-year-old man with a past medical history of allogenic hematopoietic cell transplantation for chronic myeloid leukemia when he was 13 years old. Three months before first visit, he noticed that a nodule had increased in size on his right auricle. The biopsied tumor was diagnosed as basal cell carcinoma by biopsy. After wide local excision, the subsequent follow-up revealed no recurrence. However, he later developed multiple basal cell carcinoma around both eyelids, all of which were excised.

    In recent years, with the increasing number of survival patients who received allogeneic hematopoietic cell transplantation, insights on long-term adverse events has become important. One significant late complication of hematopoietic cell transplantation is the increased risk of secondary malignant neoplasm. We suspected our patient may have association between multiple basal cell carcinoma and his history of hematopoietic cell transplantation. We recommend that he should be further monitored for skin cancer developments.

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