The relation between clinical diagnosis and histopathological diagnosis were discussed with stress laid on the following two items. 1. Statistic observation: Among 1253 patients who underwent a histopathological examination at the Dermatologic Clinic of Kyushu University during the 3 years from the 45 th to the 48 th of Showa (1970∼1973), a clinical diagnosis and a histopathological one agreed with each other in the case of 842 patients (67%), while a clinical diagnosis did not agree with a histopathological one in the case of 371 patients and making a final decision was withheld in the case of 40 patients. Almost the same result was obtained when I observed 531 histopathological examples at the Essen Dermatologic Clinic in West Germany about 1965. Each of the cases of diagnostic disagreements about skin disease was examined clinically and histopathologically. For example, the case which was diagnosed clinically as BCE was found to be histopahtologically Bowen's disease, N. pigmentosus, SCC, seborrheic keratosis, DLE, etc., while another case diagnosed histopathologically as BCE was shown to be clinically keratosis senilis, Bowen's disease, SCC, keratoacanthoma, malignant melanoma, lupus vulgaris etc. 2. Histology of the efflorescence : In order to make a histopathological diagnosis practically we must be familiar with not only each of the histopathological findings of skin disease but also the histological structure of various efflorescences, which fact shows one of the peculiarities observed in histopathology of the skin. In this essay I took papulae as an example. Papulae, excepting true neoplasm, can be classified histologically into the following 3 groups ; (1) epide-rmal papula, (2) cutane papula, (3) mixed papula. I picked out typical histological figures of these 3 groups and explained some of them referring to the relations between clinical problem in practice and differential diagnostic one.
Clinical effects of 0.05% clobetasol 17-propionate cream (SN-201·C) and 0.05% clobetasol 17-propionate ointment (SN-201·O) were studied by simple application (SA) method in principle, by a study group consisting of 27 institutes, with the patients of dermatological diseases: acute eczematous dermatitis, seborrheic eczema, chronic eczematous dermatitis, atopic dermatitis, dermatitis on hand, prurigo, pustulosis palmaris et plantaris and psoriasis vulgaris. The following results were obtained. 1) The 684 cases were treated with SN-201·O and SN-201·O…321 cases with SN-201·C and 363 cases with SN-201·O. The effective ratio was: 302/321=94.1% with SN-201·C and 336/363=92.6% with SN-201·O. 2) When compared with betamethasone 17-valerate and fluocinolone acetonide, SN-201 proved to be significantly more effective. 3) Side effects were observed in 46 cases with SN-201: irritating sensation in nine cases, folliculitis in nine, exanthema acneiform in six, xeroderma in ten, drying sensation in seven, telangiectasia in one, chaps in three and hypertrichosis in one case, but any of them were not so serious.
Patch-testing of the corticoid preparations on psoriatic lesions was performed as a new device to evaluate the therapeutic effect of topical corticoid preparations. Effects of the concentration of clobetasol 17-propionate upon the improvement of psoriatic lesions were investigated in 7 patients. The concentrations of the drug employed were at 0.1%, 0.05%, 0.025% and vehicle alone in cream and ointment base, respectively. It was found that the 0.05 % clobetasol 17-propionate preparations possessed a sufficient therapeutic effect in the both vehicles. The preparations are found more effective on psoriatic lesions than the other commercial corticoid preparations.