A leukotactic factor with a molecular weight of 12,500 daltons can be demonstrated in the lesional horny layers of certain dermatoses characterized by the formation of sterile subcorneal pustules, e. g. psoriasis, pustular psoriasis, subcorneal pustular dermatosis and pustulosis palmaris et plantaris. Moreover, the presence of biologically active C₃ and C₅-derived fragments (so-called anaphylatoxins) can be confirmed immunologically. On the basis of these lines of evidence, the role of the stratum corneum is discussed particularly with regard to that played in complement activation which occurs at the subcorneal region of these lesions. In dermatophytosis, elimination of the causative fungus in the stratum corneum is carried out by the desquamation of the horny layer, caused by increased epidermopoiesis induced by contact sensitivity to the fungal antigens. In the event of lack of success, it is suggested that fungus-derived leukotactic factors and complement-derived chemotactic factors produce subcorneal pustules to stimulate the epidermal proliferation, which in turn increases desquamation of the stratum corneum.

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Our investigations on localization of DNP groups in the skin and peripheral lymphoid system of guinea pigs following percutaneous administration of DNCB showed that DNP groups were mainly distributed on the surface of keratinocytes in the skin, and lymphocytes and macrophages in the draining lymph nodes. It is suggested that contact sensitizing agents introduced percutaneously bind with membrane components of these cell and that hapten cell membrane complexes play important roles as immunogens or tolerogens in contact sensitivity.

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Chronic urticaria is generally considered to be an allergic disease and type 1 reaction is a major mechanism. On the other hand, it has been reported that mechanisms of allergy have a minor role as the IgE levels in the sera of the chronic urticarial patients are usually normal. However, our results suggest that urticarial reactions may be evoked by type 1 reactions because antigen-induced histamine release from leucocytes was observed in some of the chronic urticarial patients, even when antigen-specific IgE was not detectable in the sera. The mechanisms of type 1 allergy in human skin were studied using an in vitro experimental model. The antigen-induced histamine release reactions in human skin were temperature-and Ca⁺⁺-dependent. The activation of serine esterase and the contractile system may be essential to the histamine release reactions. Cyclic AMP might regulate the release reactions. Our results suggest the possibility that histamine degrading enzymes may play a role in modulating the magnitude of the histamine-induced skin reaction in patients with cutaneous anaphylaxis.

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A large cirsoid aneurysm occupied half of the right side of the head of our patient. This pulsating hemangioma was remarkably reduced after the ligature of arteria carotis externa sinistra and dextra. One year after the last operation, the tumor was recurred and extended to the surrounding tissues. The angiography revealed that two abnormal ascending branches of arteria carotis superior dextra were enlarged and coiled up to the lesion. These two abnormally enlarged arteries were ligated. At present, the patient is well. Histopathologically, the tumor consisted of numerous abnormal blood vessels and abundant capillaries. The shape and thickness of blood vessels of this type were not uniform and both neutral and acid mucopolysaccharides had deposited in these abnormal walls.

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A 73-year-old man developed for the second time an elastic hard tumor, 5×10cm in size in the right thigh, from which a similar mass had been excised 1.5 years before. The tumor was excised radically in combination with cryosurgery, at a minimum margin of 4cm. The tumor was composed of multinodular and/or lobular myxomatous lesions and one walnut-sized fibrous lesion. The myxomatous lesions were rich in vasculature and composed of atypical fibroblast-like cells and bizarre-nucleated giant cells. The stroma stained positive with Alcian blue and the Alcian blue positive material was digestable by hyaluronidase. The hard fibrous lesion was composed primarily of atypical fusiform cells with a storiform pattern and there were a fewer number of giant cells. There was no lymph node involvement. The patient again developed a similar mass at the edge of the grafted area after a disease-free period of 5 months. The tumor was excised 3 months later and showed only histopathological features of a myxoid variant.

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A 40-year-old woman with primary biliary liver cirrhosis (PBLC) exhibited multiple xanthomas accompanied by vitiligo. After the normalization of hyperlipemia during the remission of PBLC, the xanthomas shrunk and some disappeared. These xanthomas assumed various clinical forms such as planer, nodular, palmar strial and gingival xanthoma and xanthelasma. These varied forms of xanthoma might indicate an essential association with PBLC. This patient had had vitiligo on her forehead since childhood. This vitiligo reappeared following the occurrence of xanthoma and at the same place as the latter. Electron-microscopy revealed that the epidermal melanocytes contained numerous lipid droplets in the cytoplasm. These findings suggest that the disturbance in melanogenesis may be the most possible cause of the induction of vitiligo.

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Effects of topical corticosteroids on ultraviolet (UV) erythema reaction were studied in healthy volunteers, and the results were as follows;
1) UV erythema induced by a dose of 1.5 MED (minimum erythema dose) is a suitable approach to the evaluation of the effect of topical corticosteroids, because the definite erythema could be readily reproduced.
2) The ODT (occulsive dressing technique) applied steroids completely suppressed the UV erythema, and the depots effect of steroids in 4 hours ODT appeared to continue within five hours.
3) The more frequently the steroids were simply applied, the better were effects.
4) With either the simple or ODT application, the steroids in ointment were more effective than those in cream.

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Thirty-five Japanese patients with drug eruptions or anamnesis of hypersensitivity due to penicillin or cephalosporin were studied using the penicillin and cephalosporin-specific RAST. Positive results to RAST were obtained in five patients with urticaria, but not in those with morbilliform or scarlatiniform exanthemas, erythema exsudativum multiforme, and previous anaphylactic-shock which had occurred 10 to 22 years previously. Of the five patients with positive results to RAST, three showed a cross-sensitivity between penicillins and cephalosporins. In three patients with positive results to RAST, the values of RAST gradually decreased with time. These findings suggest that the RAST is a useful approach for an in vitro diagnosis regarding hypersensitivity of immediate types to penicillins and cephalosporins.

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Human sebaceous glands were studied under SEM using styrene resin cracking and isoamyl acetate cracking methods, with special reference to their merits for studies on the tridimensional structure of sebum droplets. Using the styrene resin cracking method, whole or peripheral parts of sebum droplets extracted during the process of sampling, and the interior structures of sebum cavities were seen to have several large holes open into juxtaposed droplets. Such indicates the fusion of neighboring droplets, and the numerous small vesicles attributable to SER indicates tha vesicular elements of SER are often contiguous with sebum droplets. With the isoamyl acetate cracking method, sebum droplets displaying smooth surfaces were well preserved. Cracked surfaces of sebum droplets in partially-differentiated cells showed two forms: one was composed of an outer homogeneous compact layer and inner spongy substance, and another was of granular substances. In fully-differentiated cells, cracked surfaces of droplets were totally homogeneous. Our results suggest that sebum droplets change characteristics and structures in accordance with the maturation of lipid droplets.

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Of 106 patients with herpes zoster who visited the Department of Dermatology, Miyazaki Medical College between 1977 and 1980, 63 were treated with the regimen of local drying, warming and sympathetic ganglion block (either stellate ganglion or epidural block). This treatment proved effective for the management of neuralgia and skin lesions and for the prevention of postherpetic neuralgia. The importance of sympathetic ganglion block is stressed as treatment for aged persons with herpes zoster, and this treatment should be initiated early to prevent postherpetic neuralgia.

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