The 209 th Meeting of the Nagasaki Regional Society of the Japanese Dermatological Association was held on 24 th April 1977 in honor of Prof. Dr. M. Nogita who retired a month ago from the office of director of the Dermatological University Clinic, Nagasaki. This is a recollection and supplementary remarks on acropigmentatio reticularis which I made at this Meeting. It has been 34 years since we found in Nagasaki the first case of this disease and published it in 1943 as a kind of symmetric acral dyschromatosis. Acropigmentatio reticularis is now seen at times in Japan. Consisting of small, slightly sunken, uniformly brown macules which appear along furrows of the skin surface and inlaid with smallest, not pigmented, not depressed, normal skin areas, it forms a peculiar pigmentary network mainly on the external surfaces of the distal parts of extremities. Its existence universally in the world was first confirmed 1976 by Griffiths who found it in Iranians, Englishmen and negros. Histologically, besides atrophy of the epidermis and epidermal melanin deposition hitherto mentioned, Griffiths saw an increase in the number of clear cells in the basal region of the epidermis and no evidence of pigmentary incontinence in the upper dermis. According to Griffiths acropigmentatio symmetrica of Dohi, an another characteristic acral pigmentation seen in Japan, has also been recognized in 1952 by Gartmann and in 1964 by Siemens in Europians. However, the descriptions and photographs in the originals of both authors give us the impression that their cases are somewhat different from the prototype of Dohi's as well as of Kitamura's acropigmentation. In this respect Toyama told us once his opinion that among the Japanese with moderately dark skin there are various pigmentary disorders which can not be found or are disregarded in the whites and negros. From the theoretical point of view it should be said that all these pigment anomalies, especially as hereditary diseases, can occur in the whites, negros and any other races in the same way as in the Japanese.

View full abstract

A 37-year-old man has had a skin lesion on his left cheek for twenty five years. After ten years his right cheek also became involved. Alternaria alternata was isolated from the biopsy tissue. The upper and middle parts of the dermis were the site of a granulomatous inflammation. In the granulomatous lesion there were many giant cells containing round spore-like bodies. In PAS-stained sections the walls of spore-like bodies stained positive.

View full abstract

In this case, symptoms of a dental desease were lacking and the diagnosis was difficult, As a result, the patient was examined and treated by a dermatologist, but no cure was found. Later, however, when the patient, after having been subjected to dental investigation, was given dental treatment of the dental suppurative inflammation, drainage from the fistula stopped and the patient was completely cured.

View full abstract

Four cases with distinctive features were reported. They were a 54-year-old man, a 46-year-old man, a 31-year-old man, and a 25 year-old man. The duration of the diseases ranged from one and a half year to 6 years. They had several features in common. Clinically they showed swelling, abscesses, fistulas, sinus tracts, hypertrophic scars or sclerosis and pigmentation of the skin on large areas of the perianal region and the buttocks of long duration. Histopathological changes were those of chronic inflammation consisting of the infiltration of small round cells and plasma cells, fibrosis, and granulation tissues at times. Specific granulomas were not observed. Cultures showed the growth of various kinds of organisms such as Staphylococcus aureus, E. coli, Micrococcus, and Proteus at different times, but not mycobacteria or fungi. Review of the literature showed that such an entity has been reported under various names. We came to conclude that they are all the same disease and that these diagnostic names are reasonably comprised under the name of ‘chronic perianal pyoderma’. Chronic perianal pyoderma is well differentiated from other pyogenic dermatoses his topathologically and bacteriologically, such as tuberculosis, venereal diseases, deep fungus infection and neoplastic diseases of the skin.

View full abstract

We report a case of Pringle's disease. A 16-year-old boy had adenoma sebaceum on the face and a small white patch on the left lower leg. The patient suffered from intracranial hypertension for several months. A tumor mass in the right lateral ventricle was removed. It showed histologic characteristics of subependymal giant-cell astrocytoma. Postoperatively, the patient received a course of beta-tron radiation therapy. Two years after the operation, the patient showed no sign of recurrence of the brain tumor.

View full abstract

Dermatological as well as other clinical examinations of 10 patients with histologically confirmed cutaneous periarteritis nodosa were made. The patients consisted of 5 males and 5 females, the ages ranging from 21 to 61 years. There were 7 patients with arthralgia paralleling to the cutaneous lesions, 5 patients with myalgia, 6 patients with recurrent aphthae, 2 patients with epididymitis, 2 patients with hypertension and one with recurrent iritis suggesting an abortive form of Behçet's disease. The follow-up examinations were made for a period of 2 months to 5 years and 6 months, during which period the cutaneous lesions were recurrent in most of the patients though no life-threatening internal complications were observed. A review of 43 patients reported as cutaneous periarteritis nodosa in the Japanese literature revealed only 2 patients followed for over one year. This indicated that further follow-up studies on these patients might disclose systemic involvements. Cutaneous periarteritis nodosa appears to be a milder reactive group and should be further evaluated before being established as a clinical entity.

View full abstract

A 55-yearold woman with xanthoma disseminatum was reported. The gross features of xanthoma disseminatum and the origin of lipids in the tissues were discussed.

View full abstract

A 52-year-old man with type IV hyperlipoproteinemia developed discrete multiple yellow papules (2-8 mm in diameter) over the face, chest, abdomen, back and legs. Dilated follicular orifices opened on their surface. A biopsy specimen of a papule revealed foam cell nests surrounding a hair follicle. This type of xanthoma appeared to be a variety of eruptive xanthoma. The xanthomas resolved completely in three years on diet low in carbohydrate.

View full abstract

A 63-year-old male was seen to have a blackish brown, verrucous surfaced tumor for a duration of almost 8 years on the distal end of his left leg near the medial malleolus. The lesion was 6×4 cm in size and showed slight elevation with an irregular but well-defined border. Histological findings showed slight hyperkeratosis and remarkable acanthosis with many tumor cell nests in the epidermis which were sharply circumscribed from the surrounding epidermis. The tumor cells were uniform and small in size accompanied with intercellular bridges. The cytoplasm contained PAS positive materials but was not stained by alcian blue. Toluidine blue stain (pH 4.1) did not show any metachromasia. There were cystic spaces in the tumor islands, and melanin pigments were observed only in dendritic cells and not in tumor cells.

View full abstract

3 women, 42, 58, and 61 years of age, visited our hospital for multiple eccrine hidrocystomas on their faces. Every case showed marked senile elastosis on the upper dermis histologically. And the senile elastosis or dermal aging may relate to the pathogenesis of the eccrine hidrocystomas.

View full abstract

A 51-year-old man, worker, with chronic bronchiectasia had purpura on both lower extremities and forearms. The laboratory findings showed that total serum protein was normal but gammaglobulin was increased, erythrocyte sedimentation rate was elevated, RA factor and Rumpel-Leede were positive, LE test, LE cells and ANF were negative. Histological findings were that of necrotizing vasculitis. We suspected that the geneins of this case was chronic inflammation of bronchus. We treated the purpura with glucocorticoids, ACTH and azathiopurine, but had no significant effects on purpura and laboratory findings.

View full abstract

Two cases of teleangiectasia, which appeared in a 16-year-old female on her right leg and in a 12-year-old female on her upper and lower extremities, were reported in this paper. Both of them had spread proximally in a few years. Histologically, these cases showed no proliferation of capillaries, distinguished from capillary nevus. The authors proposed that these cases were acquired functional teleangiectasia, also discussing the clinical and histopathological findings.

View full abstract

In this open study, the efficacy of ointment and universal cream(w/o type) containing 0.1% diflucortolone 21-valerate (DFV), a derivative of corticosteroid without OH group at the posi-tion of 17 α, was investigated by a collaborative group of dermatologists from 30 institutions in Japan. Analyses were done on 578 cases and the following results were obtained.
1) A half side test was carried out in patients with oozing type of eczematous dermatitis, lichenified type of eczematous dermatitis, psoriasis vulgaris, pustulosis palmaris et plantaris and hand eczema, using 0.12 % betamethasone valerate (BTV) ointment as a control drug. DFV ointment of 0.1 % showed superiority to BTV ointment in the drug preference in oozing type of eczematous dermatitis, in the drug preference and general improvement in psoriasis vulgaris, as well as in the comparison of global usefulness in all cases. No significant difference was observed in lichenified eczematous dermatitis. Double blind trials are now in progress.
2) Furthermore, clinical effects were investigated with ointment and universal cream of DFV in hand eczema, seborrheic dermatitis, various types of prurigo, exfoliative dermatitis, chronic discoid lupus erythematosus, lichen amyloidosus, lichen planus, etc. Results showed a pretty good effect on skin lesions and a high global usefulness of the drugs.
3) Topical adverse reactions were noticed in 4 % of the cases.

View full abstract

The authors examined the antifibrinolytic activity of some antibiotics, external disinfectants and others against plasmin by the fibrin plate method. Fibrinolysis was completely inhibited by povidone iodine, moderately by gentamycin, and slightly by potassium permanganate.

View full abstract

The in vitro effect of corticosteroid hormone on the growth of dermatophytes was examined. Water soluble corticosteroid hormones inhibited of the growth of fungi. however suspensions did not inhibit of the growth. Therefore, corticosteroid hormone has no effect on the growth of dermatophytes.

View full abstract

Rats were treated with a daily dose of 0.2 g of 0.12 % betamethasone valerate (B-V), 0.025 fluocinolone acetonide (F-A), 0.05 % fluocinolone acetonide acetate (FAA) and 0.05%, clobetasol propionate (C-P) percutaneously for successive two weeks, and the change of body weights, the number of death during the treatment, the effects on thymus, adrenals, spleen and treated region of skin, haemogram and myelogram were compared. The results thus obtained proved to be in the order of FAA>F-A>C-P>B-V, and were not necessarily in parallel with the order of vasoconstriction index by McKenzie's method. In view of above systemic effects observed on any topical corticosteroids at clinical concentrations, although given in considerable amount, careful attention has to be paid to clinical use of topical corticosteroid in a large dose for a longer period.

View full abstract

A statistical survey on 100 cases of sporotrichosis at the Dermatological Clinic of Chiba University Hospital from May, 1965 to June, 1975 was reported. The proportion of sporotrichosis to the total number of outpatients and to the total dermatomycoses was 0.14 % and 1.8%. It has gradually increased since 1969. A higher percentage of patients was distributed in the patients less than 11 years old and more than 40 years old. Females were more affected than males. Half of the cases occured in farmers. Geographic distribution was remarkable. 44 cases had a history of injury. 62 cases showed the cutaneous lymphatic type and 38 cases showed the localized cutaneous type. The face and upper extremities were most affected. The sporotrichin test was positive in 41 of 42 cases. The causative organism in section of tissue was demonstrated in 97 of 99 cases.

View full abstract

By clinical and statistical analyses of the patients of melanosis faciei feminae observed at the dermatological clinic of Yamaguchi University Hospital for 10 years, from 1964 to 1973, the following results were obtained: 1) the outpatients observed in this period were 29,440 in number and comprised 191 cases of melanosis faciei feminae (0.6%); 2) the number of cases as well as the incidence rates of this disease per year showed a small peak at 1966 and a higher peak at 1972; 3) the number of cases per month was large in May, April, June, March and October in the order of decreasing frequency, and small in November and December; 4) the cases as well as the incidence rates of this disease at the age decade were found positively from the third decade, and increased in number rapidly at the fourth decade, reaching the highest peak at the fifth decade; 5) of 39 patients who had been tested by patching various cosmetics, 25 cases (64.1%) were positive; 6) make-up cosmetics were mostly patch-tested and creams, beauty washes and cosmetic emulsions followed them in the order of decreasing frequency, and cosmetic emulsions, make-up cosmetics, beauty washes and creams were most frequently found positive by patch testing in the order of decreasing frequency.

View full abstract