The effectiveness of commercially available, chemically-generated, novel exothermic pads which when applied elevate skin surface temperature up to 42-43°C was assessed in 35 patients with psoriasis. Conventional therapeutic modalities such as Goeckerman’s regimen, topical PUVA therapy and topically applied steroids served as the control. Skin lesions in 29 patients disappeared after the hyperthermia. The average time required for complete regression in the treated areas was 26 days in the case of hyperthermia, but 44 days with Goeckerman’s regimen. The hyperthermia achieved equal or longer duration of remission than Goeckerman’s regimen. The difference of pads exchange intervals (2 times/day vs. 4 times/day) did not affect the effectiveness of the hyperthermia. In the occlusion control study, the hyperthermia was proved to be superior to the simple occlusion with non-exothermic pads. Histological and capillary microscopic observations revealed marked improvement of psoriatic lesions by the hyperthermia. Serious side effects were nil.

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Electron microscope study of skin in psoriatic patients prior to and after local hyperthermia¹⁾ has demonstrated significant cellular changes following the treatment; increase of desmosomes, tonofibrils and keratohyaline granules and decrease in mitochondria and ribosomes. The enlargement of intercellular spaces was reduced. These findings indicate that local hyperthermia restores the fine structure in the psoriatic skin by inducing orthokeratogenesis and decrease in cell activity of keratinocytes, without any serious damages, such as observed in PUVA therapy.

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A statistical survey was made of patients with drug eruption at the Dermatological Clinic of Kyushu University Hospital from 1906-1980. The incidence of drug eruption was 0.5% of the total number of outpatients. Hypnotics and antibiotics are most usually involved. Recent 15 years drug eruption has obviously increased with the various clinical features in relation to the increase of the amount of the production.

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A statistical survey of papular urticaria (strophulus infantum) at the Dermatological Clinic of Kyushu University Hospital (1906-1980) was made. Recently, the percentage of outpatients diagnosed as having papular urticaria decreased, and has been below 0.2% since 1971. These decreases are attributed to a rise in the standard of living, a decrease of insects, transition of diagnostics and popularization of corticosteroid ointment. As for the age distribution, children from three years old and under accounted for 73.0% of all such patients.

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Chronological occurrences of SLE, DLE and Behçet′s disease were statistically analyzed by the use of the case records at Kyushu University from 1906-1980.
1) Total SLE numbered 399 cases (1.52 per year). A gradual tendency toward increase was noted after 1960′s.
2) Total DLE numbered 1200 cases (16.00 per year). Comparatively constant occurrence was observed, although there was a tendency toward increase after 1950.
3) The diagnosis of Behçet′s disease was first documented in 1960 and thereafter, 219 cases were recorded (10.43 per year). The yearly occurrence was fairly constant.

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A statistical survey of cutaneous tuberculosis was made during the years 1906-1980, at the Department of Dermatology, Faculty of Medicine, Kyushu University. The total number of the patients with cutaneous tuberculosis was 1496 and the average incidence was 0.51% of the total outpatients in this period. The incidence of cutaneous tuberculosis has decreased in the last twenty-five years. Lupus vulgaris and tuberculosis verrucosa cutis were not observed for some years, however have not been completely disappeared. One or two cases were diagnosed in one year for the last three years. As to the tuberculid, the incidence of erythema induratum Bazin has decreased, while the incidence of lupus miliaris disseminatus faciei has remarkably increased relatively.

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The findings in a statistical survey of syphilis in the Dermatological Clinic of Kyushu University Hospital during the years from 1906 to 1980 are reported. The incidence of syphilis showed a tendency toward a decline over the past 75 years. It is evident that the syphilitic patients gradually declined due to the increased use of antibiotics. Nevertheless dermatological specialists should make every effort to safeguard against reoccurrences of syphilis.

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A survey of pyodermas was carried out by reviewing the outpatient records at Department of Dermatology, Kyushu University from 1906-1980. Pyodermas include impetigo contagiosum, erysipelas, staphylococcal scalded skin syndrome (SSSS), pustulosis palmo-plantaris and pyoderma gangrenosum.
1) Average incidence of impetigo contagiosum was 1.71%. The highest incidence was observed in 1945, with a rapid decrease thereafter. The lowest incidence was in 1979.
2) There were 161 cases of erysipelas for the entire period, with the highest incidence during the period of the World War II.
3) Diagnosis of pustulosis palmo-plantaris first appeared in 1958 and reached a plateau in 1969. 1100 cases have been seen in the outpatient clinic, with an average incidence of 1.02%.
4) Few cases of SSSS and pyoderma gangrenosum were documented.

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A statistical survey was made of some virus diseases (herpes zoster, herpes simplex, chicken pox, rubella and measles) for the years 1906-1980. There were 292,047 outpatients and herpes zoster was seen in 1419, herpes simplex in 1370, chicken pox in 517, rubella in 19 and measles in 10.

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A statistical survey on mycosis at Dermatological Clinic of Kyushu University Hospital for 75 years from 1906 to 1980 was made. The outpatients observed in this period were 292,047 in number and comprised 20,571 cases of mycosis (7.04%). These outpatients with mycosis comprised 16,432 cases of dermatophytoses (79.10%), 2,525 cases of tinea versicolor (12.15%), 1,612 cases of candidiasis (7.76%), 114 cases of other superficial fungus infections (0.55%), and 92 cases of deep fungus infections (0.44%). Tinea pedis and tinea manus occupy 45.8% of dermatophytoses and were the largest and have been increasing for these 14 or 15 years. Candidiasis had increased remarkably since 1972, but has decreased for these 2 or 3 years. Sporotricosis with 69.6% of deep fungus infections was the largest and has increased recently. Only one case of actinomycosis has been observed since 1966. Instead, five cases of chromomycosis have been observed since 1967.

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Statistical observations of skin disease caused by animal-parasitism were made at the Dermatological Clinic of Kyushu University Hospital during 1906-1980. The incidence of scabies showed a tendency toward increase.

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Statistical observations of bullous skin diseases were made by analyzing the case records of Kyushu University during these 75 years.
1) Pemphigus cases numbered 67, of which most cases were within the age of 35-55 years.
2) Dermatitis herpetiformis cases numbered 108 and have greatly diminished in recent years, probably because of recent chages in criteria.
3) Epidermolysis bullosa hereditaria cases numbered 101, half of which were children (under 10 years old).
4) Pemphigoid cases numbered 46, most of which occurred in olderly patients. There has been some increase in recent years.
5) There were only 9 cases of familial benign chronic pemphigus, 6 of which were in the age group 40-50 years.

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Psoriatic patients who came to the Department of Dermatology, Faculty of Medicine, Kyushu University, from 1906-1980 were statistically surveyed. The results are summarized as follows:
1) Psoriatic patients numbered 2574, that is 0.88% of the total outpatients. Since 1965 there was a marked increase in the incidence of psoriasis and is now much the same as in European and American countries.
2) Sex ratio was 1.9 (Male): 1 (Female).
3) In age distribution, the prevalence among men was found to be most frequent in those over 60. As for women the prevalence was most frequent in those between 20-29.

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A survey of malignant tumors was carried out by reviewing the outpatient records at Department of Dermatology, Kyushu University from 1906 to 1980. Malignant tumors include Bowen’s disease, erythroplasia Queyrat, Paget’s disease, Squamous cell carcinoma, basal cell carcinoma, metastatic carcinoma of the skin, malignant melanoma, sarcomas, and malignant lymphoma and leukemia.
1) The total number of the patients with malignant tumors was 1146 and the average incidence was 0.39% of the total patients in this period. The incidence of the tumors, however, has increased gradually up to 1.50%.
2) Bowen’s disease and extra-mammary Paget’s disease were first diagnosed in 1958 and 1956, and the number with these diseases has increased markedly in the last ten years.
3) Each incidence of erythroplasia Queyrat, squamous cell carcinoma and sarcomas has stayed at a cirtain level without increase from 1906 to 1980.
4) Other tumors such as mammary Paget’s disease, basal cell carcinoma, metastatic carcinomas, malignant melanoma, and malignant lymphoma and leukemia had reached plateau in the last ten or twenty years.

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The association of psoriasis and joint symptom was investigated.
(1) Various joint symptoms in 244 patients with psoriasis were studied using a questionnaire. 85 (34.8%) patients stated that they were affected with joint pain in their past history; 57 were men and 28 were women.
(2) In laboratory findings of 10 patients with psoriatic arthritis, elevated erythrocyte sedimentation rates, seropositive for C-reactive protein test and seronegative for rheumatoid factor were observed.
(3) The HLA-B27 antigen was detected in two of eight patients with psoriatic arthritis.

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From 1975 to 1980, 11 patients with skin candidiasis on the scalp were diagnosed by mycological examinations. We studied statistically 17 cases including another six cases reported in Japan recently and discussed the clinical features, differential diagnosis and its treatment.

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A 11-year-old boy with disseminated connective tissue nevus was reported. In addition, he had sebaceous nevus, patent ductus arteriosus, asymmetry of the thorax, bilateral high frequency sensorineural hearing loss and slight disturbance of intelligence. A connective tissue nevus syndrome was suggested and we attempted to classify the diseases including a category of connective tissue nevi.

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A case of B-K mole syndrome was reported. There was no evidence of malignant melanoma among the family members.

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Statistical investigation of patients with skin tuberculosis observed in the outpatient clinic of dermatology, Hokkaido University Hospital, showed a marked decrease compared with the former investigations in the same clinic. The number of patients with erythema induratum Bazin markedly decreased. The decrease in the incidence of skin tuberculosis may be due to decreases in cases of general tuberculosis. Several interesting cases of lupus vulgaris and tuberculosis verrucosa cutis were described.

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One hundred and ten psoriatics among 4234 new out-patients at Asahikawa Medical College were studied. The results are as follows:
1. Incidence
The incidence of psoriasis among Japanese of late runs approximately 2-3% (2.6% in our study) which is similar to that of Caucasian countries.
2. Age distribution
Average age of onset was 33.2 years. Average onset-age in women (27.8 years) was significantly earlier than in men (34.7 years).
3. Sex ratio
There were 2.24 times more male patients seen in our clinic and such may reflect the characteristics of Oriental psoriasis.
4. Sites of initial affection
Scalp (40%) and lower extremities (25%) dominate other parts of body.
5. Familial occurrence
In 9.1% of our patients, immediate family members also had psoriasis and the major disorders in their history were upper respiratory tract infections.

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A typical case of malignant atrophic papulosis is reported. A 44-year-old man had episodes of generalized asymptomatic eruptions of two years duration, and also an abdominal crisis which lasted for three days. Numerous atrophic white or yellow-white lesions surrounded by a telangiectatic rim of erythema were widely scattered over the trunk and extremities. Surgical operation also revealed numerous atrophic lesions in the small intestine, and four of them had perforated. Histochemically, hyaluronic acid and dermatan sulfate were deposited in the vicinity of a typical lesion. Other histological findings of the skin lesion were characteristic to this disorder. The patient died on the 11th postoperation day.

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A summary is made of our previous investigations on the ultrastructure of skin glycosaminoglycan. In the normal skin, we observed electron microscopically the presence of a proteoglycan aggregate-like structure composed of hyaluronic acid bound to proteoglycan chains. On the other hand, papular mucinosis or systemic hyalinosis revealed different features of the glycosaminoglycan.

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An electron microscopic investigation of the facial lesion, “adenoma sebaceum”, in a 42-year-old male with tuberous sclerosis disclosed the following findings:
1) In the upper dermis, two different types of unfixed, dendritic, probably mesenchymal cells, “clear cells” and “dark cells”, were morphologically recognized. These cells were connected to each other by slim cytoplasmic processes, and in the stroma seemed to form a three-dimentional network.
2) The dark cells were usually small cells, and were characterized by the possession of an electron denser cytoplasm with sparse poorly developed organelles, and also abundant filame ntous materials.
3) The clear cells, on the other hand, were larger, and had an electronically more translucent cytoplasm. They were characterized by a remarkable thickening of the nuclear membrane. This often partially showed small peculiarly shaped processes. Frequently the cell membrane revealed a curious circumscribed thickening. Some of these cells had markedly widened, well developed rough endoplasmic reticulum, whereas others possessed a lot of lysosomal structures. Fibrous long-spacing collagen (FLSC) were usually found around these cells.
4) Intermediate cells between the clear and the dark cells were also recognized in these areas.
5) Multinucleated giant cells were often observed in the vicinity of the above mentioned cells. They usually had several nuclei, the majority of which showed a remarkable thickening of the nuclear membrane, as in the clear cells. A curious circumscribed thickening of the cell membrane was also recognized in these cells. FLSC were conspicuously found around them.
6) The capillaries seemed to be almost normal. FLSC were abundantly seen around them.
7) The production of collagen fibrils seemed to be increased. Most of them revealed a characteristic zigzag arrangement with obscure periodical bands. No elastic fibers were found in these areas.

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Two cases of malignant proliferating trichilemmal cysts in a 36-year-old woman and a 55-year-old man are reported, and pathogenesis of this peculiar type of hair follicle carcinoma is discussed.

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Leukocyte-phagocytizing cell (LPC) presented in this paper is a large mononuclear cell with phagocytized polymorphonuclear leukocytes (PMNs), nuclei of which usually show globular degeneration (Fig. 1), and closely resemble to so-called Reiter’s cell found in Reiter’s synovitis. LPCs were found in all samples of synovial fluids taken from patients with Behçet’s disease (BD), while such were rare in patients with rheumatoid arthritis (RA) except one sample and osteoarthropathy (OA) (Fig. 2). Reproduction of LPC in the peripheral blood taken from a patients with BD was successfully obtained by addition of LPS (50μg) to the sample (Fig. 3). Results of further experiments are summarized in Fig. 4. Synovial fluid from experimental arthritis in rabbits caused by injection of LPS into joint cavity contained LPC (Fig. 5), while leukocytes in those synovial fluid formed a rosette with Protein A-Sepharose CL-4B (Fig. 6).

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Following a short history of parakeratosis variegata and parapsoriasis lichenoides, we conclude the use of these terminologies should be abandonned for the ambiguity and possible misunderstanding. A 10-year-old girl with diffuse erythematosquamous lesions over the whole body was described. The course was progressive, non-responding to topical steroid, dithranol, urea ointment and PUVA, and tonsillectomy had no effect. However, improvement was observed by oral retinoid. After discussion on differential diagnosis, we considered this to be a new entity: Persistent mosaic erythrokeratoderma.

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The patient is 40-year-old housewife. The initial lesion was on the nape in the form of a small coin-sized infiltrated erythema when she was thirteen. The lesion had extended to a half of the left back when she came to the Hospital (University of Tokyo) on January 7, 1964. Microscopic examination of the scales from the lesions revealed numerous brownish mycelia and chlamydospore-like cells, and Phialophora verrucosa was cultivated from the same specimen. She was effectively treated with intravenous and/or local injection of Amphotericin B, but recurrences were unavoidable and total excision and skin graft for the initial lesion was necessary. Lesions of unquestionable hematogenic metastatic nature were frequently observed since 1964, in the upper site of her left thigh, right upper arm, and left breast and were composed of subcutaneous nodules, verrucous skin lesions and small ulcer, even after the initial lesion was completely cured in 1967. The patient remains in good general condition even at present time, and there is no sign of internal metastasis of the fungus.

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Four cases of acute guttate psoriasis and psoriasis vulgaris with familial occurrence were reported. In one family, a 10-year-old boy and his 29-year-old mother developed acute guttate psoriasis on their trunks and extremities, following tonsillitis. Laboratory studies showed white blood counts of 9,200 and 9,800, respectively. HLA typing revealed both to be homozygous for HLA DR4. On the other hand, there seemed to be no HLA haplotype characteristic of psoriasis. In another family, a 19-year-old girl and her 54-year-old father had been suffering from psoriasis vulgaris. Routine laboratory studies were normal in both cases. HLA typing revealed the daughter to be AW24, CW8, BW51. BW54, DRW6, DR4; the father was A3, AW24, CW6, CW8, B13, BW51, DR7, DRW6. Interestingly, a HLA haplotype CW 6-B 13-DR 7, which has been frequently noted in patients with psoriasis, was observed in the father, but not in the daughter. These findings do not support postulation that a ‘psoriasis susceptibility gene’ is situated at loci closely linked to the HLA loci.

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We investigated postoperative alopecia at Kitasato University Hospital during the three-month period from January through March 1980. There were 182 patients who underwent surgical procedures while under general anesthesia. Alopecia was observed in 8 out of the 182 patients. Some patients noted swelling or redness of the scalp over the occiput shortly after the operation and sometimes there was pain and tenderness. Hair loss began in 14 days after the operation. Complete regrowth of hair occured in all patients. The histopathologic findings were edema and perivascular round cell infiltrations in the upper dermis, obliterative vascular changes due to intimal swelling, the presence of perifollicular thick, homogenized connective tissue stalk, and some lipodystrophic changes.

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Transepithelial elimination is an important phenomenon in which various foreign materials in the dermis are excluded via the epidermis or the hair follicle to the exterior. Elimination phenomenon may be classified into three types, that is, (1) intercellular or intracellular elimination, (2) intermittent mass elimination and (3) epithelial perforation (= continual mass elimination). We were able to find transepidermal and transfollicular elimination in each of these three types. So-called elimination dermatoses and various skin disorders in which elimination phenomenon is observed are demonstrated in this paper. Also, in order to study how this process is initiated, effected and controlled, we attempted to produce an animal model. We injected charcoal activated powder (CAP), polystyrene latex spheres (Latex) and four kinds of pigments into the flank skin of guinea pigs. In this experiment, following results were revealed; CAP was expelled through the follicular epithelium, and Latex was directly expelled via the epidermis to the exterior. Other samples did not evoke an elimination phenomenon. The histogenesis of elimination phenomenon which is based on the effects of these experiments and histologic studies in various dermatoses is discussed.

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Of 179 patients with sarcoidosis observed in the Dermatology Departments of both Kanazawa University and Kanazawa Medical University for the period of 21 years from 1960 to 1981, 34 patients (19%) were found to have infiltration of old-standing scars most often on the knees, followed by the elbows and others. In biopsy specimens, groups of small epithelioid granulomas containing glass-like foreign bodies and fibrosis surrounding the granulomas were seen under the atrophic epidermis. By electron microscopy, the granulomas were revealed to be composed of epithelioid cells of following three types: (1) the cells containing a number of lysosome-like dense bodies in the cytoplasm, (2) those showing numerous cytoplasmic vacuoles and (3) those having a lot of residual bodies and myelin figures within the cytoplasm.

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Three cases of streptococcal gangrene were reported. The first case was a 78-year-old woman with lesions on the back of the left foot and toes, the second, a 7-year-old boy with lesions on the abdominal wall and the upper portion of the left thigh, following chicken pox, and the third, a 57-year-old woman with a lesion on the left fingers. Hemolytic streptococci were isolated from the blood culture specimens of Case 1 and Case 2. Culture material from the lesions revealed hemolytic streptococcus in Case 1, Staphylococcus aureus in Case 2, and Staphylococcus epidermidis in Case 3, respectively. Although hemolytic streptococcus was not isolated in Case 3, it was concluded that the gangrene was of streptococcal origin-because of a history of recurrent erysipelas of the same fingers.

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A 66-year-old man noticed a non-painful reddish, bean-sized nodule on the skin surface of the left cheek adjacent to the nose about eight years ago. The nodule disappeared within approximately two months without any treatment. He had similar episodes several times at regular intervals on the left cheek during the following four years. In July, 1974, he underwent total excision of a 25×40mm-sized tumor, which had been growing on a razor-cut scar of the left cheek for one month. Until October, 1977 after that, he had five similar operations whenever new tumors appeared on the left cheek. Two months ago, he came to our department complaining of a newly growing tumor on the left cheek, 10×12mm in size. The reddish-brown colored tumor had a crater-like appearance with a crust and a keratotic plug in the center. The tumor was covered with thick scales. These clinical features were rather similar to those of molluscum contagiosum. Histological examination of the tumor showed typical features of keratoacanthoma. An irregularly shaped crater was filled with keratin. The epidermal tumor mass contained cells of atypical appearance, dyskeratotic cells, many mitotic figures and horn pearls.

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Unlike western countries, prewar Japan did not witness Microsporum canis infection-cases, except in Hokkaido. However, the so-called “pet boom” prompted the import of foreign-bred high class cats and accompanying M. canis which gradually prevailed first in Tokyo and then other cities such as Kobe, Kyoto and Osaka in the Kansai district. At present, this dermatophytes is prevalent throughout the country. The mating experiments on 231 japanese isolates of M. canis were carried out. Out of these, 212 produced fertile gymnothecia in crosses with VUT 77054 “+”, 18 were non-reactive, and the only one isolated in Osaka produced fertile gymnothecia in crosses with VUT 77055 “minus;”. So far the three “+” mating type strains were reported in Japan.

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The gross, histological and immunohistological features of skin lesions in patients with systemic lupus erythematosus, including discoid lesion, are rather specific. From the findings that the lesions predominantly develop on sun-exposed skin, several attempts have been made to produce skin lesions of lupus erythematosus, using ultraviolet (uv) lights. We irradiated uv-lights (280-310nm) to the skin of eight rabbits with antibodies against heat-denatured DNA (h-DNA) and a proteinuria of over 100mg/day following repeated immunizations with h-DNA, mixed with methylated BSA and complete Freund adjuvant. A single irradiation of 20 MED resulted in an erythema resembling a burn. Histologically, the lower epidermis became diffusely eosinophilic and revealed scattered eosinophilic bodies, where immunoglobulin (Ig) was deposited. However, these findings were not specific for the immune rabbits. Twelve days’ irradiations of 7 MED produced an erythema with thick scales and crusts which resembled human discoid lesions. Histological findings consisted of acanthosis of the epidermis and an infiltrate of mixed cells in the upper dermis. In the dermo-epidermal junction area of only one immunized female rabbit, Ig deposits were demonstrated and such deposits were more conspicuous on the 12th day after the cessation of the irradiation. However, these Ig deposits were no longer apparent on the 34th day after the last irradiation.

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A 68-year-old woman with disseminated eosinophilic collagen disease is reported. The major clinical findings were recurrent erythema with pruritus and fever, hepatomegaly and transient lymphadenopathy. Blood examination showed intense neutrophilic leukocytosis and eosinophilia. A pronounced hypergammaglobulinemia and elevation of serum IgE levels were noted. As blood urea nitrogen and blood pressure were elevated in the later periods, periarteritis nodosa had to be ruled out. Corticosteroid treatment has maintained this patient in a relatively good condition for over two years.

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A 57-year-old man with ATL was reported. Clinical, histological, ultrastructural and immunological studies were performed on the patient. He was born in Kochi Prefecture. He felt itchy on his trunk and extremities and developed papules on the breast and back four months later. Histological examination of the skin lesion revealed upperdermal infiltration of pleomorphic atypical lymphoid cells and Pautrier microabscess. The nuclei of atypical lymphoid cells in the skin lesion were seen to lobulated and heterochromatic, under the electron microscope. In the immunological-membranous study, atypical lymphoid cells in the peripheral blood showed characteristics of T lymphocytes.

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Eosinophilic spongiosis (ES) is now widely accepted as one of characteristic histological features in pemphigus. However, ES is frequently observed in biopsied specimens from patients with bullous pemphigoid in this study. Six out of 25 cases with bullous pemphigoid, who were diagnosed immunohistologically, showed an equivalent change to ES. Four revealed a spongiosis without eosinophils in the epidermis. Those specimens contained massive to moderate infiltrations of eosinophils in the upper dermis. Those patients showed peripheral eosinophilia at skin biopsy. Thus, ES should be reconsidered as a histological feature of autoimmune bullous diseases.

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Our studies on the pathogenesis of xanthoma were reviewed with special references to the following problems; 1) clinical findings, 2) origin of foam cells, 3) origin of xanthoma lipids, 4) incorporation of lipoproteins into foam cells and removal of cholesterol from foam cells, and 5) cholesterol metabolism in xanthoma tissues. The concepts of LDL pathway, HDL pathway and scavenger pathway are discussed.

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I reviewed the experimental studies on the deposition of immune complexes into the skin and their localization, distribution and disappearance from the skin, as reported in the literature. Clinically, immune complex disorders are classified into two groups; a persistent immune complex disease and a transient one. The persistent immune complex can be found mainly in autoimmune diseases, while the transient ones are detected often in several infectious or allergic states. Several kinds of immune complexes can be formed in sera and in tissues of one patient. Even in the skin, immune complexes of some varieties might appear and be localized in different areas; on the dermo-epidermal junction, on the vascular walls, in the perifollicular areas or widely along the collagen fibers etc. Their biological functions may also be different. The precise analysis of immune complexes and their clinical significance should be elucidated in the future.

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Intradermal injections of compound 48/80, histamine and egg albumin were given to guinea pigs and macroscopic and microscopic features were observed. Intradermal injection of compound 48/80 produced an induration at the site and mixed cellular infiltrates such as lymphocytes, eosinophils, neutrophils and basophils were observed. Acanthosis was also repeatedly found at the site of intradermal injection of compound 48/80. Injection of egg albumin but not histamine to the sensitized guinea pigs produced the same lesions.

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Six patients with psoriasis or eczema were treated for 7 consecutive days with 0.05% diflorasone diacetate ointment 10-60g daily. The serum 11-OHCS levels, urinary 17-OHCS levels, eosinophil counts, blood glucose levels and clinical effects were monitored. The serum 11-OHCS levels were lowered in patients on 20-60g/day, and urinary 17-OHCS levels were lowered in patients on 30 and 40g/day. The eosinophil counts were decreased in patients on 20-60g/day and blood glucose levels were increased in only one patient on 40g/day. The clinical effects were excellent in all patients treated with the ointment. We conclude that the suppression of adrenocortical function and the clinical effects due to the use of 0.05% diflorasone diacetate ointment is the most extensive among the topical corticosteroids except for 0.05% clobetasol 17-propionate ointment.

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The effects of cyclophosphamide and vitamin B₂ on DNCB-induced allergic contact dermatitis were studied in guinea pigs and mice. The magnitude of the DNCB-induced allergic dermatitis was enhanced in guinea pigs treated with cyclolphosphamide intraperitoneary before sensitization with DNCB. On the contrary, in guinea pigs treated with cyclophosphamide at the same time as or after sensitization, the magnitude of the dermatitis was diminished. In vitamin B₂-deficient mice, the duration of the DNCB-induced allergic dermatitis was longer than that in normal control animals, and the inflammation was also more extensive than in the controls. In vitamin B₂-excessive mice, the inflammation was milder than in the controls. These findings suggest that allergic contact dermatitis may be modulate by not only immunological processes but also nutritional state of the animals.

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A 37-year-old man with renal insufficiency developed multiple skin ulcers while under hemodialysis treatment. The routine blood biochemistry indicated acidosis and electrophoretogram detected broad midband lipoprotein pattern. Histopathological examination of skin ulcers revealed a thrombosis and calcium depositions in the dermis and subcutaneous tissue. Under the electron microscope, PAS positive substances on light microscopy were found to be amorphous substances present in and around blood vessels in the dermis.

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Acne vulgaris, keratosis pilaris, striae distensae, verruca vulgaris, tinea, atopic dermatitis, ichthyosis vulgaris and black heel were examined in 694 middle school and 915 high school students. The incidence of striae was highest at 24.3% among the 1st year boys and at 10.7% among the 3rd year girls in the high school. Activities in sport clubs or in bicycle riding had no significant effects on the incidence of striae. Acne vulgaris or keratosis pilaris were not associated with striae to any significant degree. Specific volumes as calculated from the height, bust and weight, and their increase, corresponded well with the incidence of the striae, in both sexes.

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The creams of diflucortolone valerate (DFV), betamethasone dipropionate (BDP), hydrocortisone butyrate (HB), fiuocinonide (FC) and clobetasol propionate (CP) were at random applied to 11 healthy subjects, and the degree of skin atrophy after occlusive dressing on both volar forearms for 5 weeks was histologically compared with that due to the Nerisona Universal Cream (DFV) base used as control. The results were as follows:
1) The major epidermal change was atrophy, and hyperkeratosis and parakeratosis were also observed. The major dermal changes were telangiectasia in the dermal upper layers and perivascular cell infiltration.
2) Epidermal hyperkeratosis was found in all the preparation groups including the base, but there was no difference. The degree of parakeratosis was marked in the order of CP??FC>HB??BDP>DFV??base.
3) Epidermal atrophy was characterized by the flattening and disappearance of the epithelial prolongation and the thinning of the stratum Malpighii. The degree of atrophy was marked in the order of CP>FC??BDP>HB??DFV??base. As other peculiar findings, individual cell keratinization was observed at the FC-applied area in one case, and intra-epidermal bullae at the BDP-applied area in one case.
4) The degree of telangiectasia, the findings of which might differ with the direction of sectioning the histological specimens, was marked in the order of CP>FC>BDP??HB>DFV??base.
5) Perivascular cell infiltration was observed in the dermal upper layers. The degree was marked in the order of CP??HB??FC>DFV??BDP??base.
6) Degeneration and atrophy of the dermal collagen fiber and elastic fiber were not observed with any preparation.
7) These results of analytical evaluation were in good agreement with the result of experiments comparing the changes of the skin surface: Thus the antiinflammatory and skin atrophy effects of topical corticosteroids can be separated.

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The cytoplasmic mucin in the Paget cells of extramammary Paget’s disease was examined using a battery of histochemical techniques. The staining methods used were Alcian blue, azure A and periodic acid-Schiff. In a further attempt to identify various polyanions, staining was carried out with alcian blue containing various concentrations of electrolytes. Methylation, saponification, borohydride reduction, acid hydrolysis, and digestion with diastase, neuraminidase, chondroitinase ABC, or nucleases were also used. The results obtain edgest that the cyoplasmic mucin of the Paget cells is sialomucin without a side-chain substituent in genital Paget’s disease, and with a substituent at C₇ in anal Paget’s disease.

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A case of incontinentia pigmenti was reported. The patient was a 20-day-old girl who immediately after birth began to show signs of erythema, vesicles and pustules in a linear arrangement on the extremities and trunk. Intensive blood eosinophilia was noted. The titre of 1:32 for cytomegalovirus was discovered at age 13 months. There were no other untoward findings. Electron microscopic examination of inflammatory skin lesion revealed spongiosis and vacuolar degeneration of keratinocytes. Numerous eosinophils with degranulating change were noted within the widened intercellular spaces of the epidermis. At the vicinity of those eosinophils, degenerative changes were prominent, and the cell debris was extensive. Some of them contained melanosomes. Those findings suggest that cytotoxicity of basic proteins and some hydrolases of eosinophils play an important role in the removal of the damaged cells and tissues. The cytotoxicity seems to facilitate the phagocytosis by macrophages.

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A case of acral lentiginous melanoma was reported. Case M. M., a 65-year-old Japanese farmer, complained of a nodular swelling of the left femoral lymphnodes of 3 months duration. Light brown to dark brown pigmented fleck, 4×2.5cm in size, without any tumor or ulcer, had been present on the left sole for over 3 years. In addition with the above case report, the pre-existing flecks which are seen in the various types of malignant melanoma, are also discussed.

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The effect of castration on 5α-reductase activity in male hamster sebaceous glands was studied using a micromethod of our own design. One week after castration, the activity of 5α-reductase increased by nearly 250%, compared to the control values. This high level of the enzyme activity was maintained for at least 3 weeks after castration. Such increase in the enzyme activity in hamster sebaceous glands by castration is in contrast to the rapid decrease of 5α-reduction in other target organs such as the prostate and seminal vesicles.

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