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A 39-year-old man had recurrent generalized skin rashes for about nine years. These rashes were accompanied by blood eosinophilia and cardiopulmonary abnormalities. The microscopic findings of the skin lesions were consistent with Wells’ original descriptions. The electron microscopic studies disclosed microtubular structures in the endothelial cells of the dermal vessels as well as dermal infiltration of lymphocytes and histiocytes. Nineteen cases reported to date were reviewed and the relationship to hypereosinophilic syndrome was discussed.

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A 29-year-old woman with an unusual variant of lupus erythematosus or lichen planus was reported. Clinical lesions and histologic changes were difficult to diagnose as either lichen planus or lupus erythematosus. Electron microscopic studies revealed duplication of the basement membrane of the epidermis and blood vessels, and there were numerous paramyxovirus-like inclusion bodies in the endothelial cells. In the immunofluorescent study, there was deposition of IgG, IgA, IgM, C3 and fibrinogen at many Civatte bodies in the upper portion of the dermis, but not at the basement membrane. Laboratory studies showed the elevation of γ-globulin and positive rheumatoid factor and antibody to DNA.

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A 37-year-old woman has had many chronic cutaneous adscesses due to M. fortuitum with AML. Histological findings were granulomas and tuberculoid structures, the same as seen in case of infections with other atypical mycobacteria. M. fortuitum is one of the weakest bacterias among atypical mycobacterias and is resistant to most drugs. Incision and thermotherapy had a little effect.

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Twenty-seven mycologically confirmed cases of sporotrichosis identified over the past three years (Nov. 1979- Dec. 1982) in the Nagasaki area were surveyed and compared to forty-three similar cases occurring in the same area which had been diagnosed up to 1979.
1) The number of cases increased each year, due in part to an increase in the interest by physicians.
2) Patient under 10 and over 40 were more often affected.
3) Males and females are equally affected and lesions usually occurred on the face and upper limbs.
4) Compared to other reports in the Japanese literature, onset of these lesions was evenly distributed throughout the four seasons.

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Four cases of Trichophyton violaceum infection were reported. They were a 7-year-old boy with kerion celsi and “black dot ringworm” on the parietal and frontal regions, a 4-year-old girl, a sister of the first patient, with tinea corporis on the face, a 10-year-old boy with “black dot ringworm” on the left side of the occipital region and an 11-year-old girl with “black dot ringworm” on the parietal region. All organisms isolated from these four cases were determined to be T. violaceum, by cultural morphology and microscopic findings. In addition, published cases in Japan from 1974 through 1982 were reviewed, mainly based on the review article of Watanabe. Analysis of 71 cases of T. violaceum and T. glabrum infection revealed a distinct female preponderance with a sex ratio of 18:53. The mean age was 31.0 years of age for females and 4.4 years for males. The number of those under 12 years of age was 43 and the sex ratio of male to female was 18:25. There were 28 over 13 years of age, and all were females. These results are much the same as those on “black dot ringworm” reported by Nagata.

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Four cases of subungual melanoma which developed on the nail bed of the first finger of a 37-year-old man, 77-year-old man, 71-year-old woman and 67-year-old woman are reported. There was a history of trauma in one (case 1) and extraction of the nail in another (case 2). Three of four cases had had pigmented macules prior to the onset of the tumor. Clinical and histological findings showed acral lentiginous melanoma in all four cases, but the types of cells in the vertical growth phase differed. A statistical analysis of 72 cases of subungual melanoma reported in Japan was made with reference to clinical symptoms.

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Five cases of pseudocyst of the auricle (Engel) are reported, four proved to be clinically and histologically typical. In one there were two lesions on both auricles, one of which had appeared fifteen years previously, but contained no fluid within the cyst wall and resulted in the thickening of the cartilage. Each lesion was surgically treated, with good results. From the viewpoint of the lack of tendency toward malignancy and because of a possible spontaneous regression, we propose that patients with such tumors be followed without treatment, if the patient refuses surgery.

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A family with a prevalence toward psoriasis vulgaris is reported. Patients are the father, 48 years old, the elder sister, 18 years old and the youngest brother, 12 years old. All had typical histological characteristics of psoriasis vulgaris. All three patients had an HLA haplotype of A 2, BW 46, CW 1, DRW 8, such being the first documented association with psoriasis vulgaris.

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Population-densities of epidermal Langerhans cell in the abdominal skins of mice (C3H/ HeNCrj) were examined on one, 4 and 7 days after stripping of the horny cell layers, respectively, using ATPase staining and electron microscopy. Contact hypersensitivity was induced by topical application of DNFB on the skin of these mice. The results obtained in the present experiments were as follows;
1) The ATPase staining showed that the epidermal Langerhans cells were decreased in number one day after tape stripping but the number reverted to normal tinctorially 4 days after tape stripping.
2) The density of epidermal Langerhans cell was not influenced electron microscopically by stripping of the horny cell layer, although the Langerhans cell and the keratinocyte in the stripped epidermis did show some degenerative changes.
3) The contact hypersensitivity reaction to DNFB was suppressed in the mice sensitized one day after the tape stripping, but normal states were reverted to in the mice sensitized on 3, 5 and 7 days after tape stripping.
4) It would appear that some suppressor cells in the spleen were induced in the mice sensitized one day after tape stripping.
From the findings, it is concluded that the contact sensitivity to DNFB is influenced not only by the population of the epidermal Langerhans cell, but also by its ATPase-activity.

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Three dimensional architecture of the blood vessels surrounding the eccrine glands was examined using the microcorrosion cast method and the scanning electron microscope. The superficial capillaries were arranged like a “crown” at the plane of the acrosyringium. At the bottom of the “crown”, the vessels gave rise to a superficial capillary network or loops and also to the vessel-mesh investing the sweat duct. The opposite direction of the blood flow around the eccrine duct and the secretion through the canal showed close resembrance to that of proximal nephron of the kidney. That is, the end portion of the sweat duct and the proximal tube is always supplied by a fresh stream of the blood.

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The bullous lesions from a patient with pemphigus vulgaris were biopsied, and the luminal surface of the bulla was studied by scanning electron microscopy. The floor of the blister was covered by columnar basal cells which gave rise to a tombstone-like arrangement of the basal cell. The prickle cell layer was seen at the root of the blister. Round-shaped prickle cells had a few microvilli. The spinous projections were reduced in number. SEM observations make feasible studies on the mechanism of blister formation.

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We measured the eosinophil chemotactic activities in the blister fluid of two patients with pemphigus and compared the findings with those obtained in cases of pemphigoid. The Boyden chamber method was used. Eosinophil chemotactic activity was present in both these fluids and Sephadex G-25 chromatography revealed the peak chemotactic activity before the marker of vitamin B₁₂. These findings suggest that this factor may differ from a substance similar to ECF-A present in cases of bullous pemphigoid.

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A statistical survey of one hundred and two Japanese inpatients with herpes zoster was carried out at the Dermatological Clinic of Kawasaki Medical School from March, 1974 to December, 1982. The number of inpatients with herpes zoster tended to increase from 1974 to 1982. The frequency of occurrence did not change according to the time of the year. Males were slightly more frequently affected than females. Inpatients of 20-29 years and 60-69 years of age were more frequently afflicted. The area most affected was the trunk. Diabetes mellitus and SLE combined with herpes zoter were noted more frequently than in other diseases. In the SLE patients, there were no changes in ANF, anti-DNA antibody and CH₅₀, before and after association with herpes zoster. In addition we sent out a questionnaire to the patients regarding post-herpetic neuralgia. Neuralgia persisted longer in older patients. One patient each with post-herpetic myelitis and Ramsay-Hunt syndrome are reported herein, in detail.

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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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