The Nishinihon Journal of Dermatology
Online ISSN : 1880-4047
Print ISSN : 0386-9784
ISSN-L : 0386-9784
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Volume 53, Issue 3
Displaying 1-30 of 30 articles from this issue
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Clinical Case Reports
  • Erthema Nodosum Associated with Menstruation
    Yumi HONDA, Takashi NAKAMURA, Kiyofumi EGAWA, Tomomichi ONO, Tatsuyosh ...
    1991 Volume 53 Issue 3 Pages 474-477
    Published: June 01, 1991
    Released on J-STAGE: September 29, 2011
    DOIhttps://doi.org/10.2336/nishinihonhifu.53.474
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    A 21-year-old female developed erythema nodosum associated with her menstrual cycle. A skin rash appeared at the premenstrual phase and persisted after the flow. The cycle of her menstruation was regular, although the patient’s serum estrogen and progesteron were not well-balanced, in addition the patient had endometriosis and luteal insufficiency.
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  • Mequitazine-Induced Photosensitive Drug Eruption in Two Patients
    Yoichiro TOI, Wataru FUJIMOTO, Joji TADA, Jiro ARATA
    1991 Volume 53 Issue 3 Pages 478-482
    Published: June 01, 1991
    Released on J-STAGE: September 29, 2011
    DOIhttps://doi.org/10.2336/nishinihonhifu.53.478
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    We reported two cases of photosensitive drug eruption due to mequitazine. One was a 69-year-old male who had developed red papules and erythema with pruritus on the back of the hands and face during the administration of mequitazine. The minimal erythematous dose (MED) for ultraviolet A was decreased and a patch test with 1% mequitazine and photopatch test with 0.1% mequitazine showed a positive reaction. The skin eruptions disappeared after stopping the administration of mequitazine. A provocation test for mequitazine revealed a positive reaction, resulting in similar eruptions in the patient. The other was a 42-year-old female who had diffuse erythema on sun-exposed areas while she had been treated with mequitazine. A photopatch test with 1% mequitazine was positive, although the MED was normal. After stopping oral administration, the erythema disappeared. It is suggested that contact allergy and phototoxic reaction to mequitazine played an important role in the hypersensitivity of the former case while in the latter case it was caused by a phototoxic reaction to mequitazine.
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  • Two Cases of Bullous Pemphigoid Associated with Nephrotic Syndrome
    Tetsuya TSUKAHARA, Kazunobu OTOYAMA, Yasuhiro HORIUCHI, Hiroshi NAKAJI ...
    1991 Volume 53 Issue 3 Pages 483-486
    Published: June 01, 1991
    Released on J-STAGE: September 29, 2011
    DOIhttps://doi.org/10.2336/nishinihonhifu.53.483
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    We reported two cases of a 81-year-old man and a 78-year-old man suffering from bullous pemphigoid associated with nephrotic syndrome. In case 1, the symptoms of an 81-year-old man could be successfully controlled by treatment with systemic corticosteroid. However, in case 2, a 78-year-old man died following pneumonia and DIC, even though he had been given systemic corticosteroid therapy. According to the autopsy examination of case 2, a kidney specimen revealed hypertrophic membranous glomerulonephritis, in which direct immunostainings showed IgA and C3 deposits. We propose that nephrotic syndrome may be one of the underlying disorders of bullous pemphigoid.
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  • Double Cancers of the Colon and Rectum Following Bowen’s Disease:
    A Case Report
    Yasuhiro HORIUCHI, Kazunobu OTOYAMA, Seiji ARITA, Nobuyuki TOKUMOTO, T ...
    1991 Volume 53 Issue 3 Pages 487-489
    Published: June 01, 1991
    Released on J-STAGE: September 29, 2011
    DOIhttps://doi.org/10.2336/nishinihonhifu.53.487
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    Bowen’s disease is a precancerous dermatosis described by Bowen in 1912. The cause for this disease is most frequently found to be due to arsenic compounds. In many cases, the association between Bowen’s disease and internal cancer has been described. Our patient, a 67-year-old man, had previously had a skin lesion of Bowen’s disease on the foot excised ten months before double cancers of the colon and rectum were found. Histologically, both intestinal tumors showed tubular adenocarcinoma, respectively.
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  • A Case of Nevus Sebaceus Accompanied by a Pilomatricoma-like Tumor Composed of Shadow Cells:
    Nevus Sebaceus as a Disorder of the Pilosebaceous-Apocrine Unit
    Kazuo ASO, Shigeo KONDO, Noriaki SATO, Yutaka HOZUMI
    1991 Volume 53 Issue 3 Pages 490-497
    Published: June 01, 1991
    Released on J-STAGE: September 29, 2011
    DOIhttps://doi.org/10.2336/nishinihonhifu.53.490
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    We reported a case of a 14-year-old Japanese male presenting a nevus sebaceus accompanied by a pilomatricoma-like tumor composed mainly of shadow cells. We also reviewed 43 previous cases of nevus sebaceus treated in our clinic over the last 14 years, and confirmed the fact that the nevus sebaceus was a teratotic and nevoid disorder of pilosebaceous-apocrine units. In the proliferating epidermis corresponding to the nevus sebaceus, proliferations of trichilemmal cells derived from the underlying infundibulum of nevoid hair follicles, were observed to various extents along with proliferations of cells resembling those of tumors such as follicular infundibulum, nevus comedonicus, dilated pore of Winer, seboacanthoma and sebaceous trichofolliculoma. The above indicated that the proliferation of the epidermis in nevus sebaceus is possibly derived from proliferating trichilemmal cells in the upper part of the nevoid hair follicle.
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  • Localized von Recklinghausen Disease
    Tsuyoshi MATSUNAGA, Chohei TAKINO
    1991 Volume 53 Issue 3 Pages 498-501
    Published: June 01, 1991
    Released on J-STAGE: September 29, 2011
    DOIhttps://doi.org/10.2336/nishinihonhifu.53.498
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    We reported on a 48-year-old man with a localized form of von Recklinghausen disease. The lesions were confined to the Th11 to L1 dermatome on the right side of the trunk. They consisted of multiple pigmented macules, a few café-au-lait spots and several soft reddish-brown 1cm nodules which proved to be a neurofibroma on biopsy. From its clinical and histological findings, we considered our case to be mosaic type of von Recklinghausen disease. Riccardi classified von Recklinghausen disease into eight groups (NF-1∼NF-8). In his classification the mosaic type falls under NF-5 and it includes cases with neurofibromas and pigmented lesions as well as cases with neurofibromas only. However, the cases with neurofibromas and pigmented lesions are fewer than the cases with neurofibromas only in Japan, so we think the classification by Niimura, which is based upon a combination of neurofibroma and pigmented lesion, is preferable so far as the mosaic type is concerned. As to age, sex and location there is no significant difference between the cases with neurofibromas and pigmented lesions and the cases with neurofibromas only, however the former tend to occur more often on the right side of the trunk than on the left side, whereas the latter appear to occur on both sides equally.
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  • Squamous Cell Carcinoma Arising in Lichen Planus Caused by Dental Metal Allergy:
    A Case Report
    Noriyuki MISAGO, Hiromu KOHDA, Yuuki UCHIDA, Eirou KUBOTA, Takeshi KAT ...
    1991 Volume 53 Issue 3 Pages 502-508
    Published: June 01, 1991
    Released on J-STAGE: September 29, 2011
    DOIhttps://doi.org/10.2336/nishinihonhifu.53.502
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    A 58-year-old woman had suffered from white plaques on her left buccal mucosa, as well as fissure and erosion on the lower lip for many years. She also had a verrucous lesion on the external genitalia and a history of nodules on the bilateral lower limbs for five years. She noticed that white papillomatous tumors had appeared in the white plaques on the left buccal mucosa, and visited Saga Medical College hospital. The tumors and white plaques were completely excised. A histological examination revealed them to be lichen planus and squamous cell carcinoma. All of the skin biopsies obtained from the lesions of lower lip, external genitalia and lower limbs also showed lichen planus. She was patch-tested to the range of metals contained in her dental metal, and showed a positive allergic reaction to SbCl3. We considered that the lichen planus had been caused by a dental metal allergy, occuring in the buccal mucosa, lower lip, external genitalia and lower limbs, while the squamous cell carcinoma arose in the lesion of buccal mucosa in this case.
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  • Adamantinoid Basal Cell Carcinoma
    Masayuki NISHIMURA, Yoshiaki HORI
    1991 Volume 53 Issue 3 Pages 509-511
    Published: June 01, 1991
    Released on J-STAGE: September 29, 2011
    DOIhttps://doi.org/10.2336/nishinihonhifu.53.509
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    A 64-year-old Japanese woman presented with an easily bleeding lesion in the lip where her false tooth had injured 5 years earlier. On examination, a crusted pea-sized nodule was seen at the center of the mucocutaneous border of the upper lip. Based on the histological findings, we made a diagnosis of adamantinoid basal cell carcinoma, which is a rare histological variant resembling dental ameloblastoma.
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  • Glomus Tumor:
    A Case Report
    Haruhisa KATO, Shuichi KUNIYUKI
    1991 Volume 53 Issue 3 Pages 512-514
    Published: June 01, 1991
    Released on J-STAGE: September 29, 2011
    DOIhttps://doi.org/10.2336/nishinihonhifu.53.512
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    A case of glomus tumor is described. A 68-year-old woman had suffered from a painful papule on the right little finger for 20 years. The reddish soft papule, measuring 6 mm in diameter, was surgically removed under local anesthesia, and submitted for a histopathological examination. Histologically, the tumor was surrounded by a fibrous capsule. There were numerous vascular lumina that were lined by a single layer of endothelial cells. Peripheral to the endothelial cells aggregates of glomus cells were seen. They had a faintly eosinophilic cytoplasm and large, round to oval nuclei of a rather uniform appearance. Factor VIII-related antigen was strongly positive for the endothelial lining cells by the PAP method. Staining with Bodian stain also showed nerve fibers to be present in the tumor.
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  • Dermatofibrosarcoma Protuberans and Malignant Fibrous Histiocytoma
    Yasuhiro HORIUCHI, Mikio MASUZAWA
    1991 Volume 53 Issue 3 Pages 515-519
    Published: June 01, 1991
    Released on J-STAGE: September 29, 2011
    DOIhttps://doi.org/10.2336/nishinihonhifu.53.515
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    We reported a case with dermatofibrosarcoma protuberans (DFSP) of a 20-year-old woman and a case with malignant fibrous histiocytoma (MFH) of a 26-year-old man. The striking histologic features of DFSP included an abundance of collagen fibers among the neoplastic cells, compared with those of MFH. Electron microscopically, the tumor cells of DFSP had numerous rough ER in the cytoplasm. Most of the neoplastic cells of MFH had oval cell-shape and nuclei.
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  • Kaposi’s Sarcoma Occurring in a Patient with Diabetes Mellitus
    Takashi BABA, Haruhisa KATO, Toshio HAMADA, Jun-ichi SEKI, Yasutugu KO ...
    1991 Volume 53 Issue 3 Pages 520-524
    Published: June 01, 1991
    Released on J-STAGE: September 29, 2011
    DOIhttps://doi.org/10.2336/nishinihonhifu.53.520
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    In November 1986, a 69-year-old man presented with painful papulonodular eruptions on the right foot of four years’ duration. He had also been sufferring from diabetes mellitus for three years. The cutaneous lesion was histologically diagnosed as Kaposi’s sarcoma. The eruption gradually extended and new lesions later appeared on the left foot and both hands. Despite chemotherapy (actinomycin D and vincristine) and insulin therapy for diabetes mellitus, the patient followed a downhill course, and died from gastrointestinal bleeding one year after admission. An autopsy was performed. Widespread Kaposi’s sarcoma was seen in the internal viscera including the gastrointestinal tract, adrenals, and lymphnodes. The patient’s sera showed a negative human T-lymphotropic virus type I (HTLV-1) antibody, human immunedeficiency virus (HIV) antibody, and cytomegalovirus (CMV) antibody. The OKT4/OKT8 ratio was 1.13, showing a slight decrease when compared with normal healthy individuals. It is presumed that immunoincompetence such as chronological aging and diabetes mellitus may play a role in the development of Kaposi’s sarcoma.
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  • A Case of Hypereosinophilic Syndrome
    Kenichi MORI, Mamoru KOHDA, Yasuji MORI, Hiroaki UEKI, Masahiko KUMAGA ...
    1991 Volume 53 Issue 3 Pages 525-529
    Published: June 01, 1991
    Released on J-STAGE: September 29, 2011
    DOIhttps://doi.org/10.2336/nishinihonhifu.53.525
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    A 37-year-old housewife with hypereosinophilic syndrome was reported. The clinical findings indicated erythema annulare cetrifugum-like eruptions over almost the entire body, without any evidence of any systemic involvement. The major laboratory findings included prolonged peripheral blood eosinophilia (max. 9,200/μl) and positive anti-nuclear antibody (ANA). A biopsy specimen, taken from left upper arm, showed epidermal microabscess and dermal infiltration with eosinophils. In our case, corticosteroid therapy cleared up the skin lesions and reduced the eosinophilia in eight weeks. In addition, the combined use of corticosteroid and azathioprine kept the patient in a good condition. Two and half years later the couse of treatment was suspended and the patient has had no recurrence of skin lesions or eosinophilia since.
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  • ATL (Adult T Cell Leukemia) clinically Manifesting MF (Mycosis Fungoides)
    Tsuguna MIYAGI, Hajime MIYASATO, Tadashi HIGA, Atsushi TAKAMIYAGI , Fu ...
    1991 Volume 53 Issue 3 Pages 530-534
    Published: June 01, 1991
    Released on J-STAGE: September 29, 2011
    DOIhttps://doi.org/10.2336/nishinihonhifu.53.530
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    A 68-year-old male case of ATL which took a clinical course and had pathological findings of classical mycosis fungoides was examined. Since about 15 years previously, the patient had found reddish papules and erythema on his left abdominal region. The skin lesions had progressively spread over his entire trunk. Some of the erythematous lesions was infiltrated. About 1 year previously, a red-brownish tumor had appeared on his cheek. Serologically, HTLV-I antibody was positive, but no abnormal cells were detected in the peripheral blood. At this stage, a diagnosis of tumor stage MF was made, and treatment was undertaken with systemic rIFN-α injection, PUVA therapy, topical application of steroid ointment and irradiation of soft X-rays to the skin lesions. After such treatment, most of the skin lesions had disappeard. A few months later, HTLV-I proviral DNA was found in a frozen specimen of the left cheek that had been preserved since his first consultation at the outpatient clinic. According to the all investigations, the disease was finally diagnosed as ATL.
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  • Sweet’s Syndrome Accompanied by Myelodysplastic Syndrome
    Eiko ICHIKAWA, Michiko IKEDA, Satoe ASANO, Seigo OKABE, Mizuho KANEDA, ...
    1991 Volume 53 Issue 3 Pages 535-540
    Published: June 01, 1991
    Released on J-STAGE: September 29, 2011
    DOIhttps://doi.org/10.2336/nishinihonhifu.53.535
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    A 54-year-old man was hospitalized because of skin eruptions and fever. He had painful erythematous plaques on his face and trunk. A skin biopsy revealed Sweet’s syndrome. Four months after the eruption first appeared hematological abnormality was discovered and he was diagnosed as myelodysplastic syndrome (RAEB). A biopsy specimen of the skin lesion revealed a dense dermal infiltraion with mature neutrophils including hyperlobulated neutrophils which were also seen in the periferal blood. A chest X-p showed bilateral pulmonary infiltrates. The histology of the lung specimen was similar to that of the previous skin biopsy and it suggested that this patient had Sweet’s syndrome involving the skin and the lung. We examined neutrophil functions of this patient and a hyperproduction of superoxide anion (O2-) was detected.
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Clinical and Investigative Report
  • Effects of Ointment Containing Prostaglandin E1·α-Cyclodextrin Clathrate Compound (PGE1·CD Ointment) on the Healing of Experimental Open Wounds of Aurisinterna in Rabbits
    Takamitsu SHIRAJI, Ryoji MATSUMOTO, Korekiyo WAKITANI, Hideki AISHITA, ...
    1991 Volume 53 Issue 3 Pages 541-547
    Published: June 01, 1991
    Released on J-STAGE: September 29, 2011
    DOIhttps://doi.org/10.2336/nishinihonhifu.53.541
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    The healing effect of PGE1·CD ointment was investigated in an experimental open wound model of aurisinterna in rabbits. Male white rabbits weighing 2.5 kg were used. A patch of the skin (1×1 cm) was excised from the epidermis on the aurisinterna. PGE1·CD ointment (ca. 100 mg) was then applied topically to the wound once a day. The area of the wound was reduced faster in the PGE1·CD ointment treated group than that in the plastibase (ointment base) treated group, and the days for complete healing were shortened significantly. The improvement of several histological parameters, such as reepithelialization, neovascularization and proliferation of granulation tissue, were also observed in the PGE1·CD ointment treated group. The ear cutaneous blood flow (CBF) of the wounding site was determined in this model with a laser-doppler flow meter. PGE1·CD ointment increased the CBF continuously in a dose dependent manner after topical application to the wound, while no significant change was observed on the systemic arterial pressure or heart rate. These results suggest that PGE1·CD ointment accelerates wound healing because of its vasodilatory action. Therefore, this ointment should prove to be effective against ischemic cutaneous ulcers, such as decubitus ulcers, in the clinical stage.
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  • Clinical Value of Anti-Scl-70 Antibody (Anti-Topoisomerase I Antibody) in Progressive Systemic Sclerosis (PSS)
    Manabu MAEDA, Yukiko SHIKANO, Shunji MORI
    1991 Volume 53 Issue 3 Pages 548-552
    Published: June 01, 1991
    Released on J-STAGE: September 29, 2011
    DOIhttps://doi.org/10.2336/nishinihonhifu.53.548
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    Sera from fifty-four patients with PSS stored under -70°C were examined anti-Scl-70 antibody by ENA-3 kid (MBL Co. Ltd.), anti-RNP antibody (ENA-1 kid), anti SSA/SSB antibodies (ENA-2 kid), anti-centromere antibody (ACA) (fluoro CENTRO slide) and antinuclear antibodies (fluoro HEPANA test). As controls, the sera from 19 cases of the non-PSS group (SLE, DM etc.), 31 cases of dermatologic diseases (non-collagen disease group) and 47 cases of the healthy control group were examined with the same methods. Nine cases (16.7%) posessed anti-Scl-70 antibody in PSS patients, while the anti-Scl-70 antibody was not deteced in the other three groups. Moreover, repeated testing of the positive PSS patients from 1984 to 1989 showed that this antibody persisted in all 7 cases examied. The PSS patients were grouped into four types: anti-Scl-70 antibody positive (9 cases), anti-RNP antibody positive (10 cases), ACA positive (12 cases) and whole negative (13 cases). The PSS group with anti-Scl-70 antibody was a significantly severe type regarding the occurrence of pitting scar, hand contracture, diffuse pigmentation and pulmonary fibrosis, compared to other antinuclear type groups (RNP positive, ACA positive and whole negative). In the pulmonary function test, the vital capacity (VC) and %DLco titers were also significantly lower than those of the three other types. These data show that the examination of anti-Scl-70 antibody is valuable for estimating the severity of PSS, which may be helpful in the clinical follow-up.
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  • MRI Diagnosis for Pigmented Skin Tumor
    —Comparison between signal intensity and histopathological findings—
    Masahiro TAKAHASHI, Hiromu KOHDA
    1991 Volume 53 Issue 3 Pages 553-557
    Published: June 01, 1991
    Released on J-STAGE: September 29, 2011
    DOIhttps://doi.org/10.2336/nishinihonhifu.53.553
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    We investigated MRI (magnetic resonance imaging) diagnosis for pigmented skin tumors in cases of malignant melanoma and blue nevus. This medical imaging is thought to be very useful for obtaining accurate informations of the tumors, regarding shape and location. Additionally we investigated the possibility of discriminating between benign and malignant tumors by measuring the signal intensity of the tumor and the adjoinning subcutaneous fat.
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  • Preoperative Diagnosis with MRI is Useful in Cases of Malignant Melanoma
    —Comparision and Investigation of Image and Histopathological Findings—
    Masahiro TAKAHASHI, Takashi KISHIKAWA
    1991 Volume 53 Issue 3 Pages 558-561
    Published: June 01, 1991
    Released on J-STAGE: September 29, 2011
    DOIhttps://doi.org/10.2336/nishinihonhifu.53.558
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    We compared presurgical MRI with an extirpated tumor specimen in a malignant melanoma case occuring in a 40-year-old man’s left shoulder area. There was close agreement in shape and size between the MRI and the extirpated tumor specimen. MRI is therefore thought to be a very useful presurgical medical imaging for malignant melanoma. We also discussed other aspects of utilizing MRI in such cases.
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