A 48-year-old woman with clinical and pathologic features of blue rubber-bleb nevus syndrome (BRBNS) was reported. Multiple hemangiomas were present predominantly on the extremities. Through examinations revealed hemangiomas in the liver and the left ventricular wall and typical findings of hypertrophic cardiomyopathy (HCM) were evident. One sibling also had the same cutaneous lesions and HCM. This is a clear case of the close association between BRBNS and HCM.

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In a 47 y/o Japanese woman, facial skin coarseness and general fatigue occurred 3 years before she was seen in our clinic. About the same time, she noticed a generalized pigmentation, in addition to rough neck skin and depigmentation around one congenital and two acquired nevi. She had recently been diagnosed as having a growth hormone producing pituitary tumor (ACTH was normal) and was treated surgically. The generalized pigmentation and acanthosis nigricans improved after the surgery but the Sutton’s nevi remained unchanged. Acromegaly pigmentation and acathosis nigricans were thought to be caused by the growth hormone producing tumor. This may be the first report of Sutton’s nevus associated with above described conditions. The precise relationship remains to be determined.

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A man came into contact with a high tension electrical current (60,000 volts), and suffered severe burns on the both forearms and lower extremities. Severe abdominal pain was also present. Urological examinations revealed a disturbance in the epithelium of the bladder. Emergency cystostomy and various other treatments led to recovery. Excercise and the use of a prosthesis are now being taught for this patient.

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We reported two patients with sign of Leser-Trélat. One patient was a 50-year-old woman with adenocarcinoma of the right breast, and the other was a 78-year-old man with small cell carcinoma of the lung. We reviewed 36 cases of sign of Leser-Trélat reported in Japan, including our two cases. This sign is most frequently associated with adenocarcinoma (47%), in particular carcinoma of the stomach.

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An 86-year-old woman had yellow plaques, papules and comedones on the median canthi. Histologic examination revealed that the xanthoma cells contacted with the epidermal cyst in the right upper eyelid. On the left eyelid, there were senile comedones with a basophilic degeneration of the collagenous fibers. The periphery of comedones showed inflammatory infiltrates of lymphocytes, histiocytes, giant cells and foam cell-like cells. This case and data in the literature suggest that some type of xanthelasma is a kind of dystrophic xanthomata.

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A 13-year Japanese girl had a streptococcal facial erysipelas associated with a concomitant staphylococcal infection. We recommend prescription of a β-lactamase resistant antibiotic as the first choice for the treatment of erysipelas since there may be an associated staphylococcal infection.

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Pseudoglandular squamous cell carcinoma and localized multiple neurofibromas occurred in a 58-year-old man. Pseudoglandular squamous cell carcinoma was present on the dorsal aspect of his left foot. Localized multiple neurofibromas were distributed from the right lumbar region to the right upper abdomen. The association of the two diseases was considered to be coincidental.

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An 82-year-old man had an eccrine porocarcinoma on the skin of the wall of the left abdomen. Metastasis occurred to left inguinal lymph nodes. The histology revealed that the eccrine poroma overlayed on the porocarcinoma, thereby suggesting that the latter arose in the former. Using an enzyme-immuno-assay (Biotin-Strept Avidin method), we found that the tumor cells reacted with a anti-CA 19-9 antibody.

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We reported a 54-year-old Japanese man with superficial basal cell carcinoma on the right thigh. A statistical analysis was performed on 39 cases of basal cell carcinoma on the upper and lower extremities reported in the Japanese literature from 1975-1986. About 30% of the basal cell carcinomas which occurred on the extremities were of the superficial type.

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A 63-year-old Japanese man with right parotid adenocarcinoma developed an inflamed plaque with ill-defined borders, nodules and teleangiectasia on the anterior neck and chest. Biopsy specimens from the lesions of the anterior chest revealed large and small groups of tumor cells in the dermis and fatty tissue surrounded by fibrosis. The dermal vessels were dilated and filled with tumor cell clusters which were similar to those seen in parotid adenocarcinoma. In some areas, the tumor cells were arranged in single row, referred to as “Indian filing”. These pathological findings were compatible with those of cutaneous metastasis from a parotid carcinoma. This patient died 40 days after the appearance of skin eruption. At autopsy, there were lesions in the adrenal gland liver, lung, thyroid gland and bone marrow. Cutaneous metastasis from the parotid carcinoma is rare (about 1% of all cutaneous metastasis). We describe here in 17 cases of cutaneous metastasis from a parotid carcinoma. The most common pathological type of primary parotid carcinoma is that of malignant mixed tumors. Cutaneous metastasis from parotid carcinoma tends to occur around parotis. The common clinical appearances are the nodule and inflammatory type.

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A 61-year-old man had multiple lichen planus. There were brownish papules on the bilateral pretibial regions and were considered to be common type lichen planus. He had a little finger tip sized to thumb tip sized erythematous brownish annular lesions with desquamation, itching and a slightly atrophic center on the scar of central region of the abdomen and left inguinal region. These were lichen planus annularis. He had a linear, similar lesion on the left axillar region to the inner aspect of his upper arm and this was lichen planus linearis. Histopathologically, typical lichen planus was noted. The annular lesions were not in papules form, rather they first formed a ring plaque. This was considered to be a rare case of lichen planus. If the basal cell layer is destroyed as the result of outside influences, then the epidermis will show a lichenoid tissue reaction.

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We reported a 24-year-old man with primary cutaneous mucormycosis caused by Absidia corymbifera. The lesions appeared following steady application of a functional brace. 0.12% betamethasone valerate was applied topically for 6 days. The vesicles and pustules of these lesions were indistinguishable from those of candidiasis. A topical application of 1% tolciclate cream twice daily for two weeks proved to be effective.

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We reported the findings in a case of a large parapsoriasis en plaque complicated with localized cutaneous secondary amyloidosis in a 73-year-old man. While the diagnosis was considered reasonable in view of histopathological and electron microscopic findings. The eruptions of this patient were most peculiar.

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Electrophoretic mobility of erythrocytes and neutrophils in 5 psoriatic patients with PUVA therapy was determined. They were 2 patients with oral PUVA and 3 with topical PUVA. Negative surface charges of the neutrophils were altered between these two routes of application. In case with topical PUVA, the negative surface charge was altered between erythrocytes and neutrophils.

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We performed an explant culture and a dispersed cell culture of plucked hair follicles and could obtain hair follicle cell colonies without contamination of fibroblasts by both culture methods. To determine the optimal culture condition, MMC treated 3T3 cells, collagen type I membrane (undcr surface: 3T3 cells without MMC treatment) and collagen type IV were used as feeder layers or substrate. The hair follicle cell growth could be constantly viewed only on the collagen type IV coated dishes. Therefore, it is suggested that collagen type IV, a component of the basement membrane, is essential for the growth of hair follicle cells from plucked human hair follicles.

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Three patients with enoxacin-induced photosensitivity were reported. All patients had been treated with enoxacin for over one month. The minimal dose of UVA in the photodrug tests of enoxacin was markedly reduced and eruptions occurred 24 hours after the tests in all. Clinical and histological features of the original and the ensuing eruptions were those of acute dermatitis. Enoxacin contains a halogenated naphthyridic ring. The phototests of nalidixic acid, a non-halogenated analogue, were all negative. These results suggest that the halogenated naphthyridic ring may be a requisite for photoallergen formation.

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Electron microscopic investigation was made on the guinea pigs epidermis after topical application of 1α,25-dihydroxyvitamin D₃ 5 μg ointment for four weeks. Histologically, the epidermis exhibited a thickening of the granular layer with mild acanthosis. Electron microscopically, the nuclei of the basal cells were large and the nuclear membrane was irregular. In the cytoplasm, numerous vacuoles and tonofibrillar formation were present and the intercellular spaces were widened. In the spinous cell layer, findings of nuclei and cytoplasm were similar to the events seen in the controls. In the thickened granular layer, small-sized and irregular-shaped keratohyalin granules were present in the lower part, and large-sized keratohyalin granules were seen in the upper part. The horny layer had a keratin pattern. Therefore, we consider that topical application of 1α,25-dihydroxyvitamin D₃ influences differentiation or keratinization processes of the epidermal keratinocytes.

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Two new sunscreens, “Ecran total opaque” (RoC S. A., France) (15T: teinte, and 15I: incolore), were evaluated for their efficacy and substantivity for humans, as tested both indoors and outdoors. These new sunscreens proved to be highly protective; 15T SPF (sun protection factor) for FL-SE lamp was 24.7, and the 15I SPF was 17.0. Utilizing a topical PUVA procedure, the SPF of 15T for UVA was 14.6, and that of 15I was 10.1, respectively. A study done at the Kamogawa seashore (140°06′E, 35°06′N) in midsummer showed that the 15T SPF against sunlight exceeded 13.6, and the 15I SPF was over 9.0. Based on these data, we tentatively conclude that both sunscreen preparations are effective to protect against solar UV radiation. The appearance of pigmentation was not inhibited. We also compared the efficacy of those preparations with products heretofore prepared by the same company.

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Eight glucocorticoids (GCs) were added to logarithmically growing cultures of primary human skin fibroblasts. All GCs tested inhibited DNA synthesis of the human fibroblasts, at concentrations of 0.1, 1, 10 μg/ml. From the dose-response curves of three different concentrations of GCs on the ³H-uptake in the cells, we estimated the GC concentrations causing a 50% inhibition of DNA synthesis. The order of the concentrations of each GC seems to correlate with their anti-inflammatory potency as evaluated clinically. We wish to emphasize that these doses are good indices for not only testing the anti-proliferative and anti-inflammatory potencies of GCs but also for their atrophogenic property, as related to skin.

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Statistical surveys on patients with seborrheic keratosis seen in our clinic from July 1979 to June 1986 revealed the following:
(1) The total number of specimens of seborrheic keratosis was 404 obtained from 365 patients, that is 2% of the total outpatients seen in this period.
(2) Males and females were equally affected.
(3) As to the age distribution, the highest peak was between 6th and 8th decades of life.
(4) As to the histopathological type, the hyperkeratotic type was predominant (48.5%) followed by the acanthotic type (32.7%), the irritating type (7.7%), the reticulated type (1.7%), melanoepithelioma (Bloch) (1.5%), the clonal type (0.5%), stucco keratosis (0.5%) and melanoacanthoma (0.2%).
(5) The center of the trunk was frequently involved, and in case of the hyperkeratotic type, occurrence on the extremity was not rare.
(6) When comparing clinical and histopathological findings seborrheic keratosis was sometimes mistaken for verruca vulgaris, nevus pigmentosus, lentigo senilis, follicular poroma and senile keratosis.

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[in Japanese]

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[in Japanese]

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