Five cases of eosinophilic pustular folliculitis are reported. Case 1: A 41-year-old woman developed erythematous lesions with papules and pustules on the scalp, face, trunk, extremities, soles and right fingers. The topical application of corticosteroid ointment was effective, but oral DDS, antibiotics and oxyphenbutazone were ineffective. Case 2: A 9-year-old boy developed annular lesions on the scalp and extremities, which improved after three years of the topical corticosteroid application. Case 3: A 26-year-old man with annular lesions only on the upper limbs had a remission following topical corticosteroid application. Case 4: A 38-year-old man developed annular lesions on the face, trunk and extremities and pustules on the palms and soles. A topical corticosteroid, oral antibiotics and oxyphenbutazone and the treatment of periodontitis were ineffective. Case 5: A 73-year-old man with erythematous lesions on the scalp, face, trunk and extremities was febrile with headache. The skin lesions were controlled with oral administration of prednisolone.

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A girl, aged 8, has had bilaterally disseminated brownish papulonodular mastocytosis on the trunk since at age of 6 months. Blister formations on every eruption were observed about 30 minutes after ingestion of three kinds of drugs, codeine phosphate, amoxicillin and tiaramide. Histological findings were subepidermal blister and marked infiltration of mast cells. Provocation tests using the above described three drugs failed in the reformation of blister and there were no sings of worsening of the cutaneous lesions. From 1965 to 1981, 240 cases of urticaria pigmentosa, mastocytosis and solitary mastocytoma were reported in the Japanese Journal of Dermatology. Among them, 48 had blister formation, 23 of 42 cases having solitary mastocytoma, 24 of 118 having multiple urticaria pigmentosa and one of 80 cases having an unknown type of diesease. With regard to the age of onset of blistering, 43 of 46 were under four years of age and the other three were also under seven years, namely two cases had blister at age of six and one at age of four. The present report case concerns the oldest child with mastocytosis and blister formation reported in Japan.

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The patient, a 53-year-old woman, showed clinical findings compatible with scleroderma including gross and microscopic skin changes, Raynaud’s phenomenon and esophageal motility disturbance. Also she had muscle pain, elevated serum levels of aldolase, electromyographic changes, which suggested dermatomyositis. The serologic findings included 1) positive antinuclear antibody of speckled pattern; 2) high titers of RNP antibody; 3) no detectable Sm antibody; and 4) low titers of antibody to DNA. During the course of the disease, dyspnea on effort suddenly occurred and pulmonary hypertension was revealed by a right heart catheterization. With steroid therapy, sclerosis of forearms and face disappeared gradually. The titers of immunoglobulin were reduced to normal levels, and antinuclear antibody and RNP antibody were decreased in titer. Raynaud’s phenomenon and pulmonary hypertension remaind unchanged. She died of heart failure. This patient showed mainly clinical features of scleroderma, but with such varied immunological abnormalities, this case may be placed near MCTD or mesenchymal scleroderma.

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We report a 66-year-old man with keratosis punctata palmaris et plantaris. He has yellowish round or oval hyperkeratotic papules, range from 1 to 5mm in diameter, on the palms, soles and the ventral aspect of all digits. The histology of the palmar lesion revealed a massively thickened stratum corneum without parakeratosis. The epidermis showed slight depression, but the dermis was normal. In pedigree, 2 affected individuals are presented; a brother (age 63) and a son (age 31). Treatment with etretinate (50mg/day), resulted in an almost total disappearance of the lesions within 8 weeks after initiation of the therapy.

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Two patients with stage IV malignant melanoma were treated with a combination of pepleomycin, ACNU and vincristine. A marked response was obtained in one patient with lung and brain metastasis whereas no response was obtained in the other with intestinal metastasis. Fever, nausea, vomiting and extensive alopecia followed pepleomycin administration. Pulmonary fibrosis was not observed.

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The Neodymium-YAG laser, which has been mostly used in surgery and urology for malignant tumor, has also come to be used in dermatology. The advantages of the Nd-YAG laser in irradiation is that it has a good output, adequate dispersion and penetration, no bleeding and short operating time. According to these merits it may be effective treatment for intraepidermal lesion. The patient, a 66-year-old man had Bowen’s disease on the left lateral site of the iliac region. The pathology confirmed the diagnosis. A therapeutically safe and effective dosage for treatment of Bowen’s disease with the Nd-YAG laser has not been determined. We applied the laser light at a level of 10 W to 20 W power. After 6 months of irradiation, we found no recurrence in the 20 W irradiated region, but a different region did show evidence of the disease. We confirmed the result through a pathological diagnosis. Accordingly we observed that at least a 20 W power level is needed for treatment of Bowen’s disease.

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Enhanced leukocyte functions mediated by complement components were detectable on tissue specimens, using the leukocyte attachment and NBT reduction test. Pemphigoid antibodies mediated the attachment of leukocytes at the dermoepidermal junction in the presence of complement, with subsequent activation of their metabolic pathway. Pemphigus antibodies also induced the attachment of leukocytes at the epidermis. The resultant histologic feature was similar to that of eosinophilic spongiosis in pemphigus. In psoriatic lesions, leukocytes adhered to the stratum corneum, especially to the Munro’s microabscess and thick parakeratotic lesion, where deposits of C3 were constantly demonstrable. Those leukocytes binding specifically to the stratum corneum showed vigorous incorporation of NBT dyes and respiratory burst. This simple technique is available for various types of skin disorders to detect interaction between leukocytes and complement components bound to the tissue specimens.

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Glycoconjugate was separated from urine and blister fluid of a patient with epidermolysis bullosa hereditaria simplex. The amounts of glycosaminoglycan increased in the blister fluid in patients with this disease. In addition, the amounts of neutral glycoprotein and glycosaminoglycan increased in the urine, as compared with findings in the controls. Thus there appears to be a collagen fragility in this disease. Breakdown in the collagen probably occurs as a result of minor mechanical trauma.

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Five strains of herpes simplex virus (HSV) were isolated from genital herpes lesions among 6 female patients. By typing experiments, three samples from primary infections were found to be HSV type 1 and two samples from recurrent infections HSV type 2. The difference in kinetics of antibody response was studied between primary and recurrent genital herpes infections.

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Nuclear DNA of epidermal basal cells in the guinea pig ear after oral administration of etretinate was investigated using the cytofluorometric method. The animals were given etretinate in the daily dose of 5mg or 10mg/kg. In those on 5mg/kg, growth in the relative number of S phase cells to the total cell number was highest at 2 weeks, and the value of nuclear protein in G₁ cells was also high. These changes were more prominent in animals given 10 mg/kg.

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The peroxidase-antiperoxidase (PAP) method is widely used to assess the presence of minute amounts of antigen in tissue sections. We attempted to look for deposits of immunoglobulins (Igs) in parafiin sections, using the DAKO PAP Kit. When the results were compared to the findings of cryostated sections studied by immunofluorescent (IF) techniques, the deposits of Igs were detected in 52.4% of 21 cases including pemphigus, pemphigoid, LE etc., which were investigated by IF methods. It is, however, suggested that Ig deposits are detectable, retrospectively, in the paraffin sections used for routine histological studies.

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The effects on erythema induced by ultraviolet-B (UV-B) irradiation of 6 commercially available topical corticosteroid ointment under occlusive dressing technique (ODT) were investigated. The results obtained provided reliable evidence for the evaluation of 1) the potency of the antiinflammatory action of the active drugs contained in ointment and 2) the duration of inflammation suppression action of the drugs, in other words, retention effects of the drugs topically applied. Of 6 drugs tested under one hour-ODT, the less potent ones exhibited no appreciable suppression of erythema, with unsatisfactory results from the viewpoint of comparison of efficacy, but a prolonged three hour-ODT revealed a rather marked difference in efficacy among 6 topical corticosteroid ointments. The extent of efficacy of the drugs was assessed as follows: 0.05% clobetasol propionate ointment and 0.05% fluocinonide ointment rank “very strong”; 0.1% hydrocortisone butyrate propionate ointment, at a higher than mid-level in “strong”; and 0.1% halcinonide ointment, 0.1% diflucortolone valerate ointment and 0.12% betamethasone valerate ointment, at a lower than mid-level in “strong”. With respect of retention effects of the drugs, three hour-ODT was superior to one hour-ODT in that the former retained the effects of drugs up to twenty hours after the treatment, whereas the latter did so for twelve hours at most.

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From 1981∼1982, 1108 strains of dermatophytic flora were isolated from patients with dermatophytosis, at four dermatologics located on Kyushu Island of Japan. Trichophyton rubrum, the most frequently isolated species was present in 785 isolates (71%), followed by T. mentagrophytes 208 (19%), Microsporum canis 90 (8%), Epidermophyton floccosum 13 (1%), M. gypseum 5, T. tonsurans 1 and T. violaceum 1. A comparative study with previously reported findings revealed that in recent years, 1) the isolates of M. canis have remarkably increased in number, 2) T. glabrum and T. violaceum are now rare fungi in the Kyushu area.

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Clinical and histological analyses of melanomas at the Department of Dermatology, Tohoku University School of Medicine, were carried out. Among the 83 cases observed during a 16-year period (1966-1982) the incidence on the skin was high (66/83) and the soles, palms and nail plates were frequent sites (43/83). The incidence of melanomas on the heels was high among melanomas on the soles. Thumbs were the frequent sites among subungual melanomas. Most acral melanomas exhibited a biphasic growth pattern clinically, i. e., the radial and vertical growth phase. About half of the acral melanomas presented nodules in the pigmented freckles within one year. The intraepidermal component of acral melanomas included large, atypical melanocytes with large, often bizarre nuclei. Acral melanomas should be distinguished from lentigo maligna melanomas by the absence of damage due to sunlight, short duration of radial growth phase and a worse prognosis.

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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