A case of keratoacanthoma centrifugum marginatum was reported. The patient was a 75-year-old female, and had an extensive lesion measured 2.5×4.0cm on the right cheek. The lesion showed progressive peripheral growth and central healing, and showed slow spontaneous resolution. This is the first reported case of the disease in Japan.

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One case of Gianotti’s disease was reported. The patient was a 20-month-old boy. Many erythematous papules without itching and pain were seen on his face, hands and feet. Swelling of superficial lymphnodes and hepatomegaly were not detected. Serum GOT and GPT levels were increased. Serum HBs Ag was positive, and the subtype was adr. Serum HBs Ab was negative at first, and later it was positive. Pathogenicity of HB virus in Gianotti’s disease was discussed in regard to HBs Ag subtype adr unusual in the disease.

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Skin lesions, if any, are very instrumental in making the diagnosis of subacute bacterial endocarditis (SBE). The best known manifestation is Osler’s node. In this paper we reported two cases of SBE. Case 1: The patient was a 50 year-old man who complained of fatigue, fever, painful reddish nodule (Osler’s node) and erythematous patches (Janeway spots) on fingers. The histopathologic features of biopsied Osler’s node showed slight leukocytoclastic vasculitis in capillaries and small vessels within the dermis. Gram-positive microorganisms were found around a vessel wall. Case 2: The patient was a 38 year-old man having complained of fever, polyarthralgias and small purpuric spots on the hand, fingers and conjunctiva. The blood culture was positive for Streptococcus viridans.

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A case of a 44-year-old woman with lupus erythematosus profundus was described. The diagnosis of this disease, particularly on the cases which do not exhibit clinical or laboratory manifestations associated with systemic and discoid lupus erythematosus, was discussed mainly on the clinical and histological features.

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A case of bullous pemphigoid which developed in a 75-year-old woman is presented. Primary blisters occurred at the place where patient was cauterized with moxa on the lower extremities. Then many blisters appeared on the arms, chest and abdomen. These eruptions improved by topical treatments. About one year later she was scalded with boiling water on the left thigh, and then pemphigoid lesions developed on the arms, chest, back, thigh, axilla and groins. Histological examination of the skin biopsy showed a subepidermal bulla. Direct immunofluorescent studies revealed a linear band of immunoglobulin and complement at the dermoepidermal junction. Indirect immunofluorescent testing carried out on the patient’s serum, using guinea-pig esophagus as a substrate, was positive. Treatment was started with oral administration of 40mg of prednisolone. Within one month she was free of lesions.

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Three male patients, aged 44, 52, and 45, developed skin metastasis of hepatic cancer. Small nodules were observed on the forehead and the back in the first case, on the head, nose, forearms and the legs in the second case and on the head in the third case. Histologic features of the nodules were metastatic adenocarcinomas in the first and the second cases, and undifferentiated carcinoma in the third case. At autopsy, primary tumors were proven to be cholangiocarcinomas in the first and the second cases, and hepatocholangiocarcinoma in the third case. Metastases to multiple organs and lymphnodes were revealed in all three cases.

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A case of a 36-year-old male with so-called multicentric pigmented Bowen’s disease on the dorsal site of the penis was reported. Statistical observations and discussions based on 19 cases of this disease reported in Japan including our own case were studied.

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A case of a 49-year old man with pretibial myxedema was reported. He suffered from Graves’ disease with exophthalmus and osteoarthropathia hypertrophicans. Histopathological and electron-microscopical investigation was performed. Additionally, 51 cases of pretibial myxedema and 15 cases of EMO syndrome (exophthalmus, myxedema circumscriptum and osteoarthropathia hypertrophicans) in Japan including our case were statistically studied.

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A 7 year-old female was examined in our clinic, exhibiting itchy erythema, papules and vesicles with scar formation on her face, ears and the backs of the hands. These eruptions appeared after sun exposure, especially in the spring and summer months, since the age of 3. A slight degree of increase in IgG in the serum was observed. Increasing amounts of taurin and glutamine in serum, as well as lysine and glutamine increases in the urine were also noted. No significant increase of tryptophan in urine was observed after the oral administration of tryptophan (50mg/kg). Porphyrin in blood and urine was within normal values. The following phototests were performed in order to study the action spectra of this case:
1) Exposure to natural sunlight with filters: Bright May sunlight, for a period of one hour, was exposed upon the flexural aspect of the forearms through successive Toshiba color filters, which blocked the wavelengths lower than 350, 370, 390 nm., etc., respectively. This test was performed three times on three separate days. When a UV 35 filter which blocked wavelengths less than 350nm was used on the skin, papules and vesicles were produced each time. When UV 37 and UV 39 filters, which blocked wavelengths less than 370 nm and 390nm respectively, were used, vesicles occured one out of the three times tested.
2) Exposure to long and middle wavelengths UV irradiated from Toshiba Dermaray M-DMR-2 type: After 30 minutes exposure to long UV, erythema occured. After 20 minutes exposure to middle wave UV, erythema and swelling was observed, however, vesicles did not occur.
3) Exposure to Toshiba Xenon Lamp with filter UV 29: 30 minutes exposure produced erythema and swelling. However, a 7 minute exposure daily repeated over a 6 day period did not produce vesicles.
4) Exposure to monochrometer: Exposure to 340-401 nm produced erythema.
From these findings, the long UV was considered the action spectra in this case.

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Acid α-naphthyl acetate esterase (ANAE) activity has been found to be a useful enzymocytochemical marker for T lymphocytes in human peripheral blood and lymphoid organs. ANAE staining was carried out in cells from blood smears and tissue sections (lymph node, skin) of various malignant lymphomas. The results were summarized as follows.
1) ANAE staining patterns: The majority of T cells separated by E-rosetting, showed a localized, intense brownish reaction product (T pattern). Some T cells expressed faint, diffuse reaction product (T′ pattern). Monocytes showed diffuse cytoplasmic ANAE activity (M pattern). Most B cells and granulocytes were ANAE negative.
2) T and B cell type in malignant lymphomas: All nodular lymphomas (2 cases) were proved to be of as B cell origin. Of 12 diffuse lymphomas, 11 were T, and 1 was “null” type. One case of Hodgkin’s lymphoma was T cell type.
A high percentage of ANAE-positive lymphoid cells was found in most of the malignant cutaneous lymphomas, including Sézary’s syndrome and mycosis fungoides. Only one case was B cell type. The histochemical demonstration of ANAE activity seems to be a useful method for the identification of T and B cells in lymphoid tissue sections and smears of malignant lymphomas.

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Intradermal skin tests and in vitro antigen-induced histamine release from leukocytes were carried out using mite, house dust and several fungal allergens in chronic urticarial patients who had no other atopic diseases. The causes were not identifiable from the history in the patients. Seventy-two out of 106 cases (67.9%) gave positive skin tests with at least one of the allergens used in the present experiments. The results of the skin tests suggest that mite, house dust and Candida allergens may be important allergen in chronic urticaria. These were supported by the results of the antigen-induced histamine release from leukocytes of the chronic urticarial patients.

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Five patients with psoriasis or eczema were treated for 7 consecutive days with 0.1% halcinonide ointment 20∼40g daily (20∼40mg halcinonide). The serum 11-OHCS levels and urinary 17-OHCS levels were estimated for fifteen days before, during, and after treatment. The eosinophil counts and blood glucose levels were also estimated. The serum 11-OHCS levels were lowered in four cases. Decreasing of eosinophil counts occured in two cases and increasing of blood glucose levels was observed in two cases. The clinical effects were almost equal with some other potent steroids. The results indicate that the use of 0.1% halcinonide ointment 20∼40g daily results in percutaneous absorption of halcinonide to cause strong inhibition of adrenocortical function.

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A statistical survey on 29 cases of metastatic skin cancer at the Department of Dermatology, Okayama University Medical School from January, 1965 to December, 1978 was reported. 29 cases were discussed on frequency, sex, age, metastatic site, original organs, clinical findings, pathological findings and prognosis, compared with the other reports.

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