The Japanese Journal of Dermatology
Online ISSN : 1346-8146
Print ISSN : 0021-499X
ISSN-L : 0021-499X
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Seminar for Medical Education
Original Articles
  • Summary of 30 Cases of Introduction of Hydroxychloroquine for Lupus Erythematosus at the Department of Dermatology, Asahikawa Medical University
    Hiroyoshi Nozaki, Mari Kishibe, Kyoko Kanno, Satomi Igawa, Masaru Honm ...
    2024 Volume 134 Issue 4 Pages 733-741
    Published: April 20, 2024
    Released on J-STAGE: April 22, 2024
    DOIhttps://doi.org/10.14924/dermatol.134.733
    JOURNAL RESTRICTED ACCESS
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    The efficacy and safety of hydroxychloroquine (HCQ) were evaluated in 30 patients (CLE 18 cases, SLE 18 cases) with cutaneous lupus erythematosus and systemic lupus erythematosus who were introduced to it at our department. Their ages ranged from 19 to 80 years (median age 48). Four cases were male, 26 cases were female. In terms of efficacy, the Cutaneous Lupus erythematosus disease Area and Severity Index activity score (CLASI) and Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) were significantly reduced; 60% of patients receiving concomitant prednisolone were able to reduce their prednisolone dose after HCQ induction. In terms of safety, due to adverse events, HCQ was discontinued in 9 patients, of whom 4 were diagnosed with drug eruptions and only 1 was able to resume the drug. Although three patients received more than 6.5 mg/kg/day of HCQ per actual body weight, none of them developed retinopathy.

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Case Reports
  • A Case of Eosinophilic Granulomatosis with Polyangiitis Presenting as Granulomatous Arteritis
    Takashi Ito, Chen Ko-Ron, Toshiyuki Yamamoto
    2024 Volume 134 Issue 4 Pages 743-748
    Published: April 20, 2024
    Released on J-STAGE: April 22, 2024
    DOIhttps://doi.org/10.14924/dermatol.134.743
    JOURNAL RESTRICTED ACCESS
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    A 65-year-old male was diagnosed with eosinophilic granulomatosis with polyangiitis (EGPA) based upon findings of adult-onset asthma, polyneuropathy, renal dysfunction, intestinal involvement, and laboratory findings of elevated serum IgE levels and eosinophils counts in the peripheral blood, as well as positive anti-MPO neutrophil cytoplasmic antibody. He developed livedo, infiltrative erythema with a few subcutaneous nodules on the lower extremities. Histopathological examination revealed exclusive involvement of muscular vessel in the dermo-subcutaneous junction. Higher magnification revealed fibrinoid necrosis of the vessel wall with neutrophil infiltration and marked angiocentric infiltration of CD68-positive histiocytes, and a number of eosinophil infiltration. Elastica van Gieson staining revealed disrupted internal elastic lamina, and a diagnosis of granulomatous arteritis was made. Granulomatous arteritis is rare in EGPA. We emphasize that those histopathological findings observed in the present case are characteristic features of EGPA different from other granulomatous vasculitis. In addition, we reviewed previous cases of granulomatous arteritis in patients with EGPA, and discussed differential diagnosis of granulomatous arteritis of EGPA.

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