The Nishinihon Journal of Dermatology
Online ISSN : 1880-4047
Print ISSN : 0386-9784
ISSN-L : 0386-9784
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Volume 51, Issue 6
Displaying 1-23 of 23 articles from this issue
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Color Atlas
Mini Review
Clinical Case Reports
  • Neutrophilic Erythema
    Mitsuru IDA, Taisuke SEKI, Akihiro SAITOH, Masaaki MOROHASHI
    1989 Volume 51 Issue 6 Pages 1101-1105
    Published: December 01, 1989
    Released on J-STAGE: March 03, 2012
    DOIhttps://doi.org/10.2336/nishinihonhifu.51.1101
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    We describe a 32-year-old Japanese male patient who developed recurrent neutrophilic dermatosis. He had been suffering from some red papules which appeared initially on the right side of the neck one week prior to his first visit to our clinic. One of them had gradually increased in size to thumb-tip size, then resulted in an infiltrative erythema within a few weeks. The same episodes had been observed several times a year for the last few years. Neither fever nor any other general symptoms had been observed during that period. Laboratory data were within normal limits except for polymorphocyte dominant leukocytosis. Biopsy specimen from the lesion showed dense polymorphocytic infiltration in the upper to middle layers of the dermis. In 1968, Whittle et al. reporoed two cases as recurrent neutrophilic dermatosis of the face (RND), which seemed to belong to the category of Sweet’s syndrome without showing general symptoms, like our case. Since then, several cases of RND have been reported. Since both RND and Sweet’s syndrome belong to the same category, we consider the term “neutrophilic erytherna” to be more appropriate.
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  • Cholinergic Urticaria Occurring in a Man with Hypohidrosis
    Kazunobu OTOYAMA, Yasuhiro HORIUCHI, Ryuji SAKAKIBARA, Toshio FUKUTAKE
    1989 Volume 51 Issue 6 Pages 1106-1108
    Published: December 01, 1989
    Released on J-STAGE: March 03, 2012
    DOIhttps://doi.org/10.2336/nishinihonhifu.51.1106
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    We report a case of cholinergic urticaria occuring in a 30-year-old man with acquired hypohidrosis. The patient had irritable wheals which appeared after exercising for thirty minutes. Intradermal injections of acetylcholine and strong sodium chloride to the patient’s skin produced such wheals. After wholebody and chest warming, extensive hypohidrosis was observed when tested for sweating.
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  • Acute Diffuse Scleroderma Preceded by Facial Erythema
    Yuichi TERAKI, Makoto SUGIURA
    1989 Volume 51 Issue 6 Pages 1109-1113
    Published: December 01, 1989
    Released on J-STAGE: March 03, 2012
    DOIhttps://doi.org/10.2336/nishinihonhifu.51.1109
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    We report a case of acute diffuse scleroderma preceded by facial erythema. A 72-year-old woman had had facial erythema, which was slightly indurated and edematous, for two years. Dermatomyositis or SLE was initially suspected, however, no other systemic symptoms were seen and no abnormal laboratory data were detected except for 1:40 positive ANA. Four years later, in March, 1986, sclerosis of the skin was noticed on her arms and face, and this rapidly spread all over the body. General fatigue and fever of up to 38°C were also observed. She was diagnosed as suffering from systemic scleroderma and was admitted to our hospital. Although she was treated with predonsisolone, scleroderma kidney with nephrotic syndrome developed and she died of heart failure in September, 1986. The preceding facial erythema was distinguishabie from the typical eruptions which are seen in dermatomyositis, SLE, polymorphous light eruption, lymphocytic infiltration of the skin, or Sjögren syndrome. The facial erythema seen in this cases may have been the first symptom of systemic scleroderma.
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  • Arteriosclerosis Obliterans, Succesfully Treated with Percutaneaus Transluminal Angioplasty: A Case Report
    —Application of Thermography for Diagnosis and Evaluation—
    Keiko MINAMOTO, Tomomichi ONO, Yukinori KOHROGI, Mutsumasa TAKAHASHI
    1989 Volume 51 Issue 6 Pages 1114-1119
    Published: December 01, 1989
    Released on J-STAGE: March 03, 2012
    DOIhttps://doi.org/10.2336/nishinihonhifu.51.1114
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    A 50-year-old man, who has a history of diabetes mellitus and hypertension, complained of purpura, cyanosis and severe pain in the lateral plantar region of the left foot. Thermography showed the skin temperature to be lower from the left proximal thigh to the digits compared with the right leg. Pelvic angiography revealed marked narrowing of the most proximal portion of the left common iliac artery with diminished diameter of the left femoral artery. Percutaneous transluminal angioplasty (PTA) was applied to this stenotic lesion with excellent results, as was demonstrated by post-PTA angiography. Thermography showed a rise in the skin temperature of the left lower extremities compared to the right, three days following PTA, with gradual improvement of the pain and the eruption of his left plantar region. Thermography is very useful for evaluating the effects of various therapies, including PTA. We think PTA is a very valuable method for arteriostenotic stenosis and obstruction in dermatologic practice because it is less invasive than bypass surgery.
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  • Metastasizing Atrial Myxoma:
    Multiple Subcutaneous Tumors
    Yoko KAKEHASHI, Yutaka NARISAWA, Hiromu KOHDA, Kohji FUCHI
    1989 Volume 51 Issue 6 Pages 1120-1122
    Published: December 01, 1989
    Released on J-STAGE: March 03, 2012
    DOIhttps://doi.org/10.2336/nishinihonhifu.51.1120
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    We report the case of a 66-year-old man with a left atrial myxoma in the heart and multiple subcutaneous tumors on the trunk. We assumed that the left atrial myxoma had metastasized to the dermis, because the specimen of the tumors was histopathologically the same as that of the left atrial myxoma. We attempted anti-coagulation therapy for the tumors and all of them disappeared after 8 months. Thus, we reached the conclusion that the multiple subcutaneous tumors were the organized thrombi and that the left atrial myxoma was also an organized thrombus.
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  • Type III Atypical Blue Nevus (Kawamura):
    A Case Report
    Tetsuo SHUKUWA, Makoto HORI, Hironori TAKAGI
    1989 Volume 51 Issue 6 Pages 1123-1128
    Published: December 01, 1989
    Released on J-STAGE: March 03, 2012
    DOIhttps://doi.org/10.2336/nishinihonhifu.51.1123
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    A case of atypical blue nevus Type III (Kawamura) is reported. A hard black nodule was found on the chest of a 15-year-old girl. Histopathologically, melanocytes with a large amount of melanin granules were scattered in the upper dermis. In the lower dermis, there was a tumor-like proliferation of collagen fibers. However, no melanocyte nor elastic fiber was found in the tumoral lesion. On transmission electromicroscopic examination, there were many immature melanosomes in the cytoplasm of the dermal melanocyte. From these findings, according to Kawamura’s classification, we diagnosed this case as a Type III atypical nevus, occurring on a fibroma. To our knowledge, however, there have been no previous reports of atypical blue nevus Type III in the Japanese publications.
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  • Malignant Blue Nevus
    Yoshimasa FUKUI, Yoshinari MATSUMOTO
    1989 Volume 51 Issue 6 Pages 1129-1133
    Published: December 01, 1989
    Released on J-STAGE: March 03, 2012
    DOIhttps://doi.org/10.2336/nishinihonhifu.51.1129
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    A case of malignant blue nevus of the face and a review of previously published cases are reported. A 59-year-old man with congenital blue nevus at the right temple and the inner temporal region developed a subcutaneous tumor within the area of discoloration. The tumor had been present for several months and subsequently increased in size rapidly. The preoperative diagnosis was malignant melanoma. Review of the specimen revealed a common blue nevus and malignant blue nevus as well as a celluler blue nevus. In our hospital, the patient was diagnosed as suffering from early gastric cancer, and complete excision was performed. The patient remains free of disease for 4 years following the wide excision.
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  • Acral Lentiginous Melanoma in Situ Arising from Compound Nevus
    Masashi KANAMORI, Masayuki SHIMIZU
    1989 Volume 51 Issue 6 Pages 1134-1138
    Published: December 01, 1989
    Released on J-STAGE: March 03, 2012
    DOIhttps://doi.org/10.2336/nishinihonhifu.51.1134
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    We report a case of acral lentiginous melanoma in situ arising from a pigmented nevus of compound type. After simple resection of a small pigmented fleck on the right sole, recurrence occurred twice on the same site. As the histological examinations during surgery suggested malignant melanoma, a wide-resection and full-thickness skin graft were performed. The pathological specimen showed a picture of advanced stage of acral lentiginous melanoma in situ. After surgery, two courses of chemotherapy with DTIC (100 mg/day for 5 days ×2) were carried out, and no recurrence has been observed during these last 2.5 years.
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Clinical and Investigative Report
  • Seborrheic Keratosis, a Tumor of the Infundibular and Isthmus of Hair Follicles:
    —Identification of Hair Sheath Keratins and Histopathological Features Suggesting Hair Follicle Origin—
    Kazuo ASO, Takako SHIMOURA, Hideki HASHIMOTO, Yutaka HOZUMI
    1989 Volume 51 Issue 6 Pages 1139-1144
    Published: December 01, 1989
    Released on J-STAGE: March 03, 2012
    DOIhttps://doi.org/10.2336/nishinihonhifu.51.1139
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    Because of their specificity, hair sheath keratins (Moll’s keratin catalog, No. 6, 16, 17) can be markers of hair sheath tumors. Hair sheath keratins were identified in all seborrheic keratoses investigated by both two-dimensional gel electrophoresis and immunoblotting after extracting the keratins from the tumors. As compared with hair sheath keratins, epidermal keratin (Moll’s catalog No. 1) in seborrheic keratosis was small in size according to the densitometric analysis of electrophoretic spots. A histopathological study of 164 cases of seborrheic keratosis suggested that they originated from the infundibulum and isthmus of the hair follicle. Pathological features such as continuity of tumor to the upper part of hair follicle, the coexistene of intermediate and clear cells within the basaloid tumor cells were also seen. The identification of hair sheath keratins coupled with the histopathological findings strongly suggested that seborrheic keratosis may originate from the upper part of the hair follicle.
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  • Rapid and Direct Detection of Herpes Simplex Virus in Clinical Specimens of Kaposi’s Varicelliform Eruption by in situ Hybridization
    Michio FUKUDA, Masamitu ISHII, Takeshi KOHNO, Kazuyoshi FUKAI, Nobuyuk ...
    1989 Volume 51 Issue 6 Pages 1145-1150
    Published: December 01, 1989
    Released on J-STAGE: March 03, 2012
    DOIhttps://doi.org/10.2336/nishinihonhifu.51.1145
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    Herpes simplex virus was detected in the clinical specimens of two patients with Kaposi’s varicelliform eruption by in situ hybridization method using a commercially available DNA probe kit. To detect herpes simplex virus DNA directly, we applied this in situ hybridization method to identify the herpes simplex virus of two patients with Kaposi’s varicelliform eruption. Case 1 was a 27-year-old male, case 2 was a 54-year-old-female, and both patients were suffering from adult type of atopic dermatitis. Recently, many trials using in situ hybridization methods with radiolabelled nucleic acid probes have been reported for detecting viral DNA, and it is suggested that this method is more closely related to infectivity, when compared with other more conventional immunohistochemical methods. More recently, some biotinylated probes have become available, which make such assays possible without the inherent disadvantages of working with radioactive reagents as well as saving time. Viral DNA was found either granularly or agglomerately, in the nuclei of giant cells and ballooning cells in the vesicles. The viral antigen in one case was identified by monoclonal antibodies specific for herpes simplex virus-1, 2. The herpes simplex virus-1 antigen was found peripherally in the nuclei of infected cells. We believe that the in situ hybridization method using a non-radioactive probe is useful in examining viral-infectious diseases, because it is rapid, direct and safe.
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  • A Clinical Study on Patients with Anti-cardiolipin Antibodies
    Eriko IIYOSHI, Yasuhide TAKAHASHI, Tetsuo SASAKI, Hiroshi NAKAJIMA
    1989 Volume 51 Issue 6 Pages 1151-1156
    Published: December 01, 1989
    Released on J-STAGE: March 03, 2012
    DOIhttps://doi.org/10.2336/nishinihonhifu.51.1151
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    Serum anti-cardiolipin IgG, IgM antibodies (A-CL) were measured with an enzyme-linked immunosorbent assay in 87 patients with collagen diseases and related disorders. Twenty one patients including 15 scleroderma cases, which have been reported elsewhere, were positive. In this paper, the remaining 6 (1 male and 5 female) patients with dermatomyositis (DM), DM+Sjögren’s syndrom (SjS), cryoglobulinemia+SjS+Hashimoto’s disease, chilblain lupus, Behçet’s disease and livedo reticularis with summer ulceration were analyzed. Skin symptoms such as livedo, purpura and ulcer, which were secondary to the peripheral circulatory disturbance, were present in 2 cases, while none had any past histories of either fetal distress or frequent abortion. Antinuclear antibodies were positive in 5 cases except Behçet’s disease, patterns of which were homogeneous and speckled in 4 and nucleolar in 1. Two cases among them showed lupus-like symptoms, although they did not fulfill the criteria for diagnosis as SLE. These results suggest that A-CL positive patients have both some clinical features and laboratory findings in common which may form a syndrome classified as atypical and undifferentiated collagen diseases.
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  • Studies on the Microcirculation in the Rabbit Ear Chamber with a Vital Microscope
    —The Process of New Growth of Vessels—
    Noriyuki TODA, Hideki NAKANISHI
    1989 Volume 51 Issue 6 Pages 1157-1162
    Published: December 01, 1989
    Released on J-STAGE: March 03, 2012
    DOIhttps://doi.org/10.2336/nishinihonhifu.51.1157
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    Since angiogenesis is an important process of wound healing, the entire process of the new growth of vessels was microscopically investigated using a rabbit ear chamber. After installation of a transparent chamber on the ear, new capillary sprouts arose from the surrounding blood vessels on the edge of the table in 5 to 7 days. There were two types of sprouts. One was tapered and the other was saccular. After about 2 weeks, the sprouts formed capillary loops by fusion and new sprouts were produced from the loops. During the process, some capillaries were differentiated into arterioles and venules, while some remained as capillaries, and still others retracted and disappeared. The average time for complete vascularization of the table area was between 3 to 4 weeks after operation and then it was possible to clearly observe microcirculation in the capillary networks on the transparent chambers through a vital microscope over a period of several weeks. This technique can be a powerful tool for better understanding the process of wound healing.
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Review
Statistics
  • A Survey of the Dermatophytes in Shiga Prefecture
    Masaki HIRONAGA
    1989 Volume 51 Issue 6 Pages 1174-1177
    Published: December 01, 1989
    Released on J-STAGE: March 03, 2012
    DOIhttps://doi.org/10.2336/nishinihonhifu.51.1174
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    To elucidate the incidence of all types of dermatophyte species in Shiga prefecture, fungal cultures were made from all patients with dermatophytosis seen at my private dermatological clinic during the period of 1982 to 1988. A total of 3,609 dermatophyte cultures were obtained: namely, 2,808 (77.8%) were Trichophyton rubrum, 672 (18.6%) were T. mentagrophytes, 7 (0.2%) were T. violaceum, 32 (0.9%) were Epidermophyton floccosum, 78 (2.2%) were Microsporum canis, and 12 (0.3%) were M. gypseum. Some epidemiological aspects of dermatophytoses in Shiga prefecture are also described and discussed. This is the first report on the isolation of T. violaceum in this area.
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  • Systemic Lupus Erthematosus and Pregnancy
    —Neonatal Outcome of Maternal Systemic Lupus Erythematosus—
    Sanae HORIUCHI, Tooru BABA, Kenichi UYENO
    1989 Volume 51 Issue 6 Pages 1178-1181
    Published: December 01, 1989
    Released on J-STAGE: March 03, 2012
    DOIhttps://doi.org/10.2336/nishinihonhifu.51.1178
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    It is known that patients with systemic lupus erythematosus tend to give birth prematurely. We were engaged in statistical study to determine whether there exists a difference between term delivery and premature delivery among the levels of intrauterine growth retardation. A statistic study was also performed on the relationships between various items and intrauterine growth. The items used in this study were as follows; WBC, lymphocyte, platelet, Hb, CH50, C3 and C4. Birth weight was used as an indicator of intrauterine growth. In a review of 10 infants delivered to patients (5 premature deliveries and 5 term deliveries), half of the infants’ birth weights were lower in comparison with the mean birth weight of gestational age. No significant difference was found between term delivery and premature delivery on the ratio of each birth weight to the mean birth weight of corresponding gestational age. The ratio of each birth weight to the mean birth weight of corresponding gestational age and CH50 at delivery were found to correlate with each other. However, no such correlation was obseved in any other of the combiner items during pregnancy.
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