A case of multiple Bowen’s disease with squamous cell carcinoma in skin and lung is described. A 55-year-old man had several, brownish pigmented cutaneous lesions (about 0.3-1 cm diameter) on the trunk and extremities for over 25 years. Some of the pigmented lesions formed gradually scales and crusts. A skin biopsy taken from the crustous pigmented lesion led to a diagnosis of Bowen’s disease. He had also multiple verrucous lesions on the palms and soles. About 1 year ago, he developed a tumor with an ulcer on the right thumb, and here the histology showed a squamous cell carcinoma. A chest x-ray in 1980 showed a solitary tumor in the right lung. Histologically, this tumor proved to be squamous cell carcinoma. He had no history of ingestion or exposure to arsenic.

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Because of the interest, rarity and controversy in histogenesis, a case of malignant hemangioendothelioma in a 66-year-old man is presented. Electron microscope study confirmed that the tumor was composed of vascular lumina, bordered by immature cells having the characteristics of endothelial cells such as Weibel-Palade’s granules, and by basement membrane and pericytes. It was indicated that the tumor arose from a malignant proliferation of endothelial cells of the blood vessels but not of the lymphatic vessels.

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Three autopsied cases with malignant haemangioendothelioma were reported. The first case was a 58-year-old man with a primary lesion on the right knee. Autopsy showed metastatic lesions in the lung, the spleen and the lymph nodes. The second case was a 55-year-old woman with a primary lesion on the face and scalp. Autopsy revealed metastatic lesions in the lung, the liver, the spleen, the kidney, the bone and lymph nodes. The third case was a 35-year-old man with a primary lesion on the right upper arm. Here, metastatic lesions were demonstrated in the lung, the kidney, the spleen, the bone, the brain, the diaphragma and lymph nodes.

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An 80-year-old Japanese woman presented a severely painful tumor on the right side of the neck. The area had been treated with radiation under a diagnosis of lymphadenitis colli tuberculosa 50 years before and then with radiation for swelling on the same site (details of the condition and the dosage of radiation were not available) for a period of one year 15 years previously. A diagnosis of postirradiation malignant fibrous histiocytoma was made. Surgery and cryosurgery were not effective and the patient died about 6 months later. A review of 25 cases of postirradiation sarcoma was made.

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Eight cases of solitary lichen planus-like keratosis (SLPLK) were studied clinically and histologically during a 5-year period. The patients ranged in age from 31 to 69 years with a mean age of 53 years. The female to male ratio was 7 to 1. All lesions occurred on the face. Pigmented spots preceded SLPLK in 4 cases, and verrucous papules in 2 other cases. Histologically, heavy mononuclear cell infiltrations into the epidermis, pronounced inter and intracellular edema were found in all specimens. In only one case were there atypical epidermal cells.

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A 30-year-old male had a red and blue tattoo applied on both sides of his upperarms and shoulders in 1965. Three years after the application of the tattoo he noticed swelling and redness on the red portion and these reactions recurred once a year. The reactions occurred spontaneously and subsided in about ten days. From the end of April to the beginning of May 1978, fever persisted for one week and recurred once. Since the 20th of May he noticed redness, swelling and pain on the red portion of the tattoo. Several days later, fever (approx. 40°C) occurred and diffuse redness on the face, chest and back as well as on the extensor aspects of the extremities appeared. Although fever subsided within two days and redness disappeared in one week, scale, redness and swelling on the red portion of the tattoo persisted and so the patient visited our clinic. When he visited first, thick scale, redness and swelling were observed on the red portion of his tattoo and these manifestations were similar to psoriatic lesions. Subjective symptoms were not observed. (Figs. 1, 2) Findings of blood, serum and urine were normal with the exception of CRP 2+ and a slight increase in LDH. Patch tests were unable to be performed due to the patient’s refusal. However, application of 0.1% thimerosal did not produce any abnormal reactions. Histologically, hyperkeratosis, parakeratosis, a slight degree of acanthosis, exocytosis of lymphocytes and spongiosis were observed. Dense cell infiltration composed of lymphocytes and histiocytes were observed in the upper and middle dermis, particularly around the dilated blood vessels. There were no giant cells or eosinophils. Marked edema was observed in the upper dermis (Fig. 4). Brown granules are either phagocytized in the histiocytes or are present independently (Fig. 5). Identification of pigments present in skin lesions was performed using a scanning electron microscope x-ray microanalyzer. We clarified that Hg was present in the tissues (Fig. 6). Also, it was suspected that the pigments were composed of Hg and S. Conversely, the presence of Cd was not confirmed (Fig. 7). When the patient visited our clinic three weeks later, the abnormal reaction on the red tattooed portion had subsided completely (Fig. 3). Complications of tattooing (Tab. 1), the number of reported cases of abnormal reaction to pigments in tattooing (Tab. 2), pigments used for red colors (Tab. 3), determination of chemicals applied (Tab. 4), skin findings of abnormal reactions on red portion (Tab. 5), time lapse between tattooing and abnormal reaction (Tab. 6), clinical course (Tab. 7), factors influencing abnormal reaction (Tab. 8), results of patch test (Tabs. 9, 10), and other problems were discussed.

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We treated 33 patients with ingrown nails using the partial nail excision method, in which the incurved portion of the nail, the nail bed, the matrix and the nail wall are removed. There was a recurrence in 7 out of 33 patients, in 8 out of 64 lesions. As the cause of the recurrence, it was suggested that the nail matrix was partially reserved. All recurrent lesions were re-operated and good results obtained.

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A 6-year-old boy had had edema of the right cheek, genitalia and right lower extremity since birth. ¹³¹I-RISA tissue clearance of the right leg shows its half-decreasing time is 155 hours whereas that of the left leg (control) is 9 hours. There was no visible lymphatic vessel in the right dorsal foot, using the blue-dye test. EEG and chromosome examinations are all normal. He has been treated with compressionmassage, elastic stocking and oral administration of millotus-extract for 2 and a half years without a remarkable effect. Voiding was facilitated following circumcision of the fore skin.

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The relation between the corticosteroid atrophogenic effect on rat skin and its inhibitory effect on DNA synthesis of cultured human and rat skin fibroblasts was studied. Flumethasone pivarate, triamcinolone acetonide, clobetasol propionate had strong atrophogenic and inhibitory effects, while hydrocortisone butyrate, betamethasone valerate had weak effects. These findings suggest a correlation between the corticosteroid atrophogenic effect and its inhibitory effect on DNA synthesis. Rat and human skin fibroblasts have different sensitivities to some corticosteroids.

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The level of lipoperoxide was estimated in the muscular tissues and serums of rats with experimental myositis in the posterior limbs induced by injection of 20% NaCl solution. The muscular lipoperoxide levels of the inflammatory tissues were 1.5-2 times as high as in the non-inflammatory tissues. With pretreatment of vitamin E, there was a 40% decrease in these levels. This tendency was not evident in experiments using vitamin E deficient rats. The serum lipoperoxide levels in the rats with myositis were elevated one and half times over the normal, and in the vitamin E deficient rats, the enhancement was 8.3. Previous treatment of neither hydrocortisone nor pantethine inhibited the increase, but vitamin E did almost completely. There was no pathological evidence that the antioxidant effect of vitamin E was the result of an inhibition of the myositis.

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The permeability of water through five medical tapes, that is, 3M micropore tape, 3M transpore tape, Kowa K-FA tape, Drenison tape and Nichiban cotton tape was examined. The methods of measurement used in the first, is that a small polyurethane polymer which has seven small holes (7mm in diameter) was used. After these holes were filled with redistilled water (1.3ml), covered with a medical tape and placed in the electric balance into which the silica gel, the desiccative had been placed. The amount of water passing through a medical tape was measured by the loss of weight at each 15 minutes. In the second method, a medical tape, 50×60mm in size, was applied on the inner aspect of the upper arms for 24 hours and the amount of retentive water was calculated by measuring electrical resistence to high frequency alternating current, immediately after the tape was removed. The permeability rate was; 3M micropore tape>3M transpore tape=Kowa K-FA tape>Drenison tape=Nichiban cotton tape at less than 0.1% error. The amount of water which was retentive underneath Drenison tape was greater than that underneath Kowa K-FA tape at less than 1% error.

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