A 39-year-old woman had noticed several red bean-sized erythemas on both legs since 1966, and these erythemas had been gradually spread over the trunk in three years. She appeared in our clinic at first on December, 1969. At her first visit she had had generalized exfoliative dermatitis with severe itching, and hyperkeratotic palms and soles. In addition the skin of trunk, neck and extremities had revealed many solid papules and several nodules. The hairs of scalp, axillae and pubis were so sparse. In clinical examinations, they showed no abnormal findings except for leucocytosis (15,500/mm3) and atypical mononuclear cells (8%) which had PAS positive and diastase non-resistant granules in a wreath like arrangement at peripheral cytoplasm. Histologic specimen of the skin nodule showed parakeratosis, acanthosis, elongation of rete ridges, microabscesses in the upper epidermis and mononuclear cell infiltration in the dermis with a few eosinophiles and lymphocytes. Numerous mitotic figures of infiltrated cells were also found. The inguinal lymphnode showed the same cell infiltration as the skin nodule. She had been treated with injection of methotrexate and corticosteroids in mouth. She died of cachexia and autopsy revealed swelling of generalized lymphnodes, liver and spleen (mononuclear cell infiltration). No paticular finding in the bone marrow. The characteristics of Sézary’s cell and the relationship between Sézary’s syndrome and mycosis fungoides were discussed.
A case of systemic scleroderma accompanied with cryoglobulinemia is presented with clinical and immunological studies performed. The immunological studies revealed that cryoglobulin from this patient was composed of IgG and IgM. The review of the literature was carried out with special reference to the clinical and immunoglobulin features of the cryoglobulinemia.
In order to investigate a genetic aspect of congenital functional and/or biochemical anomalies of the skin, chromosome analysis of cells cultured from the leucocyte component of the blood obtained from six cases of keratosis palmaris et plantaris hereditarium, nine of ichthyosis vulgaris, two of keratosis follicularis, two of Darier’s disease, one of dyschromatosis symmetrica hereditaria, two of xeroderma pigmentosum and six of atopic dermatitis were performed, revealing following results. 1) Long Y chromosome was found in one case of ichthyosis vulgaris. 2) One case of keratosis palmaris et plantaris hereditarium showed low modal cell percentage, compared with control, which was statistically significant (p>0.05). 3) In one case of keratosis palmaris hereditarium and one of xeroderma pigmentosum, the rates of appearance of hyperdiploid cells were significantly higher than in control (p<0.05). 4) In one case of xeroderma pigmentosum and two of atopic dermatitis, the occurence of breaks was more frequent than in control, which was statistically significant (p<0.05). 5) Aneuploid cells and structual abnormalities of chromosomes showed a tendancy to appere more frequently in the group of functional and/or biochemical anomalies, such as keratosis follicularis, Darier’s disease, dyschromatosis symmetrica hereditaria, xeroderma pigmentosum and atopic dermatitis than in the group of organic anomalies such as phacomatosis and nevus described in the 1st report.
Pregnant female mice of DD strain were subjected on the whole body to a single exposure of X-irradiation on each day from day 8 to 11 of gestation with doses 200r, 250r, 300r or 350r, using Dermopan (soft X-ray from beryllium tube 50 KV, 25mA, 0.1mmAL, FSD 30cm). Fetuses were taken out by cesarean sections on day 17 and examined grossly and microscopically with special reference to the skin anomalies. The group of 300r irradiation was studied by chromosome analysis. The study revealed hematomas, bullas and a form of projection of the skin as the anomalies of the skin and/or its underlying tissue. The hematomas were mostly located near the median line, the angle of mouth, the base of limb or the foot. Histologically they were found as a localized mass of erythrocytes extravasated in the connective tissue between the epidermis and the bone, being usually accompanied with abnormal dilatation of blood vessels around them, which seemed to indicate that the hematomas might be due to the injury of blood vessels. Hematomas on the limb were occasionally complicated with a contraction or a hypertrophy of the neighboring portion of limb, and those on the scalp with a defect of the bone underneath the hematoma. The bullas were found on the head, the back or the whole body only in the group of irradiation over 300r. Histologically, they were found as an extracellular edema diffusely distributed through the subepidermal connective tissue, usually accompanied with abnormal dilatation of surrounding small blood vessels and sinus-like structures encircled by endothelial cells. The bullas were presumed to be brought about not by a single cause but by various ones such as the injury of cranial nerves or of blood vessels, or of connective tissues around blood vessels. A certain form of projection of the skin was found in one fetus of the group exposed on day 9 with dose 200r. By chromosome analysis, it was revealed that cells showing chromosome anomalies were found more frequently in the order, the X-irradiated group with external anomalies, the X-irradiated group without anomalies, as compared with control group (P<0.05). From the fact that the grade of chromosome anomalies seemed to be closely related to that of external anomalies, it was suspected that the former may be one of the factors which brought about these anomalies.
In 1968, the patients complaining of acneform eruption have been mainly discovered in Nagasaki and Fukuoka prefectures. It has been proved that this disease is caused by the rice oil contaminated with chlorobiphenyl during the purification process and designated so “Yusho (chlorobiphenyl toxication)” at the basis of the clinical findings and pathogenesis. This report describes analyses of serum lipids of Yusho patients and control by thin layer chromatography and gas chromatography. 1) In serum, comparing with controls, levels of free fatty acid and triglyceride were elevated, but that of cholesterol ester was low among these patients. Thre fore, it was assumed that high levels of these two fractions in serum were maintained by the increase of synthesis of triglyceride in liver as the result of an increase of the release of free fatty acid from adipose tissue. It was also assumed that high triglyceride level in serum was caused by the shift of equilibrium between free fatty acid and triglyceride in liver as the result of an increase of release of free fatty acid from adipose tissue. 2) On fatty acid composition analyses of free fatty acid, triglyceride and cholesterol ester fractions by gas chromatography, significances between Yusho and controls were observed. 3) The significant correlation between liver function and lipid and its fatty acid composition in serum were not observed, suggesting the disturbance of lipid metabolism in adipose tissue of Yusho patients. 4) It is observed that the serum triglyceride level of the patients treated for one year decreased to normal range. 5) From the serum lipid analysis it is apparent that Yusho and acne vulgaris showed difference in composition of serum lipid.
Based on light microscopic studies, many investigators, such as Zimmermann and Becker maintained the neural crest theory concerning the embryonic origin of the melanocyte in the skin. In order to investigate this problem on ultrastructural level, the present study was undertaken and concerned with the ultrastructural comparison between the melanocytes found in skins of fetus and newborn black mice of C57BL, from 10 days in utero to 5 days post partum and the neural crest cells as well as the neuroblast-like cells that were found in a mouse embryo of C57BL and contained premelanosomes and melanosomes. The study revealed a small number of melanocytes in the dermis of 18 days and 20 days in utero and in the epidermis of 1 day and 5 days post partum. In addition, the cells probably identified as so-called agranular dendritic cells were found in the epidermis of 19 days in utero, and 3 days and 5 days post partum. The ultrastructural similarities between the neural crest cells displaying melanosome formation and the melanocytes found in the skin seemed to indicate that the former might differentiate into the latter, moving through the mesenchyme.
Two species of soil fungi, Chaetomium cochlioides and Trichothecium roseum, are reported as keratinophilic fungi newly in Japan. Descriptions, photographs and a drawing of these species are added. The delimitation of the expression “keratinophilic”, hair-colonizing fungi and conidium ontogeny of Trichothecium roseum are briefly discussed.