The author introduces to the basic facts and of brief histories of the perfect state of the dermatophytes. The classification of Trichophyton mentagrophytes, prior to the discovery of its perfect states, is reviewed. On the basis of the perfect states obtained by confrontations of strains of T. mentagrophytes, it is demonstrated that it is minimum of a complex of different asexual strains corresponding to three perfect states : Arthroderma simii, Arthroderma benhamiae and Arthroderma vanbreuseghemii. On the basis of their mating behaviour, their morphology in culture and/or their biochemical characters, the members of the T. mentagrophytes complex can also be divided in races, varieties and conidial forms. Though Trichophyton interdigitale is a member of the T. mentagrophytes complex, its exact status remains unknown so far.

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The author reported several morbid anatomical findings of deep fungus infections, especially on candidiasis, aspergillosis, mucormycosis, and cryptococcosis. Special stress was layed on cryptococcosis, and described the followings: 1) The degree of size variation and the occurrence of aberrant forms of Cryptococcus cells could be assumed as a reliable clue for the determination of the stage of the infection. 2) Morphological peculiarity of the multinucleated giant cells in the granulomatous lesion was pointed out. 3) Fluorescence microspectrophotometry could be assumed as a reliable tool not only for the evaluation of the viability of the fungus in tissue, but also for the evaluation of antifungal drugs.

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A 38-year-old woman who had been suffering from pemphigus vulgaris developed pustular psoriasis-like eruptions on her whole body. The clinical studies of this patients are reported. Diagnostic problems of this patient are discussed.

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A case of dermal duct tumor, which appeared in 36-year-old female, was presented. Histologically, epidermis showed poroma-like involvement related to the underlying tumor masses. On electronmicroscopic examination, intracytoplasmic lumina were found in some of the tumor cells. Those lumina coalesced to form large extracytoplasmic lumen, which was bordered by numerous short villi. This lumen formation showed considerable resemblance to the formation of the intra-epidermal eccrine duct in the embryo. It was suspected that the dermal duct tumor probably originated in the intra-epidermal eccrine duct and extended downward into the dermis. In conclusion, it seemed that this tumor was not an eccrine poroma, nor an eccrine poroepithelioma (Mishima et al.). Probably it was a distinct entity in histological and clinical appearance.

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Case 1: A 61-year-old man was admitted to Nagasaki City Hospital with vesicles on exposed skin and with diabetes mellitus. He had taken large amounts of alcohol since age of twenty. Routine laboratory studies were within normal limits except for slight elevation of S-GOT, S-GPT and hyperglucosemia. There were some vesicles and scars on his exposed skin. Histological examination of the skin on the back of left hand revealed a slight accumulation of PAS-positive material surrounding the small vessels in the upper dermis. The values of urinary uroporphyrin were 690.8 to 3130.6 μg/l, and coproporphyrin were 242.2 to 774.2 μg/l. Case 2: A 72-year-old man came to our clinic with vesicles and hyperpigmentation on exposed skin. He had a history of alcohol ingestion since age of eighteen. There were some vesicles and hyperpigmentation on his exposed skin. An accumulation of PAS positive material was the same as in case 1. The values of urinary uroporphyrin were 1168.0 to 1919.7 μg/l and coproporphyrin were 447.9 to 797.5 μg/l. Twenty eight cases of porphyria cutanea tarda was reported in Japan inclueding our two cases.

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A case of 67-year-old woman with longitudinal grooving the left middle finger-nail due to mucous cyst involving posterior nailf old was reported. The cyst was radically excised and skin-grafted without recurrence afterwards.

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A 57-year-old male developed generalized herpes zoster after the excision of the atheroma on his forehead. His granddaughters, who called on him in the hospital, were attacked with varicella. Varicella-zoster virus could be isolated from the eruptions of herpes zoster and varicella.

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A case of infantile digital fibromatosis which developed on the left second and third toe of 3 year-old girl has been reported. The lesions were excised and a full split thickness skin graft was carried out. No recurrence has been seen in four months after the operation. Microscopically, the eosinophilic cytoplasmic inclusions were frequently seen in the cytoplasm of the fibroblasts.

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A 19-year-old girl was observed in whom several scalp hair shafts are encircled for several millimeters by which translucent acretions at the portion of the temporal scalp. Examination revealed perifollicular reddish papules with fine scales, hair loss with slight itching in this area. Scanning electron microscopic observations of these acretions were presented in detail.

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Palmar surface lipids were collected by the acetone method in 25 healthy male cases, 29 healthy female cases and 85 keratodermia tylodes palmaris progressiva (KTPP) cases, and analysis was made of lipid and fatty acid by thin layer chromatography and gas chromatography. C_16-0 (palmitic acid) showed the highest value in healthy men, healthy women and KTPP alike, but was almost constant in both right and left palms; on the other hand, C_16-1 (palmitoleic acid) showed variations. As a result, the C_16-1/C_16-0 ratio tended to show high values in the order of healthy men, healthy women and KTPP This trend was noted in both the right and left palms. Inversely, the C₁₈/C₁₆ ratio, the C_14-0/C_16-0 ratio and the C_18-0/C_16-0 ratio were inclined to show high values in the order of K.T.P.P., healthy women and healthy men. From these findings it is deduced that there might be a relation between KTPP and changes in the properties of palmar surface lipids.

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For the purpose of clarifying the relationship between DLE and SLE, fifteen cases of widespread DLE with a large number of typical discoid type exanthema developing over a wide range of area were classified into 4 degrees according to the degree of exanthema distributed. They were examined for LE cell, LE test, anti DNA antibody, anti-nuclear factor, complement titer (C₃), serum immunoglobulin, tuberculin test, DNCB test, blastoid transformation of lymphocytes of peripheral blood by PHA, subpopulation (T cell, B cell) of lympocytes of peripheral blood, and studies were made in relation to the way exanthema is distributed. With results of above-mentioned various tests put together, it was surmised that widespread DLE would be an intermediate type (shifting type) that is positioned between localized DLE and SLE and shows a tendency to shift to either of these two types of disease depending on the situation as indicated by the results of a clinical study made on it.

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Some electron microscopic observations on black hairy tongue were performed. Hair-like substance was formed by horny materials. Keratin pattern was not found but keratin filaments were recognized densely in all area. A few vacuoles were seen in keratin filaments. Nucleus, melanosome and other intracellular organs were not seen.

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Five patients with psoriasis or eczema were treated for 7 consecutive days with 0.025% beclomethasome 17, 21-dipropionate ointment 20g-40g daily (5mg-10mg beclomethasone 17,21-dipropionate). The serum 11-OHCS levels and urinary 17-OHCS levels were estimated for fifteen days before, during and after treatment. The eosinophil counts, blood glucose levels and urinary Na⁺ excreted were also estimated. The serum 11-OHCS levels were lowered in one case of eczema, but it was temporary. Decreasing of eosinophil counts and increasing of urinary Na⁺ excreted occurred in another case of eczema. The clinical effect was equal with, or better than some other steroids. The results indicate that the use of 0.025% beclomethasone 17, 21-dipropionate ointment, 20g-40g daily results in percutaneous absorption of beclomethasone 17, 21-dipropionate to cause inhibition of adrenocortical function, which is extremely slight, in patients with eczema.

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