A 43-year-old Japanese woman with lupus erythematosus profundus associated with hyperimmunoglobulin E was reported and an evaluation was made of twenty-five patients with lupus erythematosus profundus.

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A case of widespread discoid lupus erythematosus in a 42-year-old woman was reported. She had erythema with telangiectasia, pigmentation and depigmentation on the face, ears, hands and left foot. Laboratory examinations indicated an intermediate or transient form of localized discoid lupus erythematosus and systemic lupus erythematosus. Immunohistological studies revealed deposition of immunoglobulins and complement in dermoepidermal junction and hyaline bodies, and that of IgG in the epidermal nuclei.

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Five patients with cutaneous myxoid cyst (63-, 55-, 60-year-old women, 75-, 61-year-old men) were reported. The pathogenesis of this disease was discussed. Two patients were successfully treated with cryosurgery. Seventeen cases with cutaneous myxoid cyst reported in Japan were reviewed.

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Three cases of bullous pemphigoid with hyperimmunoglobulinemia E are included in this report. The treatment with paramethasone induced remission and serum IgE level reduced gradually after clinical improvement. A review of literature of IgE, eosinophilic chemotactic factor and eosinophilia was made.

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Urinary porphyrin analyses were carried out in five patients with porphyria cutanea tarda and control of 44 individuals. In quantitative analyses, the mean value of coproporphyrin was 67.3μg/l in the controls, and the value of uroporphyrin was from 5.0 to 13.7μg/l in 11/44 controls. In patients with porphyria cutanea tarda, four of them showed marked elevation of coproporphyrin and uroporphyrin, but there was no elevation in one. In pattern analyses of urinary porphyrin, the mean value of coproporphyrin was 85.5%; penta carboxylic porphyrin 3.6%; hexa carboxylic porphyrin 2.5%; hepta carboxylic porphyrin 3.4%; and uroporphyrin 5.5%. In the porphyria cutanea tarda group, hepta carboxylic porphyrin and uroporphyrin were predominant in two, but five spots equally appeared in three.

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Polymorphonuclear leukocyte chemotaxis was assessed by the agarose plate method in 34 psoriatic patients and 20 healthy human subjects. It was found to be significantly enhanced in psoriatic patients, as compared with healthy controls. The enhanced chemotactic activities of psoriatic leukocytes showed a good correlation with the degree of skin involvement. In all 6 cases, chemotaxis in the advanced period was significantly higher than that in the remission.

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For studies on the pathogenesis of drug eruptions related to gold sodium thiomalate (GST), the lymphocyte transformation test (LTT) to GST was performed in patients with rheumatoid arthritis (RA). RA patients who developed some form of drug eruptions during the treatment with GST and, as controls, RA patients who had undergone no treatment with GST served as the subjects under study. LTT was done on three groups in the presence of GST, PHA or both GST and PHA. All the tests were made using the whole blood culture method. Of 11 patients with drug eruptions, two showed a positive results in LTT to GST. LTT to PHA exhibited marked reduction in blastoid transformation in most patients, but no difference was noted between the patients with drug eruptions and the controls. LTT to PHA added GST, also caused a reduction in blastoid transformation. However, correlations between the increased serum gold level and the reduced blastoid transformation in LTT to PHA were not evident, thereby indicating the suppression of lymphocyte function in the RA patients. Consequently it was considered that GST-induced lymphocyte transformation was a specific reaction and would occur at a significant level even under conditions in which the lymphocyte function is suppresses. Cell-mediated immunity may be involved in some cases of drug eruptions due to GST.

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The correlation between levels of zinc in the plasma and hair and alopecia was examined in hemodialyzed patients. In a number of patients, the plasma zinc concentration remained low not only before but also after hemodialysis, although the zinc levels were elevated at the time of dialysis. Levels of zinc in the hair of dialyzed patients were significantly low as compared to during the dialysis. These results, together with the clinical observation that alopecia improved with dialysis, suggest that the low zinc levels in the plasma and hair may relate to the loss of hair in dialyzed patients.

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The chemical structure of this compound is characterized by the presence of butylidene in positions 16 and 17 and the absence of a halogen. The 6 sample types-budesonide cream (A base), budesonide cream (B base), budesonide cream (C base), budesonide ointment (white petrolatum base), betamethasone 17-valerate cream and betamethasone 17-valerate ointment (white petrolatum base)—were used for comparison of vasoconstrictive effect. Three bases were used for budesonide cream, A base (o/w dissolved type), B base (o/w suspended type) and C base (o/w dissolved type with solvent different from that of A base). We have so far experienced that when a comparative study is made on formulations with original concentrations, there are few significant differences in the vasoconstrictive effects. Therefore, serial four-fold dilutions of the samples were prepared for more accurate comparisons. The subjects included 17 healthy male volunteers. Test samples of serial four-fold dilutions were occluded on the upper part of the back for 4 hours. The vasoconstriction reactions 2 and 4 hours after removal of the samples were evaluated and the following results were obtained.
1. Budesonide ointment was significantly superior to betamethasone 17-valerate ointment in the vasoconstrictive effect.
2. The difference in the vasoconstrictive effect between budesonide cream and betamethasone 17-valerate cream was not as clear-cut as the findings with ointment.
3. Among 3 types of budesonide creams with A, B and C bases, the suspended type tended to be superior to the dissolved type.
These observations show that budesonide ointment is superior to betamethasone 17-valerate ointment with regard to vasoconstrictive effect.

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In recent years there is an increasing tendency towards the use of more potent topical corticosteroids for the treatment of various dermatological disorders. These corticosteroids are useful to repair skin lesions, however, they sometimes produce adverse cutaneous reactions, such as redness, telangiectasia, skin atrophy, etc. These topical side effects occur more readily in infants and in the aged, and in women rather than in men. Also, intertriginous as well as face and neck areas are more susceptible areas. Although it has been reported that erythema, telangiectasia, or skin atrophy are induced more readily by potent topical corticosteroids, more basic comparative studies are required as the frequency of use of each topical corticosteroid should be considered when treating patients with these side effects. This study was performed to compare the potency of several topical corticosteroids in producing erythema, telangiectasia or skin atrophy. The local side effects caused by topical 0.05% clobetasone 17-butyrate were studied in 17 adult male volunteers in a double blind study, in the following combinations. 0.05% clobetasone 17-butyrate ointment (CB) vs. 0.1% hydrocortisone 17-butyrate ointment (HB), for eleven subjects. 0.05% clobetasone 17-butyrate ointment (CB) vs. 0.12% betamethasone 17-varelate ointment (BV), for three subjects. 0.05% clobetasone 17-butyrate ointment (CB) vs 0.025% fluocinolone acetonide ointment (FC), for three subjects. The drugs were applied once a day on the fixed bilateral flexor areas of the forearms, at about 9:00 a. m. A reapplication was made at about 9:00 p. m. of the same day, then the area was occlusively dressed, and removed the following morning. This drug treatment was repeated on a daily basis for seven weeks. Double skin folds were measured with a micrometer three, four, five, six, and seven weeks after the initiation of drug application, and one and two weeks after cessation of application. Also, erythema and telangiectasia were assessed by macroscopic examination and atrophy of the skin was assessed by palpation. The results of these examinations were compared.
1. The micrometer examination on the atrophy of the skin showed that the atrophy of the skin with CB was significantly less than that seen with HB. Also, CB seemed to be less prone to cause atrophy of the skin than did either FA or BV.
2. It was confirmed that CB was significantly less prone to cause erythema, telangiectasia, and atrophy of the skin. Also CB was less prone to cause topical side effects, as compared to FA and BV.
3. Overall assessment confirmed that CB was significantly safer than HB, in terms of these local side effects.

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