The Nishinihon Journal of Dermatology
Online ISSN : 1880-4047
Print ISSN : 0386-9784
ISSN-L : 0386-9784
Volume 52, Issue 2
Displaying 1-31 of 31 articles from this issue
Color Atlas
Mini Review
Clinical Case Reports
  • Shinji KOMADA, Sakuhei FUJIWARA, Susumu TAKAYASU, Takehiko TORISU
    1990 Volume 52 Issue 2 Pages 226-230
    Published: April 01, 1990
    Released on J-STAGE: October 06, 2011
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    A 28 year-old woman was referred to us because of recurrent fever, aphthous stomatitis, genital ulcers and arthralgia for the past 15 years. Besides, she had sufferd from transient, tender erythematous nodules on the left elbow and lower legs. Physical examination revealed a swelling of the soft tissues around the proximal interphalangeal (PIP) joint of the left index and middle fingers and a marked motor disturbance of both hand joints. Radiographs of the bone revealed ankylosis of carpal bones of bilateral hands and erosive destruction and narrowing of space of the left second and third PIP joints and the left ankle joint. She had an episode of nearly 400 ml of genital bleeding from vaginal ulcers during administration. Laboratory examination revealed positive RA and RAHA tests, an increased level of IgG-rheumatoid factor and HLA B5. The patient was successfully treated with systemic administration of prednisolone, salazopyrin and aspirin.
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  • —With an Analysis of the Association of Dermato- and Polymyositis with Malignancy by Reviewing Nippon Boken Shuho from 1975 until 1986—
    Tae NATSUME, Hiromi CHIKENJI, Ichiro SUZUKI, Hiroshi TAKAZAWA
    1990 Volume 52 Issue 2 Pages 231-236
    Published: April 01, 1990
    Released on J-STAGE: October 06, 2011
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    A case of dermatomyositis with gastric carcinoma is reported. A 61-year-old female developed erythematous eruptions in sun-exposed areas associated with muscle weakness. At the same time carcinoma of the stomach was discovered. Following steroid therapy, a subtotal gastrectomy was performed, which seemed to improve the skin eruptions but did not improve muscle ability. The tumor recurred and metastasized 7 months later. The patient eventually died of disseminated carcinomatosis. Autopsy cases of dermato- and polymyositis compiled in Nippon Boken Shuho from 1975 until 1986 were studied to assess the incidence of malignancy. The total number of cases was 615. One hundred and sixty-three had malignancy (26.5%): 86 for males (35.1%) and 76 for females (20.6%). Dermatomyositis (30.5%) had a higher incidence of malignancy than polymyositis (19.8%). Stomach cancer was most frequently associated (27.8%), however the rate was less than those reported previously. In contrast, lung, ovary and thyroid gland malignancies were more common compared to previous reports.
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  • Report of A Case
    Akira YOSHII, Reiko NOGAMI, Yoshihiro MAEKAWA
    1990 Volume 52 Issue 2 Pages 237-240
    Published: April 01, 1990
    Released on J-STAGE: October 06, 2011
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    A 36-year-old women is reported who suffered from CREST syndrome with Barrett’s esophagus. The patient had a disorder comprising of calcinosis manifestations, Raynaud’s phenomenon, esophageal dysfunction, sclerodactyly and teleangiectagia. In addition, the patient had Barrett’s esophagus, which is defined as a replacement of the normal stratified squamous epithelium of the esophagus by a columnar epithelium. Recently we have begun to regard Barrett’s esophagus as a premalignant condition, and therefore the patient underwent operation and had a smooth postoperative course.
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  • Seiji ARASE, Hideki NAKANISHI, Katsuyuki TAKEDA, Atsuo FUJIMOTO
    1990 Volume 52 Issue 2 Pages 241-244
    Published: April 01, 1990
    Released on J-STAGE: October 06, 2011
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    A 21-year-old healthy Japanese woman developed an abscess on the right lower leg. There was no regional lymphoadenopathy. A large number of acid-fast bacterium were observed in a puss smear (Gaffky score: 7). An atypical acid-fast bacterium was isolated from the pus and confirmed to be mycobacterium fortuitum. The patient was then successfully treated with oral minomycin. Ten Japanese cases of previously reported cutaneous mycobacteriosis due to mycobacterium fortuitum, including our case, were reviewed and analysed briefly, especially in regard to clinical characteristics and treatments.
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  • A Report of 3 Cases
    Kazuaki YANAGISAWA, Masanori SHIRAISHI, Yoshinori SUENAGA
    1990 Volume 52 Issue 2 Pages 245-255
    Published: April 01, 1990
    Released on J-STAGE: October 06, 2011
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    We reported 3 cases of infectious mononucleosis in which eruptions were observed after the administration of antibiotics.
    Case 1: The patient was a 21 year-old woman. After she was treated for hepatitis, she came down with a high fever and took cefaclor. Two days later, numerous eruptions appeared over her entire body, and several lymph nodes enlarged.
    Case 2: The patient was a 7 year-old male. He took cefatrizine and piperacillin, because he had a high fever. Many papules and petechiae soon appeared over his entire body, and the cervical and axillary lymph nodes enlarged.
    Case 3 (A sister of case 2): The patient was a 4 year-old girl. After she took cefatrizine to relieve a high fever, many eruptions appeared over her entire body.
    The importance of differentiating this disease from other diseases such as viral infections, malignant lymphoma, drug eruptions and so on was also discussed.
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  • Takuro KATOH, Meiko TSUNODA, Shuhei FUKURO, Takao SANO, Saburo KAGAWA, ...
    1990 Volume 52 Issue 2 Pages 256-259
    Published: April 01, 1990
    Released on J-STAGE: October 06, 2011
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    Phaeohyphomycosis due to Exophiala jeanselmei in a 76-year-old woman with diabetes mellitus and hypertension was reported. She developed a subcutaneous nodule on the left hand and was treated by an operation at another hospital. However, 4 months after the operation two small nodules appeared on both sides of the operation scar. Some cellular immunological tests were also abnormal. Isolated organims from the lesion were identified as Exophiala jeanselmei. The histopathological findings showed a subcutaneous abscess walled by a mixed cell granuloma. There were many spores and hyphae in the granuloma. The patient was successfully treated by operation without antimycotics.
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  • —Clinical Evaluation of Japanese Cases Involved in the Skin—
    Yoshihiro MAEKAWA
    1990 Volume 52 Issue 2 Pages 260-262
    Published: April 01, 1990
    Released on J-STAGE: October 06, 2011
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    A 59-year-old Japanese man, who complained of yellow red and verrucous nodule on the left scrotum, was presented. Histological findings showed an irregular elongation of the rete ridges and numerous foamy cells with large cytoplasma in the papillary and upper dermis, which were stained with SudanIII. There have been 20 such cases reported in Japan, of which 18 were male and 2 were female. All patients were afflicted with genital lesions except for one with scalp lesion.
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  • Noriyuki TODA, Hideki NAKANISHI, Hiroaki NAGAE, Shinji TANAKA, Makoto ...
    1990 Volume 52 Issue 2 Pages 263-267
    Published: April 01, 1990
    Released on J-STAGE: October 06, 2011
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    A 33-year-old man, who had received an operation for paranasal sinusitis at the age 16, developed an asymptomatic mass in the right cheek. Our examination showed a cyst destroying the maxillary bone. The cyst was surgically removed and ultimately considered to be a postoperative maxillary cyst. The resulting defect in the maxillary bone was filled with iliac bone chips with satisfactory results. Though most cases of such cysts tend to occur under the supraorbital nerve and vessels, this case was found to overlie them. We reviewed previously reported cases and briefly discussed the cause, differential diagnosis, and treatment of this disorder.
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  • Yukiko OGIYAMA, Fujio ANDO, Kazuo HARA, Hatsumi FUJII, Masaru OHASHI
    1990 Volume 52 Issue 2 Pages 268-274
    Published: April 01, 1990
    Released on J-STAGE: October 06, 2011
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    In December 1984, a 60-year-old woman who had been suffering from rheumatoid arthritis for 10 years noticed tumors and erythema on her bilateral legs. She had twice spontaneous regression of the skin lesions. The histopathological findings of the tumor revealed a diffuse infiltration of tumor cells mainly composed of large non-cleaved cells in the dermis and subcutaneous tissue. The presense of intracytoplasmic monoclonal immunoglobulin (IgM-kappa type) in the tumor cells was demonstrated by immunofluorescent examination. We diagnosed this case as diffuse large cell type B-cell lymphoma. She was treated with VEMP and CHOP therapy. However, the therapy could not provide her with complete remission. She died of pneumonia and cachexia in June 1987.
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  • Masashi ONO, Mamoru KOHDA, Maya HAMADA, Hiroaki UEKI
    1990 Volume 52 Issue 2 Pages 275-278
    Published: April 01, 1990
    Released on J-STAGE: October 06, 2011
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    A 35-year-old woman had been suffering from mycosis fungoides for four years. The tumors rapidly advanced, and at the same time, her peripheral blood count showed a remarkable eosinophilia (max; WBC 124,000/μl, Eosinophil 89.5%). The findings of a bone marrow examination and dissection showed neither the existence of eosinophilic leukemia nor parasites. We, therefore, speculated that the cause of eosinophilia may have been associated with some other factors related to malignant T-lymphocytes.
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  • Seiji KONDO, Chizu MIYAMOTO, Chin-Huai KEONG, Yoshiaki SATOH, Yoshisad ...
    1990 Volume 52 Issue 2 Pages 279-284
    Published: April 01, 1990
    Released on J-STAGE: October 06, 2011
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    Sib patients bearing basaliomas with xeroderma pigmentosum (XP), XP90TO (42 yr, male) and XP92TO (40 yr, female), were assigned to group F by a complementation analysis in heterodikaryons. Clinically, both patients manifested from moderate to severely acute sun-sensitivity by the age of 8, pigmented freckles by age 10, and skin malignancies in their forties (6 basaliomas at 42 yr in XP90TO; 1 basalioma at 41 yr in XP92TO). The patients were not consanguieous. Despite the still currently sunsensitive state, the patients showed a normal minimal erythema dose (MED) at wavelengths of 290, 300 and 305 nm but abnormally delayed peaking of erythema rection after 48 h after exposure. The XP90TO and XP92TO fibroblasts exhibited typical XP-F characteristics of a higher sensitivity at 3 times the lethal effect of 254 nm ultraviolet light (UV) (n (extrapolation number)=1.1, Do (mean lethal dose)=1.7 J/m2) as well as a reduced level of 12% unscheduled DNA synthesis (UDS), compared to normal cells (n=1.5, Do=5.0 J/m2).
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  • Takahiro SATOH, Seiji KONDO, Michio KATSUMATA
    1990 Volume 52 Issue 2 Pages 285-287
    Published: April 01, 1990
    Released on J-STAGE: October 06, 2011
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    A 36-year-old woman was seen at our hospital because of a slowly enlarging lesion of 2 years’ duration. Examination revealed a nodule of the size of a little finger’s head on the occipital region. Histologically, a circumscribed, non-encapsulated tumor composed of basophilic cells with peripheral palisading was located in the dermis. However, some of the tumor cells exhibited either a pale granular or clear cytoplasm. In these cells, many vacuoles of different sizes were found. While the cytoplasm of the clear cells showed negative for Sudan III, PAS produced a sparse positive staining. Neither S100 protein, carcinoembryonic antigen, nor lysozyme was detected. Based on these observations, our case was diagnosed as a clear cell basal cell epithelioma.
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  • Noriyuki MISAGO, Kiyohisa MOTOKI, Hiromu KOHDA
    1990 Volume 52 Issue 2 Pages 288-292
    Published: April 01, 1990
    Released on J-STAGE: October 06, 2011
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    A 68-year-old man had tuberculosis verrucosa cutis on the right lower limb with incomplete treatment for fifty years. He had never received X-ray therapy. The lesion of tuberculosis verrucosa cutis was an atrophic scar surrounded by elevated verrucous dull red plaque. A walnut-sized reddish tumor appeared in the scar and grew rapidly over a three month period. The diagnosis of tuberculosis verrucosa cutis was confirmed on biopsy examination and a histological examination of the tumor revealed a malignant proliferating trichilemmal tumor. The tumor was completely excised and the tuberculosis verrucosa cutis lesion cleared with an oral administration of isoniazid and rifampicin for about half an year. This case is the first report of a malignant proliferating trichilemmal tumor occurring in the scar of tuberculosis verrucosa cutis.
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Clinical and Investigative Report
  • Takeshi KONO, Nobuyuki MIZUNO, Shoji TANIGUCHI, Tsukasa TANII, Masamit ...
    1990 Volume 52 Issue 2 Pages 293-297
    Published: April 01, 1990
    Released on J-STAGE: October 06, 2011
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    Ornithine decarboxylase (ODC) is a rate-limiting enzyme of polyamine biosynthesis and a well-established marker of the tumor promotion process. Ultraviolet-B (UV-B) irradiation induced this activity remarkably in hairless mouse skin. To elucidate this mechanism molecular biologically, mRNA was extracted from the mouse skin and the ODC mRNA level was evaluated by Northern blotting analysis using a 32P-labelled ODC cDNA probe. UV-B irradiation (90 mJ/cm2) markedly increased the ODC mRNA level (2.0-and 2.6-fold of control at 4 and 24 hours, respectively). On the other hand, the expression of the actin gene, an important house-keeping gene, did not increase by irradiation. These results showed that increased ODC mRNA levels by UV-B was responsible for the UV-B-induced ODC activity.
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  • Toshitsugu SATO, Yuichirou YOSHINAGA, Toyomi WASEDA, Yuzou KUNO, Katsu ...
    1990 Volume 52 Issue 2 Pages 298-305
    Published: April 01, 1990
    Released on J-STAGE: October 06, 2011
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    Focusing on tension as a cause of scar keloid in this study, we retrospectively observed the morphology and time sequence changes in scar keloids occuring in various sites of the body surface. The human body surface was divided into 22 regions, and then 160 scar keloids with phymatoid appearances found in 119 patients, who were grouped by their sites using the above mentioned resions, in order to determine the relationship between the site and morphology of keloid. Phymatoid scar keloids could be divided into 3 types: Type I defined as keloids which were markedly protuberant from the surrounding skin and showed dome-like appearances, Type II defined as those which tended to diffuse into the surroundings and showed features of the so-called keloid type, and Type III consisted of those which had a concave region in the center and often showed a tendency toward recovery.
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  • Jun YAMAGUCHI, Seiji KONDO, Akira KAWADA, Yoshiaki SATOH
    1990 Volume 52 Issue 2 Pages 306-309
    Published: April 01, 1990
    Released on J-STAGE: October 06, 2011
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    The relationship between histopathological types and the degree of dermal elastotic degeneration was examined in 69 actinic keratoses (AKs) excised from 59 patients. Elastotic degeneration of AKs was compared to that of 25 seborrheic keratoses (Seb-Ks) excised from the faces of age-matched controls. The degree of elastotic degeneration of AKs was severer than that of Seb-Ks. Hypertrophic AKs exhibited a severe elastotic degeneration in uninvolved regions, but only a mild degeneration in involved regions. On the other hand, atrophic AKs showed a severe elastotic degeneration in both the involved and uninvolved regions. These results suggest that sun exposure is one of the most important factors in inducing AKs, and that other individual factors (e. g., skin type, aging) may also be involved, and finally that elastotic degeneration is repairable.
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  • Toshiyuki AKI, Munehiro TANIGUCHI, Tetsuya NISHIO, Mitsuru TANIGUCHI, ...
    1990 Volume 52 Issue 2 Pages 310-313
    Published: April 01, 1990
    Released on J-STAGE: October 06, 2011
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    We classified 51 hemodialysed patients with pruritus into four groups according to the severity of itching and evaluated the duration of hemodialysis, and urea nitrogen, creatinine, calcium, phosphorus, parathormone, uremic acid in the blood, as well as any skin changes in each group. The results were as follows: (i) the patients who were in the long term hemodialiser group complained of severe itching; (ii) statistically, there was no difference between the pruritic group and non-pruritic group in regard to age and biochemical findings; and (iii) as to skin changes, the severe pruritic group showed several skin symptoms (eg: whole body xerosis, pigmentation, prurigo, nail deformity, and acquired perforating disease), although both the non- and local pruritic groups showed a few skin symptoms such as focal xerosis. Therefore we consider that xerosis may be responsible for the pruritus in hemodialysed patients.
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  • Kanji ISHII, Akira KOHCHIYAMA, Daisuke OKA, Mamoru KOHDA, Hiroaki UEKI
    1990 Volume 52 Issue 2 Pages 314-317
    Published: April 01, 1990
    Released on J-STAGE: October 06, 2011
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    Serum samples from 107 patients of collagen diseases and related disorders were measured for the serum toxoplasma antibody by the indirect hemagglutination technique in the Department of Dermatology, Kawasaki Medical School, between Jan 1, 1986 and Dec 31, 1988. Specific antibody against toxoplasma was found in 50% of the patients with dermatomyositis (DM), in 5.9% of normal pregnant women, in 12.9% of those with collagen diseases without DM and related disorders, in 9.4% of those with systemic lupus erythematosus (SLE), and in 17.4% of those with progressive systemic sclerosis (PSS). The incidence of toxoplasma antibody was statistically greater in patients with DM than either in patients with other collagen diseases or in normal pregnant women. The clinical interpretation of the antibody was discussed with a special reference to DM.
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  • Katsutaro NISHIMOTO
    1990 Volume 52 Issue 2 Pages 318-322
    Published: April 01, 1990
    Released on J-STAGE: October 06, 2011
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    A cotton-swab sampling method combined with Sabouraud’s dextrose agar supplemented with antibiotics was applied for the mycological examinations of tinea pedis lesions. A comparison of the results obtained by the cotton-swab method with those using an ordinary culture method revealed that both methods were almost equally useful as far as the culture rate is concerned, but the latter was superior for skin used as the subject for fungus culture, when there were no pathological changes. The method was applied to the examination of a supposed small epidemic of tinea pedis in a group of 22 females living together in a dormitory in Nagasaki. In four patients tinea pedis (2 due to Trichophyton rubrum and 2 due to Trichophyton mentagraphytes) was mycologically confirmed. In three females, T. mentagrophytes was isolated from clinically normal interdigital spaces. In 10, who were suffering from either maceration or desquamation, the mycological examination failed to demonstrate the presence of the fungi by either potassium hydroxide preparations and cultures using an ordinary inoculation method or by the cotton-swab sampling method. It is concluded that the skin lesions of the group were in most part due to the local conditions in the shoes which they were forced to wear during their work. The significance of the presence of T. mentagrophytes on the clinically normal skin surface is also discussed.
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