There have been few prospective studies about the efficacy and safety of antiherpesvirus drugs for Kaposi's varicelliform eruption(KVE). In the present study,we investigated the efficacy(patients analyzed,n=114)and safety(patients analyzed,n=131)of famciclovir(FCV)in FCV-naïve patients with KVE. Assessment of overall improvement and the frequency of side effects during the approximate period from the start of FCV administration to three weeks after completion of administration(Day 21)showed that among patients analyzed for efficacy,the proportion of patients determined to have an overall improvement of “marked improvement” or “improvement”(improvement rate)was 96.5%,and none of the patients were determined to have an “exacerbation”. The median number of days until complete crust formation was seven days,and the median number of days until healing was eight days. In addition,among patients analyzed for safety,the frequency of side effects was 0.8%. These results confirmed the efficacy and safety of FCV in patients with KVE. We also analized the relationships between the hearing time and the severity of KVE, severity or treatment contents of atopic dermatitis, the most common underlying disease of KVE.

View full abstract

We experienced two epidemic outbreaks of scabies. In the first incidence,12 inpatients and 2 nurses were nosocomially infected with scabies from a patient with hyperkeratotic scabies(proband). As the proband,who came from a geriatric health services facility,had been diagnosed and treated for pemphigus by his previous doctor,the correct diagnosis was delayed and the epidemic outbreak lasted for two months. The proband died before mites were microscopically negative,although oral ivermectin had been administered 6 times. In the geriatric health services facility,where the proband had been admitted,7 patients were found to be infected with scabies. In the second incidence,epidemic outbreak in a children's home resulted in 23 patients with scabies,including 19 children and an adult living in the home,2 family members of an employee and 1 person living in another home next door. None of them had any underlying diseases and most of them had been diagnosed and treated for atopic dermatitis. In both instances,administration of steroids triggered a worsening of the infection and the significance of early correct diagnosis was reinforced.

View full abstract

We report the case of a 66-year-old man who had a left forehead mass for 5 years. Positron emission tomography-computed tomography(PET-CT)was performed in 2013 because he had tongue cancer,and it revealed cutaneous accumulation at the left forehead; however,the standardized uptake value(SUV)was low and passage was observed. On PET-CT performed in 2015,an increase in cutaneous accumulation was noted,and therefore,skin biopsy was performed. Pathological findings indicated accumulation in luminal structures of various sizes and a cribriform structure from the dermis to the galea aponeurotica. The luminal structures included basophilic cells,which contained basophilic material. Additionally,neuronal invasion was noted. Therefore,he was diagnosed with primary cutaneous adenoid cystic carcinoma,and surgery was performed. No recurrence has been noted for 5 months following surgery. Adenoid cystic carcinoma often shows neuronal invasion and regional relapse. Therefore,extended resection and a long-term follow-up are needed. Even if the SUV is low,it is important to perform dermatological examinations.

View full abstract

A 46-year-old man had developed an eruption on the face,arms,and legs about 3 years before he first visited our hospital. The skin pruritus was mild; however,there was erythema surrounded by several vesicles on his right forearm. The histological features showed evidence of papillary microabscesses composed of neutrophils. The direct immunofluorescence test revealed the presence of granular Immunoglobulin A(IgA)deposits on top of the dermal papillae. Therefore,we diagnosed this condition as a case of dermatitis herpetiformis(DH). The patient was treated with a topical steroid ointment,and eruption dramatically reduced. Topical steroids are often effective in mild cases of DH,but numerous cases progress and ultimately undergo chronic course. Furthermore,we may need to administer diaminodiphenyl sulfone(DDS)to this patient in the future. The outcome of this present case suggests that when a case of skin eruption with erythema surrounded by several vesicles is observed,the possibility that it may be a case of DH should be considered during the diagnosis.

View full abstract