The efficacy of drugs known as potent hair growth stimulators has been evaluated by both clinical trials and in vivo studies using various animals. We succeeded in culturing human hair follicle cells (HFC) from plucked-off hairs on collagen type IV without contaminating any other cells. Using these cells, we have measured the effects of the drugs on (1) proliferation, (2) DNA synthesis, (3) life span, of HFC. The results were easily obtained within short periods of only 1 to 4 weeks and they can be correlated with those from in vivo studies. Here we would like to emphasize that we have developed this new method not only to elucidate the effects but also to evaluate the efficacy of these drugs on in vitro hair growth.

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A case of pemphigus foliaceus (PF) with schizophrenia is reported. We tried to identify PF antigen from normal human skin using PF sera by immunoblot analysis. PF sera specifically bound to molecules of 110 kd, 90 kd, and 18 kd. The 110 kd band was stained intensely but the 90 kd and 18 kd bands were faint and broad. We considered that the 110 kd protein was PF antigen and the 90 kd and 18 kd were proteolytic breakdown products of the 110 kd molecule. A lymphocyte stimulation test revealed that two medicines containing chrolpromazine which had been taken by the patient for 16 years were positive. We also discussed a possible role of chrolpromazine inducing pemphigus foliaceus.

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We report a case of subacute cutaneous lupus erythematosus (SCLE) associated with Sjögren’s syndrome observed in a woman and her newborn developing neonatal LE (third pregnancy). Case 1: A 33-year-old woman had a history of erythema on her back during her second and third pregnancies. Laboratory studies revealed positive anti-nuclear antibody (ANA), anti SS-A and SS-B antibodies. Biopsy specimens from the eruption on her back showed both hyperkeratosis and hydropic degeneration of the epidermal basal cell layer. Both a histologic examination and sialogram of the minor salivary gland indicated the co-existence of Sjögren’s syndrome. The administration of 20 mg of prednisolone per day succeeded in healing the eruption, and the patient successfully gave birth to a girl (Case 2). Case 2: About one month after birth, the neonate developed erythema similar to the mother’s eruption. Serologic findings such as positive ANA, positive anti SS-A and SS-B antibodies were also similar. No physical or mental disturbance, and no ECG abnormality were found. The skin manifestation diminished during the following month without any specific treatment and the serologic findings simultaneously returned to normal. The relationship between the erythema of SCLE and Sjögren’s syndrome is considered briefly in this study.

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A 65-year-old woman developed bullae and erosions on the dorsum of her hands by minimum trauma. Laboratory tests showed a predominance of uroporphyrin in the urine, and an abnormal porphyrin pattern compatible to PCT. Histopathologically, there was a deposition of PAS positive materials surrounding the small blood veseels in the upper dermis, as well as a deposition of C3 materials determined by means of immunofluorescence technique. In Japan, ninety-five percent of PCT cases are middle-aged men with a history of alcohol ingestion, but the number of female cases reported is gradually increasing. Increased incidence in females is probably due to the widespread ingestion of estrogenic hormones and the increased consumption of alcohol by women in recent decades. But, this case had no history of toxic substances (alcohol, drugs, chemicals) in spite of the clinical, laboratory and pathologic features of PCT.

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We report two patients with psoriasis vulgaris, who developed bullous eruptions during the treatment of Goeckerman’s regimen. The first case was an 81-year-old man who developed bullous eruptions on his extremities 52 days after treatment. A biopsy examination revealed subepidermal bullous formation with numerous eosinophils which was consistent with that of bullous pemphigoid. The second case was an 81-year-old woman who developed bullous eruptions on her trunk and extremities 6 days after treatment. A biopsy examination revealed intraepidermal bullous formation with the infiltration of eosinophils consistent with that of pemphigus vulgaris. Both patients had no recurrence of the bullous diseases after cessation of the treatment. It seems that the bullous eruptions observed in these cases are related to coal tar and/or ultraviolet radiation.

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We reported a 4-month-old boy with congenital total lipodystrophy, who weighed 2,915 g at birth after a normal pregnancy and deliverly. There was no family history of diabetes mellitus. His physical features were characteristic; generalized marked lipodystrophy, hypertrichosis and generalized hyperpigmentation were present. Hepatosplenomegaly and hypertrophy of genital organs were also observed. Laboratory studies revealed liver dysfunction and hyperlipemia (Fredrickson, type V). OGTT and insulin challenge test revealed a decreased glucose tolerance with insulin resistance. A skin biopsy showed papillomatosis and hyperkeratosis of the epidermis, which were compatible with acanthosis nigricans. An electronmicroscopic study demonstrated that fat cells of the subcutaneous tissue were inmature and small in size.

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A 71-year-old woman with a 3 year-history of multiple red nodules on the left point of her elbow recently noted both swelling and pain of the affected elbow joint. An X-P indicated osteolytic lesions of the radial, ulnar and humeral epiphysis and pathological fracture of the proximal end of the ulna. A histologic examination of the cutaneous nodules showed multiple aggregated epitheloid cell granulomas admixed with mild lymphocytic infiltration. Caseation necrosis was not present. A histologic examination of the affected bone showed complete bone necrosis, i, e., bone caries. The intact area was situated both between and independent of the bone caries and epitheloid granuloma of the skin. The laboratory findings were as follows: PPD 10×12mm/20×25mm, serum ACE level 19.4 IU/L, serum lysosome level 27.5 μg/ml; chest X-P, nodular lesion in the right upper lung and the absence of BHL. Cultures from the sputum and affected joint fluid for mycobacteria gave growth within 4 and 6 weeks, respectively. Identification of the mycobacteria was human type M. tuberculosis according to the niacin test. The patient was consequently treated with 450 mg RFP and 300 mg INAH a day, and a curettage on the affected joint was performed. Within two weeks following the joint curettage, all skin nodules on the elbow became flat with red color fading. Histologic examination at that time revealed involution of the epitheloid cells and increased lymphocytic infiltration. In the present case, primary tuberculosis was likely present in one of her lungs. Assuming this to be so, the baccillus had transmitted hematogenously to the elbow joint fluid, resulting in the formation of bone caries and in reinfected tuberculosis of the skin.

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A 68-year-old male farmer had scattered cutaneous lesions on his left lower eyelid and left cheek. These lesions fit neither the cutaneous lymphatic type nor fixed type of sporotrichosis. He was successfully treated with oral potassium iodide. A statistical study was made on 11 patients with sporotrichosis, who visited the Department of Dermatorogy, St. Marianna University Hospital between February of 1974 and December of 1987. Eight out of eleven patients were male. The ages of the patients ranged from 19 to 87 years old. The onset of the disease occured in summer in five cases. A history of injury was noted in six cases. All cases showed positive sporotrichin reactions. The site of residence for all the patients at the time of onset was Kawasaki city. The results observed were compared with statistical observations in Kanagawa prefecture and in other areas. It was thus found that relatively few cases of sporotrichosis visited our university hospital.

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We reported a case of 26 year-old man with the decreased cellular immunity, complaining of verrucous lesions on both his hands and feet. We diagnosed him as generalized verrucosis, because of positive staining by anti-HPV and HPV-2b pattern with southern blot hybridization method. We tried to treat him using both interferon-β and -γ intralesionally. The Interferon-γ was much more effective, whereas interferon-β showed only a slight effect. On the other hand, interferon-β and -γ were evenly effective on the warts of 4 controls. The fact that this patient showed a decreased response to interferon-β could be a clue as to why warts were generalized in this case. We failed to find any inhibiting factors of interferon-β in his serum.

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A 38-year-old Japanese male patient, who presented a giant ulcer on glans penis and multiple papules and pustules, was reported. His serologic test for syphilis (Ogata’s method) and Treponema pallidum hemagglutinin test disclosed a remarkably high titers. Although the histological findings of the skin lesion were not specific for secondary syphilis, we were able to reach the diagnosis by proving the presence of Treponema pallidum in the section by immunohistochemical technique using BSA method.

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A 55-year-old Japanese woman was first seen in August 1987 with a 30-year history of a slowly growing painfull mass on her back, measuring 7.8×6.5 cm. The gross specimen disclosed a firm, circumscribed mass with giant comedones on the surface, containing cheesy materials. The tumor was located in the dermis and subcutaneous fat tissue. Microscopic examination revealed nests of basaloid cells with high mitotic activity. The basaloid cell islands showed peripheral palisading of nuclei and a sharp transition to amorphous debris or shadow cells. The tumor recurred 14 months later after the initial surgery and a wide resection was performed. There has been no evidence of recurrence for 6 months after the second surgery.

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Two cases of malignant eccrine tumors with partial squamous differentiation are reported. Case 1 of eccrine porocarcinoma, possibly transformed from pre-existing eccrine poroma, presented symptoms reminiscent of squamous cell carcinoma in the peripheral and invasive area. In case 2 of eccrine ductal carcinoma, the metastatic specimens from the cervical lymph nodes were mainly composed of squamous nests forming keratin cysts, which were only a minor component of the primary tumor. Squamous differentiation in eccrine tumors is thus considered to be one of the important clues indicating malignant transformation.

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To clarify the effect of atomic bomb exposure on the skin, a cytogenetic study of cultured cells of the skin was performed. In non-exposed controls, only a few chromosomal aberrations were found. On the other hand, in A-bomb survivors, chromosomal aberrations such as translocation, deletion and inversion, which seem to have occurred at A-bomb exposure, were observed. The percentage of cells with chromosomal aberrations was high among A-bomb survivors proximally exposed. In some of these A-bomb survivors, a clonal formation of cells with the same abnormal karyotype was observed. The above facts may indicate that considerable DNA damage of skin cells could have been induced by A-bomb exposure and that some of these cells formed clones thereafter. Based on these findings, it is deemed necessary to carry out a skin cancer survey on all A-bomb survivors.

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In Report 1 of this series, we described that, in the cultured cells of skin tissues, chromosomal aberrations seemingly induced by A-bomb exposure were observed in Nagasaki A-bomb survivors, especially in those proximally exposed, and some of these cells with chromosomal aberrations formed clones. Based on these findings, we suspected that the incidence of skin cancer in A-bomb survivors might have increased. In this study, we tried to clarify the incidence of skin cancer among Nagasaki A-bomb survivors using the data of a total of 66,276 A-bomb survivors recorded at the Scientific Data Center of the Atomic Bomb Disaster, Nagasaki University School of Medicine. One hundred and ten cases of skin cancer were collected from the three major hospitals in Nagasaki City and were statistically analyzed in respect to the estimated distance from the hypocenter. The results were as follows: A high correlation was observed between the incidence of skin cancer and exposure distance in the analysis of all 110 cases and of the 50 male cases (p<0.01). However, no such correlation was observed in a separate analysis of the 60 female cases.

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In Report 1 of this series, we suspected that the incidence of skin cancer in Nagasaki A-bomb survivors might have increased based on evidence of chromosomal aberrations and clonal formations in cultured skin cells. In Report 2, we described the results of a preliminary study using 110 cases of skin cancer collected from the three major hospitsls in Nagasaki City (Nagasaki University Hospital, A-bomb Hospital and Citizens Hospital). In that study a high correlation was observed between the incidence of skin cancer and exposure distance in the analysis of all 110 cases and of the 50 male cases (p<0.01), but no such correlation was noted in a separate analysis of the 60 female cases. In this report, 140 cases of skin cancer collected from 31 hospitals in Nagasaki City and adjacent districts were statistically analyzed in respect to the estimated distance from the hypocenter, using the data of a total of 66,276 A-bomb survivors recorded in the Scientific Data Center of the Atomic Bomb Disaster, Nagasaki University School of Medicine. The results disclosed a high correlation between the incidence of skin cancer and the exposure distance (p<0.01). In addition, this correlation was the same even when the cases were analyzed separately according to sex.

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We previously reported that there was a high correlation between the exposure dose and the incidence of skin cancer in A-bomb survivors using the data of the Nagasaki Life Span Study of Radiation Effects Research Foundation and Nagasaki Tumor Registry. In Report 3 of this series, we clarified that the correlation between the exposure distance and the incidence of skin cancer was statistically significant in 140 cases of skin cancer collected from 31 hospitals in Nagasaki City and adjacent districts on the basis of the data of a total of 66,276 A-bomb survivors recorded in the Scientific Data Center of Atomic Bomb Disaster, Nagasaki University School of Medicine, and that the correlation was the same even when the cases were divided by sex. In this report, we examined the chronological change of the incidence of skin cancer in Nagasaki A-bomb survivors, using the data of the Scientific Data Center of Atomic Bomb Disaster. It is likely that the incidence of skin cancer in Nagasaki A-bomb survivors has increased after 1962, especially after 1975 in those exposed within 2.5 km from the hypocenter compared to those exposed at 3.0 km or more.

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We already reported that there was a high correlation between the exposure dose and the incidence of skin cancer in A-bomb survivors using the data of the Nagasaki Life Span Study of Radiation Effects Research Foundation and Nagasaki Tumor Registry. In Report 3 of this series, we confirmed that the correlation between the exposure distance and the incidence of skin cancer was statistically significant. In Report 4, we clarified that the incidence of skin cancer in proximally exposed Nagasaki A-bomb survivors when compared to distally exposed victims appears to be increasing since 1975. In this final report of the series, we examined the characteristics of skin cancer in Nagasaki A-bomb survivors using 140 skin cancer cases collected from 31 hospitals in Nagasaki City and adjacent districts on the basis of the data of a total of 66,276 A-bomb survivors recorded in the Scientific Data Center of Atomic Bomb Disaster, Nagasaki University School of Medicine. Among the various items examined, the only item that showed a statistical significance was the age at exposure in the cases of squamous cell carcinoma, i. e., those exposed within 2.5 km from the hypocenter were significantly younger than those exposed at 3.0 km or more.

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[in Japanese]

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Enoxacin (ENX) is one of the pyridone-carboxylic derivatives with a broad spectrum of antibacterial activity against both gram-positive and gram-negative bacteria. It has been commercially available in 100 mg and 200 mg tablets under the trade name of Flumark in Japan. ENX was administered orally to 43 out-patients with various skin infections, ranging from 17 to 86 years of age. The dose was 400 to 600 mg daily and the duration of administration was usually 7 to 14 days, with a minimal duration of 3 days and a maximal duration of 80 days. The efficacy of the drug was as follows: excellent in 20 (46.6%), good in 17 (39.5%), fair in 5 (11.6%) and poor in 1 (2.3%). The efficacy rate was 86.1%. An adverse reaction, which included epigastralgia, was seen in one patient. It is therefore considered that ENX is one of the best drugs for the treatment of bacterial skin infections.

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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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A new protective agent named “Handcare” (S-7990E) for the skin of the patients suffering from occupational contact dermatitis was evaluated with 14 occupational dermatosis and contact dermatitis patients. It was used several times a day while the patients worked by making a rapid membrane of acrylate over the entire skin surface of the patients’ fingers, hands and arms. Antisymptomatic treatments with corticosteroids and urea ointments were also used at the same time. The usage of Handcare for periods ranging from two weeks to 11 months resulted in a remarkable improvement in 4, and improvement in 7 patients. Therefore, a total of 11 out of 14 patients showed improvement with the rate of effectiveness at 79%. No side effects were observed. Consequently, Handcare was judged to be an effective treatment for occupational dermatoses which cannot be cured with antisymptomatic treatment alone. However, its effect was not considered sufficient for hairdressers who proved to be strongly sensitized to PPDA, and the other additional treatments are regarded as necessary.

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