The Nishinihon Journal of Dermatology
Online ISSN : 1880-4047
Print ISSN : 0386-9784
ISSN-L : 0386-9784
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Volume 49, Issue 1
Displaying 1-24 of 24 articles from this issue
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Clinical Case Reports
  • A Long Course of Epithelioid Sarcoma
    Hiroyuki TOYOSHIMA, Yoshinori AKAHOSHI, Makoto HORI, Hikotaro YOSHIDA
    1987 Volume 49 Issue 1 Pages 17-23
    Published: February 01, 1987
    Released on J-STAGE: March 10, 2012
    DOIhttps://doi.org/10.2336/nishinihonhifu.49.17
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    A 30-year-old man had a thumb-size nodule on the extensor surface of right articulatio pedis. Four years after the excision, the tumor recurred at the same area and amputation of rt. lower leg was performed. Twelve years later, metastases to the scalp and lung were evident. Wide excision of the scalp tumor was done and adjuvant chemotherapy prescribed. He is living. Histopathologically, the tumor consisted of atypical fibroblast-like cells, atypical epithelioid cells, proliferated fibrous connective tissue and central necrosis. An electron microscopic examination revealed numerous well-developed rER in fibroblast-like cells and filopodia in the epithelioid cells.
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  • Localized Skin Manifestation of Tissue Damage Following Drung Injections
    Keiko TANAKA, Yuji SHUDO, Akira TANAKA
    1987 Volume 49 Issue 1 Pages 24-27
    Published: February 01, 1987
    Released on J-STAGE: March 10, 2012
    DOIhttps://doi.org/10.2336/nishinihonhifu.49.24
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    Localized tissue damage is rarely caused by injections, however, once skin ulcers occur, they are resistant to therapy. We treated two men with skin ulcers caused by extravasation. A sixty-one-year old man had esophageal cancer and was treated with injections of adriamycin, cisplatin, pepleomycin given through the left thyroid-neck artery. Forty minutes after the injections, he complained of paresthesia and pain. He was unable to sleep due to severe pain on the neck and the left shoulder. Computerized tomography revealed a fatty degeneration in the neck muscle. A sixty-year-old man had Parkinson’s disease and severe pneumonia. When he went into shock, he was treated with a drip infusion of dopamine, given via an infusion pump through the left saphenous vein. After 48 hours, a giant bulla occurred in his lower leg, at the central area of the vein. Débridement showed that the saphenous vein was present in the center of the ulcer.
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  • Seven Cases of Porphyria Cutanea Tarda
    Shigeo NONAKA, Taro OHGAMI, Hikotaro YOSHIDA, Fumio MURAYAMA, Kazunori ...
    1987 Volume 49 Issue 1 Pages 28-34
    Published: February 01, 1987
    Released on J-STAGE: March 10, 2012
    DOIhttps://doi.org/10.2336/nishinihonhifu.49.28
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    Seven cases of porphyria cutanea tarda (PCT) are reported. All the patients were male, and ages ranged from 47 to 69 years. A history of alcohol drinking was noted in 6 of 7, the history of the remaining one was equivocal. Five lived in Nagasaki Prefecture, and 2 in Saga Prefecture. All had symptoms of hyperpigmentation, scars, erosions and skin fragility. Hypertrichosis and milium were present in 2. A photosensitive state was noted in 2, that is, an exacerbation of skin changes due to sunlight. Analysis of urinary porphyrins revealed elevations over 500 μg/L and predominant excretion of uroporphyrin (UP) in 6 of 7. One showed no increase in urinary porphyrins but there was a predominant excretion of UP. Faecal porphyrin analysis, revealed levels of over 100 μg/g dry weight and there was a predominant excretion of coproporphyrin (CP) in 3 of 6. Faecal porphyrin levels in 2 ranged from 50 ro 100 μg/g dry weight. One showed a predominance of CP and the other a predominance of protoporphrin (PP). Erythrocyte PP levels were within normal limits. Two of seven showed high levels of over 200 μg/dl for serum iron. Although abnormalities in liver function test were present in all patients, these were comparatively slight. Immunoglobulin G (IgG) levels were over 2,000 mg/dl in 2 of 5 patients.
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  • Drug-Induced Anaphylactoid Purpura, Nephritis, and Pleuritis in a Patient with Rheumatoid Arthritis
    Haruhiko OOTSUBO, Yutaka NARISAWA, Shozo HONBO, Hiromu KOHDA
    1987 Volume 49 Issue 1 Pages 35-39
    Published: February 01, 1987
    Released on J-STAGE: March 10, 2012
    DOIhttps://doi.org/10.2336/nishinihonhifu.49.35
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    We treated a 66-year-old woman with rheumatoid arthritis in whom anaphylactoid purpura, nephritis, and pleuritis developed following the intravenous administration of antibiotics. Simultaneously with the occurrence of purpura lesions on the extremities the arthritic symptoms worsened and a subcutaneous nodule developed in the right elbow. Urinalysis showed 3+ hematuria and rentogenogram of the chest revealed bilateral pleural effusion. Biopsy specimens of the purpura lesion and subcutaneous nodule revealed angitis. Direct immunofluorescence techniques showed granular IgA deposits within the mesangium in the renal biopsy specimen. A clinical differentiation from malignant rheumatoid arthritis is also discussed.
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  • A Case of Pseudo-Porphyria Cutanea Tarda in a Hemodialysed Patient
    Masao SUWAKI, Mamoru HIROHATA
    1987 Volume 49 Issue 1 Pages 40-44
    Published: February 01, 1987
    Released on J-STAGE: March 10, 2012
    DOIhttps://doi.org/10.2336/nishinihonhifu.49.40
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    A 30-year-old man with chronic renal failure developed bullae and erosions of the skin of the dorsum of his hands about 4 years after the initiation of hemodialysis treatment. Biopsy specimens revealed subepidermal bullae, liver function tests were normal and erythrocyte and stool porphyrins were at normal levels. It was speculated that prolonged excretory disturbance of the surplus porphyrins into the urine and the dialysate might have caused skin deposition of the porphyrins, leading to a photosensitive skin.
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  • Two Cases of Erythema Chronicum Migrans
    Kimiko TOHGI, Kumiko SUGIHARA, Joji JIDOI
    1987 Volume 49 Issue 1 Pages 45-49
    Published: February 01, 1987
    Released on J-STAGE: March 10, 2012
    DOIhttps://doi.org/10.2336/nishinihonhifu.49.45
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    The two patients were women aged 64 and 74 years and both live in Shimane Prefecture. They had tick-like insect bites, but ticks were not immediately evidenced. Both remarkably improved by surgical excision of the indurations and each had a favorable prognosis. In the second patient, part of the insect was found in the dermis. The aetiology in relation to a tick bite of erythema chronicum migrans and epidemiology in Japan are discussed.
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  • Smoldering Type Adult T Cell Leukemia Associated with an Extensive Hypogammaglobulinemia
    Yoshika TAKANO, Masayuki NISHIMURA, Noritaka HAYASHI, Shoji TOSHITANI
    1987 Volume 49 Issue 1 Pages 50-55
    Published: February 01, 1987
    Released on J-STAGE: March 10, 2012
    DOIhttps://doi.org/10.2336/nishinihonhifu.49.50
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    We treated a Japanese man with adult T cell leukemia. He had been born at Sasebo and is now 44 years old. Asymptomatic red papules were seen in a disseminated pattern on the trunk and upper and lower extremities, and to some extent the papular eruptions fused to form irregular shaped plaques. Histologically, there was a dense infiltration of abnormal lymphocytes with a prominent nuclear atypism present in the upper dermis and some of those lymphoid cells infiltrated the epidermis and formed a microabscess. Immunohistological characterization of cell surface marker antigens revealed that the abnormal lymphoid cells were positive for OKT4, OKT11, Tac, Leu3a+3b and Leu4. Laboratory data: WBC 7,500/mm3, lymphocyte 10%, abnormal lymphocyte 1%, LDH 541 U/L, γ-globulin 0.58 g/dl, anti ATLA antibody ×130. To our knowledge, it is the association of such an extensive hypogammaglobulinemia in the smolderling type of adult T cell leukemia.
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  • Localized Cutaneous Cryptococcosis
    —Report of a Case and Review of the Japanese Literature—
    Shunei TANABE, Ryoichi FUKUSHIRO
    1987 Volume 49 Issue 1 Pages 56-63
    Published: February 01, 1987
    Released on J-STAGE: March 10, 2012
    DOIhttps://doi.org/10.2336/nishinihonhifu.49.56
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    A 42-year-old Japanese man developed an erythematous, partly pustular, plaque-like lesion on the left clavicular region. There was no regional lymphadenopathy. Laboratory findings were within normal limits. The chest X-ray and cerebrospinal fluid examination were normal. A diagnosis of cutaneous cryptococcosis was made after histological examination of the cutaneous lesion and confirmed by isolation of the organism, Cryptococcus neoformans, from the biopsy specimen. The patient was successfully treated with oral 5-fluorocytosine. The cutaneous manifestations of cryptococcosis are briefly reviewed, and the Japanese cases are analyzed and partially tabulated.
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  • Chromoblastomycosis Caused by Fonsecaea compacta
    Mizuko TANIKAWA
    1987 Volume 49 Issue 1 Pages 64-67
    Published: February 01, 1987
    Released on J-STAGE: March 10, 2012
    DOIhttps://doi.org/10.2336/nishinihonhifu.49.64
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    The first Japanese case of chromoblastomycosis caused by Fonsecaea compacta is presented. The patient, a 73-year-old farmer being resident in Kita-Matsuura Country of Nagasaki Prefecture, had a widespread erythematosquamous lesion with a slightly elevated border of 20 years duration on the left arm. The diagnosis was established by demonstration of F. compacta through direct examination of scales and culture of biopsied materials from the lesion. The patient was successfully treated with a combination of oral 5-fluorocytosine and local heat therapy for 3 months.
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Clinical and Investigative Report
  • The Rate-Limiting Effect of the Stratum Corneum of Transcutaneous Pco2 Measurement
    Hirotsugu TAKIWAKI
    1987 Volume 49 Issue 1 Pages 68-73
    Published: February 01, 1987
    Released on J-STAGE: March 10, 2012
    DOIhttps://doi.org/10.2336/nishinihonhifu.49.68
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    Response rates of tcPco2 measurement, the rate of Pco2 increase from air level to steady state, were recorded with tcPco2 monitor in various body surface and on the stripped skin. The half-time (t1/2) on the oral mucosa was shortest, followed in order on the arm, back, sole. Tape stripping shortened t1/2. As a result of in vitro examination using isolated stratum corneum sheets from the upper arm, it was proved that the response rate of tcPco2 measurement is mainly limited by diffusion through the stratum corneum, the CO2 diffusion constant of which estimated to be 0.1×10-7cm2/sec in vitro. These results suggest that the t1/2 lengthens with thickening of the stratum corneum, therefore, this method may be utilized to evaluate the thickness of the stratum corneum.
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  • Pathogenesis of the Cowdry Type A Inclusion Bodies in Dermal Cells of Mucocutaneous Varicella Zoster Virus Infections
    Masami YOSHIDA, Tadashi TEZUKA
    1987 Volume 49 Issue 1 Pages 74-78
    Published: February 01, 1987
    Released on J-STAGE: March 10, 2012
    DOIhttps://doi.org/10.2336/nishinihonhifu.49.74
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    Cowdry type A inclusion bodies (eosinophilic intranuclear inclusion bodies) have been found not only in epidermal cells, but also in dermal cells of mucocutaneous varicella zoster virus infections. We studied the pathogenesis of Cowdry type A inclusion bodies in dermal cells. Skin biopsies were obtained from 10 patients with herpes zoster, 10 patients with generalized eruptions of herpes zoster generalizatus and 6 with varicella. Capillary endothelial cells with Cowdry type A inclusion bodies were found in 1 out of 16 specimens from generalized eruptions and varicella, and in 4 out of 10 specimens from herpes zoster. Fibroblasts with Cowdry type A inclusion bodies were found in 4 out of 16 specimens from the former, and in 5 out of 10 specimens from the latter. Dermal cells with Cowdry type A inclusion bodies were located within the dermal papillae and the subpapillary layer just beneath the intraepidermal bulla. These observations indicate that Cowdry type A inclusion bodies in the dermal cells are due to direct spread of the virus from the intraepidermal bulla.
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  • Experience in Treatment of Dupuytren’s Contracture
    Kyoko WADA, Kimihiko MIHARA, Hidetoshi WADA
    1987 Volume 49 Issue 1 Pages 79-87
    Published: February 01, 1987
    Released on J-STAGE: March 10, 2012
    DOIhttps://doi.org/10.2336/nishinihonhifu.49.79
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    5 patients with Dupuytren’s contracture were reviewed. In addition to the characteristic flexion contractures, palmar fibromatosis, knuckle pads and plantar fibromatosis were observed. A limited fasciectomy was performed on 3 hands and 2 feet, and the results were satisfactory in all cases. But in 2 cases of a simple resection of the palmar or plantar nodules, recurrences were noted. Therefore, it is important for the treatment that early in Dupuytren’s contracture, when there were only multiple nodules of the palmar or plantar region, we should not excise them easily.
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  • Laboratory Studies on UVA Protection with Parsol A
    Minoru FUKUDA, Masako NAGANUMA, Keisuke NAKAJIMA
    1987 Volume 49 Issue 1 Pages 88-94
    Published: February 01, 1987
    Released on J-STAGE: March 10, 2012
    DOIhttps://doi.org/10.2336/nishinihonhifu.49.88
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    New ultraviolet absorber, Parsol A with dibenzoyl methane structure, was examined about protection efficacies against UVA using guinea pigs and human volunteers. In a guinea pig model using 8MOP and UVA radiation, Parsol A was more effective in preventing photosensitizing skin reactions than were the conventional UVA absorbers, such as benzotriazol and benzophenone derivatives, titanium dioxide, dihydroxyacetone and Lawson, etc. Immediate pigment darkenning eliciting in healthy human volunteers and in one patient with polymorphous light eruption were obviously protected by the sunscreen containning Parsol A, which had a marked effective protection against UVA.
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