We described a 48-year-old man with a 15 year history of rheumatoid arthritis and a recent occurrence of urticarial rash. Leucocytoclastic vasculitis was detected in the dermis of the urticarial lesion. Deposition of IgM, C₃ and fibrinogen was observed in the dermoepidermal junction and wall of dermal blood vessels, using immunofluorescent techniques. Laboratory studies showed elevated ESR and positive antinuclear antibody and rheumatoid factor, and the serum levels of C₁q, C₃, C₄ and CH₅₀ were persistently low. On the basis of these findings, urticarial vasculitis was diagnosed.

View full abstract

A 33-year-old woman with mixed connective tissue disease had a severe thrombocytopenia. Raynaud’s phenomenon, arthralgia, swollen hands, butterfly rash, and purpura were all present. There were antibodies only to ribonucleoprotein (RNP) in the serum, and on immunofluorescence microscopy, a speckled epidermal nuclear IgG deposition was evident.

View full abstract

A 80-year-old woman developed diffuse edematous infiltrative erythematous dermatitis over her face, neck, breast and extremities following ingestion of cyproheptadine hydrochloride. A biopsy of the skin lesion revealed a lichenoid tissue reaction. While the closed patch test of cyproheptadine hydrochloride was negative, the photopatch test was positive. The action spectrum for the photosensitivity was under 320nm, within the absorption spectrum of cyproheptadine hydrochloride. One year later, the closed patch test of cyproheptadine hydrochloride became positive.

View full abstract

A 59-year-old woman who had been in a varied clinical course for several years with the diagnosis of myeloid disease, drug allergy, pulmonary tuberculosis and leukocytosis, developed painful erythemas and nodules on the face, neck and extremities plus fever of 38°C. Positive needle reaction, neutrophilia and elevated ESR were noted. The histological findings of an eruption were consistent with the diagnosis of Sweet’s syndrome. On the other hand, a statistical analysis on 149 cases of Sweet’s syndrome and Sweet’s disease reported in Japan was made with reference to clinical symptoms, laboratory data and medication. As a result, we found no appreciable difference between Sweet’s syndrome and Sweet’s disease. A review of the literature led to the idea that Sweet’s syndrome might represent an acute condition or an acute stage of Behçet’s disease. It was also suggested that the terminology be unified to the term “Sweet’s syndrome”.

View full abstract

Three patients with TEN type drug eruption were reported. Case 1: A 60-year-old man had generalized erythema multiforme-like eruptions with subsequent appearance of typical TEN type drug eruption. The course was relatively satisfactory. Case 2: A 63-year-old woman, who had been in a serious condition since admission had complications of agranulocytosis and pneumonia and died. Case 3: A 34-year-old woman with TEN type drug eruption due to intravenous injection of sulfonamide was discharged very much improved on the 28th hospital day. Statistics of TEN type drug eruption reported in Japan during the past 17 years were summarized, and from the standpoint of differential diagnosis, the histopathological features were discussed.

View full abstract

From 1975∼1981, 35 patients bitten by Japanese mamushi (adder) were treated in the Minamata City Hospital. A discussion were made on the clinical features and treatment.

View full abstract

An analysis of urinary porphyrin patterns using high pressure liquid chromatography (HPLC) was carried for a comparison of data between 13 patients with porphyria cutanea tarda (PCT) and 32 with other hepatic diseases. The result of urinary porphyrin pattern analysis was as follows: In the latter group, the mean value of coproporphyrin (CP) was 80.1% and the other porphyrins were less than 6.0%, while in the PCT group, the mean value of uroporphyrin (UP) was 59.8%, hepta-carboxyl porphyrin was 18.8%, hexa-carboxyl porphyrin was 4.9%, penta-carboxyl porphyrin was 6.8% and CP was 9.7%. The predominance of hepta-carboxyl porphyrin and UP was seen in 12 out of 13 patients with PCT. In only one was there an equivalence of CP and UP levels in the urine. The efficacy of a phlebotomy was evaluated by use of urinary porphyrin pattern analysis. Five patients with PCT were treated with phlebotomy. A marked decrease of urinary porphyrin levels was seen in 4 of 5 patients after phlebotomy, while a slight decrease was seen in only one case. In 4, there was a remarkable shift from the UP fraction to the CP fraction in the urinary porphyrin profile, however in one, there was little change of the urinary porphyrin profile. The analysis of urinary porphyrin profile by the HPLC is a simple and readily facilitated and many samples can be analyzed simultaneously.

View full abstract

Basal cell epithelioma (BCE) on the face of an 87-year-old and a 47-year-old man were cytologically studied by using Papanicolaou stain. The findings were highly specific and most useful for the diagnosis of BCE. The aspiration method proved to be the most useful method, as compared to swept or stamp methods.

View full abstract

A simplified method for measuring skin surface lipids and the hydrated state of horny layers was devised with a newly developed instrument. A good correlation was seen, as compared with conventional methods. The lipid assay makes use of frosted plates which become transparent with the adherence of lipid and the increased transmittance can be optically measured. The output of the instrument was precisely responsible for an amount of the lipids treated artificially on the plate (r=0.96). Comparative studies revealed that this method coincides with gravimetric analysis of lipids from skin surface (r=0.72). As for detection of skin surface hydration, conductivity of skin surface under high frequency current was measured and was found to generally increase by increasing the frequency. Conductivity of skin surface reaches a maximum between 10 and 50KHz regions which is substantially different from the usual frequency of 3.5MHz. A good correlation (r=0.98) was found between the conventional method reported by Tagami et al and our method with the alternating current of this region. Following applications of this instrument to the human skin and a variety of states of hydration, this method indeed closely reflects the hydration state on the skin surface.

View full abstract

Pearl barley (“hatomugi”) is a Chinese medicine used to treat verruca (warts). In vitro experiments showed that the effect of pearl barley extracts on verruca was more potent when the rind of the seed of the fruit (especially the former) compared with the seed as a whole (“Yokuinin” in Japanese). (See Report I and Report II) After extraction of the contents from the rind with hot water, an injectable solution was obtained from the supernatant and a topical agent, from the sediment. We used these extracts in experiments to determine their usefulness in the treatment of verruca vulgaris and verruca planae. Injections were given intracutaneously in a dose of 0.1 to 0.3 ml once a week, while the topical agent was applied to the lesion several times a day. The results of the application of topical agent on verruca vulgaris and verruca planae were satisfactory. The preparatory method for the topical agent, subjects for treatment, results and related discussion were reported herein.

View full abstract

Two hundred and twenty patients with rubella were assessed statistically with regard to age and sex, clinical symptoms, clinical findings and laboratory data. Epidemics of rubella occurred mainly during May and June in 1981, and affected predominantly males 16-20 years of age. In adults, relatively serious symptoms consisted of malaise, sore throat, headache, fever and an itchy sensation. Important features were rash on the face which appeared in 98.5%, erythema of the palate and throat (87.4%) and lymphadenopathy (92.4%). During the acute stage, there were characteristically a leucopenia (67.6%), a lymphocytepenia (51.2%) and a decrease in thrombocytes (68.4%). Virocytes were evident in 30.4% of all the patients. The rubella hemoagglutination inhibition test was used for 130 patients.

View full abstract

[in Japanese]

View full abstract

[in Japanese]

View full abstract

[in Japanese]

View full abstract

[in Japanese]

View full abstract

[in Japanese]

View full abstract

[in Japanese]

View full abstract

[in Japanese]

View full abstract

[in Japanese]

View full abstract

[in Japanese]

View full abstract