A case of epithelioid sarcoma was reported in a 58-year-old man, The small nodular lesions, up to 10×10 mm in diameter, were present on the scalp, face and upperarm. On chest X-ray examination, the nodular lesions were noticed in the right upper and middle lung field. Biopsy specimen of the scalp nodules and lung lesion showed a granulomatous changes composed of irregular-shaped eosinophilic cells with nuclear atypism, spindle-shape fibroblast-like cells and a few multinucleated giant cells. Electron microscopical examination showed that two types of cells, dark cell and light cell were present in the dermal lesion. The cytoplasma of the dark cell contained many dilated rough-surfaced endoplasmic reticulums and well-developed microfilaments. This finding suggests that the dark cell tends to differentiate towards a fibroblast. Most light cells have some underdeveloped rough-surfaced endoplasmic reticulums and no filamentous element, but some light cells have many rough-surfaced endoplasmic reticulums. Therefore, it seems that the clear cell has a potency to differentiate towards a histiocyte. These findings suggest that epithelioid sarcoma cells were derived from undifferentiated mesenchymal cells.

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A 2-month-old female baby with sacral lipoma, hemangioma, hypertrichosis, dimple and spina bifida occulta was reported. The cutaneous manifestations of spinal dysraphism are reviewed. We urge that dermatologists become more knowledgeable of this syndrome.

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A case of malignant hemangioendothelioma was studied electronmicroscopically. Increased lysosomes, well-developed mitochondria, r-ER, ribosomes and presence of inter/intra-canaliculi were observed in the tumor cells. A working hypothesis (shown in Fig. 17) about the formation of immature blood vessel was proposed by the present observations.

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A case of pityriasis lichenoides chronica (PLC) in a 4-year-old boy and a case of pityriasis lichenoides et varioliformis acuta (PLVA) in an 18-year-old pregnant woman were presented. The former case was diagnosed as PLC from the clinical features but showed dense lymphocytic and histiocytic infiltrates with diapedesis of red blood cells, whereas, the latter case with typical histological features showed post-delivery involution after a 16 month duration. From the clinical and histopathological findings of our cases, we favor the view that both PLC and PLVA should be considered as a single entity.

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A 26-year-old man developed recurrent keratotic papules of the extremities since his infancy. Histologically, keratotic plugs perforated into the dermis and contained nuclear debris and mature collagen fibers. Needle-prick or scratches induced Köbner’s phenomenon. Thirty-one cases so far reported were summarized.

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A 53-year-old man, affected with Rud’s syndrome whose clinical features were ichthyosis probably X-linked, oligophrenia and epilepsy with other neurological disorders, was reported. The etiology of this syndrome was also reviewed in the literatures.

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A 22-year-old Japanese female with Netherton’s syndrome was reported. She had the clinical features of this syndrome characterized by trichorrhexis nodosa, and a peculiar serpentive, migratory, scaling eruption on the skin. The skin rash of this case responded well to the combination therapy of 8 MOP and UVA and also to the topical treatments with betamethasone, urea ointment and polyethyleneglycol.

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35 cases with salmon patch (8.2%) and 7 cases with strawberry mark (1.6%) which were observed in 426 newborns in the obstetrical clinic of our hospital for two years (1976-1977) were studied. Salmon patch was most often seen at the back of the head including napes (47%) and then at the eyelid (36%). There were no marked differences in sex. No clinical symptoms in all cases with strawberry mark were noticed at birth. As the first clinical symptoms, erythema in 5 cases, anemic macule in 2 cases and teleangiectasia in one case were surveyed between 3 days and 10 days after birth. Symptoms of all the cases were inclined to disappear between 6 months and one year after birth.

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A case of so-called mixed tumor of the skin was reported. The patient was a 54-year-old woman and the tumor appeared five years ago on the left zygomatic region. Histopathological investigation was performed and some literature was reviewed for reference.

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A 14 month old baby boy who suffered from nevus verrucosus systematicus with epidermolytic hyperkeratosis was reported. Using an electron-microscope, we observed thick bundles of tonofibrils with a speckled pattern, and around them filamentous substances in the cytoplasm of the keratinocyte in the prickle cell layer. In the granular layer, filamentous substances filled up the cytoplasma. The epidermolytic hyperkeratosis (EH) is generally considered to be a genetic disturbance of keratinization. It is our view that EH should also be recognized as a dynamic state caused by a specific metabolic disturbances of congenital hyperkeratosis and/or hyperproliferation of epidermis, and that EH also acquired in some other cases.

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Three cases of solitary glomus tumors were reported. There were 2 patients with painful subungual lesions and one patient with painless neck lesions. Review of the literature showed that the degrees of the pain of solitary glomus tumor were not related to the size, and the subungual lesions caused more severe pain than the other site lesions.

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A patient who suffered from chronic eczema and prurigo recalcitrant against various therapies and developed the adrenocortical hypofunction due to the prolonged use of corticosteroid, was successfully treated with the immunosuppressive therapy by azathioprine. From this, it seems to be worth trying the immunosuppressive therapy by azathioprine for such cases of chronic eczema or prurigo.

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A 16-year-old man with psoriasis arthropathica was reported. In this case, the onset of skin and joint symptoms were simultaneous. Cutaneous manifestations were similar to ordinary skin lesions of psoriasis, but his psoriasis was of a pustular variety and had an exudative tendency. His skin lesions and arthritis were improved with an oral administration of methotrexate. Psoriatic arthritis is an entity distinct from rheumatoid arthritis.

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Dermatophytes isolated in Wakayama prefecture for the last 3 years total 1327 strains: 1049 (79.1%) were identified as Trichphyton rubrum, 17 (1.3%) as Epidermophyton floccosum, 230 (17.3%) as T. mentagrophytes, 18 (1.4%) as Microsporum canis and 10 (0.8%) as M. gypseum. Of the 230 strains, identified as belonging to T. mentagrophytes complex, 1) 12 were compatible with “−” tester strain of Arthroderma vanbreuseghemii and could be divided into 2 of the granulosum-asteroides form, 3 of the “powdery” form and 7 of the “persicolor” form, and 2) 218 were incompatible with the tester strains of A. simii, A. benhamiae and A. vanbreuseghemii and divided into 1 of the granulosum-asteroides form (neuter strain?) and 217 T. interdigitale (all “+” mating type). All of the 18 strains identified as M. canis were compatible with Nannizia otae and proved to be “−” mating type. Of the 10 strains identified as belonging to the M. gypseum complex, 2 of them proved to be N. gypsea “+”, 6 to be N. gypsea “−”, and 2 to be N. incurvata “+” and “−”, respectively.

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The ultrastructures of the mast cells in the skin specimens of urticaria pigmentosa and degranuration of rat peritoneal mast cells produced by compound 48/80 were observed with transmission electron microscopy (TEM) and scanning electron microscopy (SEM). Finger-like, villous protrusions were seen along the periphery of the mast cells and granules were prominent in the cytoplasm. The granules showed various electron densities and contained lamellar structures which formed either parallel, straight or curved figures. It was suggested that lamellar structures were related with intracytoplasmic filaments. After incubation with compound 48/80, the peritoneal mast cells were altered and swollen, or vacuolated granules were observed by TEM. By SEM, the mast cells showed spherical in shape and the external surface had numerous granules which were adherent to the outer surface of the cell. After mast cell stimulated with compound 48/80, several openings were present in the surface of the cell.

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The toxicological properties such as irritations to the rabbit and inhibition of growth of cultured cells was compaired between synthesized homogeneous polyoxyethylene lauryl ethers and esters, and commercial diverged polyoxyethylene lauryl ethers and esters in relation to their analytical results of the components. The results indicated that the commercial products contained many components, and both commercial and synthesized products of polyoxyethylene lauryl ethers produced the irritation to the rabbit and the inhibition of cells growth in the same degree, although the polyoxyethylene lauryl esters had slightly different effects on the both tests. A good correlation was observed between the inhibition of growth of cultured cell and skin irritation to the rabbit. This method using cultured cells was found to be valuable to study the toxic effect of surfactants on the skin.

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The inhibitory effect of polyoxyethylene lauryl ether (LA-8EO) on the growth and macromolecular syntheses of cultured HeLa-S₃ cells were studied. The syntheses of cellular protein, DNA and RNA were inhibited in the presence of LA-8EO and the growth inhibition of the cultured cells seemed to depend on the change in the ability of cells to allow the passage of protein and nucleic acid precursors after treatment with LA-8EO. These results suggest that LA-8EO may affect the permeability of cell membrane to those precursors as a result of its adsorption of cell membrane.

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The patients of drug eruptions who attended the Department of Dermatology, Branch Hospital, University of Tokyo, from 1966 to 1968, were 113 persons or 1.08% of the total outpatients. The number of drug eruption patients in their twenties was the largest—31 persons, and those in their thirties was the next largest—28 persons. The sum of both groups was slightly more than half of the total drug eruption patients. Cutaneous eruptions were classified according to the list of American Medical Association. Fixed eruption with 45.1% was the largest, followed by exanthematic eruption with 25.7%, erythematous eruptions with 11.5%, papulovesicular eruption with 8%, urticarial eruption with 2.7%, erythroderma with 0.9%, acne form with 0.9%, toxic epidermal necrolysis with 0.9%, photosensitive eruption with 0.9%. Causative drugs of 10 cases were ascertained by a provocation test and the ones of another 21 cases were suspected by determing that the patient had used one drug only. The largest group of causative drugs was antibiotics with 12 cases, followed by sulfonamide with 8 cases, sedativa with 2 cases and so on. Of the drugs used, chloramphenicol in 5 cases, sulfisomezole in 3 cases and carbamazepine in 2 cases were outstanding. Both in exanthematic and in papulovesicular eruptions, trunk and extremities were frequently involved but the face was seldom affected. In erythematous eruption, extremities most were frequently involved; secondarily, the face and trunk were affected. The dosage of drug, used in the provocation tests of exanthematic, papulovesicular and erythematous eruptions, was about one fifth of the normal single dose and when no reactions were observed in the following 24 hours, an additional dosage was used. If the distribution of exanthems in the provocation test was compared with that in the previous reaction, areas which were at an early stage and severely involved were unchanged. The tendency was observed that exanthems appeared earlier in the arms than legs. In 3 of 6 provocation tests, leukocytosis was observed. In other 3, leukopenia was observed. A decrease in the number of platelet was observed in both cases.

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