The Nishinihon Journal of Dermatology
Online ISSN : 1880-4047
Print ISSN : 0386-9784
ISSN-L : 0386-9784
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Volume 54, Issue 4
Displaying 1-28 of 28 articles from this issue
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Color Atlas
Mini Review
Clinical Case Reports
  • A Case of Bullous Congenital Ichthyosiform Erythroderma Treated with Etretinate for Ten Years
    Kazuko OSADA, Mariko SEISHIMA, Yukiko SHIKANO, Shunji MORI, Nobuo FUKU ...
    1992 Volume 54 Issue 4 Pages 678-682
    Published: August 01, 1992
    Released on J-STAGE: September 29, 2011
    DOIhttps://doi.org/10.2336/nishinihonhifu.54.678
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    A 5-year-old boy was referred to our department complaining of generalized erythema with thick, brown, verrucous scaling. These complaints had been present from his birth. Vesicles and bullae were encountered during the first five years. No physical abnormalities were seen (height and weight were 107 cm, 15.8 kg, respectively) and the bone development was normal. The laboratory data were all within normal limits. Histologically, acanthosis and a remarkable granular degeneration were observed in the upper portion of the stratum Malpighii. The upper dermis showed a moderate lymphocytic infiltration. These clinical and histopathological findings were consistent with those of bullous congenital ichthyosiform erythroderma. After 2-4 weeks treatment with etretinate at a dosage of 1 mg/kg weight/day, remarkable effects were observed. Although the patient has been treated with etretinate for ten years and the total dosage over that period has been 75.5 g, no side effects have been observed up to now. No physical abnormalities were found (height and weight were 165 cm, 43 kg, respectively). However, the physis has not been closed yet. In addition, although no side effects have yet been found, it will still be necessary for him to be carefully followed up.
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  • “Scrub-Cream” Dermatitis
    Hidezo FUKUDA, Shuhei IMAYAMA
    1992 Volume 54 Issue 4 Pages 683-685
    Published: August 01, 1992
    Released on J-STAGE: September 29, 2011
    DOIhttps://doi.org/10.2336/nishinihonhifu.54.683
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    We reported 12 cases of facial papulo-vesicular eruptions which developed after application of a so-called scrub cream. The papules seen preferentially in the summer were characterized by 1) a relatively acute onset, usually occurring some 2 to 5 days after the initial application of the cream, 2) the uniform appearance of each skin lesion of about 5mm in diameter; slightly elevated erythematous macules and papules with tiny tips, 3) a distribution mainly on the cheeks of middle-aged females, and 4) a slight burning or itchy feeling. These characteristics may imply a non-allergic etiology of the dermatitis which was presumably initiated with epidermal micro-injuries produced by “scrub” grains and followed by successive irritation due to certain contents in the vehicle.
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  • Contact Dermatitis Caused by Amlexanox (ELICS®) Opthalmic Solution
    Enko YANO, Mitsunari HIGUCHI, Singo TSUDA, Eiko TANIGAWA
    1992 Volume 54 Issue 4 Pages 686-690
    Published: August 01, 1992
    Released on J-STAGE: September 29, 2011
    DOIhttps://doi.org/10.2336/nishinihonhifu.54.686
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    This paper deals with four cases of contact dermatitis caused by an antiallergic agent, amlexanox (ELICS®) opthalmic solution. All four cases were females, and a few different types of opthalmic solutions, including amlexanox, were administrated by opthalmologists under the diagnosis of allergic conjunctivitis. About three weeks to 10 months after the initial administration, bilateral periocular erythema and edema accompanied by itching, and conjunctival hyperemia appeared. Skin patch-tests revealed that all four patients were positive for ELICS® opthalmic solution, while two patients, who were further tested for its individual constituent, showed a positive reaction to its principal ingredient, amlexanox.
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  • Contact Dermatitis to Dimethyl Phthalate and Diethyl Phthalate in Spectacle Frames
    Sawako NAKAMURA, Keiko TANAKA, Shuhei SHIMAO
    1992 Volume 54 Issue 4 Pages 691-694
    Published: August 01, 1992
    Released on J-STAGE: September 29, 2011
    DOIhttps://doi.org/10.2336/nishinihonhifu.54.691
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    A 21-year-old male developed an itchy, red rash on both sides of the bridge of his nose as well as behind both ears 10 days after he began wearing new spectacles. Materials to which the patient showed a positive skin patch test reaction included scrapings from his spectacle frames, diethyl phthalate, and dimethyl phthalate, which were all substances contained in the frames, as well as the cobalt sulfate and cinnamic alcohol used in the standard series. The patient also showed a negative patch test for other constituents of the frames. Cobalt was not detected in the spectacle frames by absorbance analysis. The rash was therefore thought to be due to allergic contact dermatitis caused by both the diethyl phthalate and dimethl phthalate contained in the frames.
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  • A Case of Sho-seiryu-to-Induced Drug Eruption
    Kenichi MORI, Daisuke OKA, Hiroaki UEKI
    1992 Volume 54 Issue 4 Pages 695-697
    Published: August 01, 1992
    Released on J-STAGE: September 29, 2011
    DOIhttps://doi.org/10.2336/nishinihonhifu.54.695
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    This is a case report of Sho-seiryu-to-induced drug eruption in a 51-year-old man. He had initially developed toxicoderma after taking a cold medicine (Lu Lu K®) five years earlier. Within one day after taking Sho-seiryu-to, both his thighs and hip showed itchy erythematous changes with a slight induration. Common components in Sho-seiryu-to and Lu Lu K are Mao, Kanzo, and Keihi. In order to determine the causative component, a skin patch test was performed with Mao, Kanzo, and Keihi. Both Mao and Kanzo showed a positive response. As a consequence, we suspect that the possible causative agents in this case were either Mao or Keihi.
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  • A Case of Allergic Granulomatosis
    Hiroyuki TOYOSHIMA, Naoki MIURA, Hikotaro YOSHIDA
    1992 Volume 54 Issue 4 Pages 698-703
    Published: August 01, 1992
    Released on J-STAGE: September 29, 2011
    DOIhttps://doi.org/10.2336/nishinihonhifu.54.698
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    A 35 year-old man with a three-year history of bronchial asthma was referred to us because of purpura on his extremities and nodules on his elbows. A laboratory examination revealed that
    1) leukocytasis and eosinophilia of the peripheral blood,
    2) a positive RA test, and
    3) a high titer of IgE.
    A histopathological examination showed leukocytoclastic vasculitis with eosinophilia and extravascular granuloma of the skin. We therefore concluded that this was a case of allergic granulomatosis.
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  • Arrector Pili Nevus: Report of A Case
    Masako SATO, Satoshi ITAMI
    1992 Volume 54 Issue 4 Pages 704-707
    Published: August 01, 1992
    Released on J-STAGE: September 29, 2011
    DOIhttps://doi.org/10.2336/nishinihonhifu.54.704
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    A 4 month-old infant presented with a brownish, hairy plaque on the posterior site of his left shoulder. A biopsy specimen showed a slight elongation of rete ridges with hypermelanosis in the basal layer and an increased number of well-defined, smooth muscle bundles throughout the whole dermis. The presence of smooth muscle fibers was confirmed by Azan-Mallory staining. The smooth muscle bundles were positively stained with desmin but negative for vimentin by the PAP method. These results indicate that the smooth muscle bundles in the present case showed a well differentiation comparable to that of the arrector pili muscle. A similar eruption was also later recognized on the right thigh of his younger brother.
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  • Four Cases of Subungual Exostosis
    Hiroshi SAITO, Akihiko YANADORI, Soji YAMAZAKI
    1992 Volume 54 Issue 4 Pages 708-712
    Published: August 01, 1992
    Released on J-STAGE: September 29, 2011
    DOIhttps://doi.org/10.2336/nishinihonhifu.54.708
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    Four cases of subungual exostosis are herein reported. The lesions were seen on the right 1st toe, left 2nd toe, right index finger and right 1st toe. In general, subungual exostosis demonstrates a solitary hard tumor found on the distal phalanx of the great toe, either beneath or adjacent to the nail. Trauma may be a precipitating factor though the exact cause of this lesion is still unknown. There have been a few cases caused after significant trauma, but some authors said that such patients might also have had chronic microtrauma due to some sports, e. g. soccer, basketball, baseball, judo etc. Two out of our four cases had sports backgrounds (soccer, baseball) while one of the other 2 cases had suffered a significant irritation to his toe. Histologically, 2 were exostosis type, 1 osteochondroma type and 1 mixed type. A local excision is the treatment of choice in principle. We operated all cases under local anesthesia and no recurrence has been recognized. Recently, sports population is raised, so similar cases of our cases might be increasing.
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  • A Case of Malignant Trichilemmoma
    —Cytofluorometric Study on Nuclear DNA Content of Tumor Cells—
    Kazutoshi SUZUKI, Shigeki FUJISAWA, Takafumi MORISHIMA
    1992 Volume 54 Issue 4 Pages 713-717
    Published: August 01, 1992
    Released on J-STAGE: September 29, 2011
    DOIhttps://doi.org/10.2336/nishinihonhifu.54.713
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    A malignant trichilemmoma(mTr) is histopathologically composed of basaloid cells with Bowen’s disease-like changes such as clumping cells and dyskeratosis, and glycogen-rich clear cells with low atypicality. Utilizing tumor cells from the lesion of mTr in the right leg of a 77-year-old male that had rapidly grown in the last few months, the content of nuclear DNA in basaloid and clear cells was determined by cytofluorometry. The DNA content in the normal lymphocyte was assigned to 2C and the DNA histogram of the basaloid cells showed an aneuploidy pattern, with their average DNA content being 10.3C. The DNA histogram of the clear cells had a polyploidy pattern, with their average DNA content being 4.2C. Basaloid cells showed an abnormality severer than that of clear cells on the nuclear pattern as well as on the histological findings. A follicular structure is basically maintained in this tumor. The basaloid cells originated from a basal cell of a hair follicle with a natural ability to divide. The difference in the nuclear DNA content between the basaloid cells and clear cells may have thus accounted for the differential cell dividing ability between the cells.
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  • Malignant Fibrous Histioicytoma with von Recklinghausen’s disease
    —A Case of So-called Inflammatory Type with Neutrophilic Leukocytic Infiltration—
    Kumiko MIZUTARI, Masayoshi JOHNO, Tomomichi ONO
    1992 Volume 54 Issue 4 Pages 718-721
    Published: August 01, 1992
    Released on J-STAGE: September 29, 2011
    DOIhttps://doi.org/10.2336/nishinihonhifu.54.718
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    We herein report a 33-year-old woman suffering from malignant fibrous histiocytoma associated with von Recklinghausen’s disease. Besides the typical histopathological features of malignant fibrous histiocytoma, this tumor showed a prominent and diffuse infiltration of neutrophilic leukocytes as well as prominent leukocytosis. A diagnosis of the so-called malignant fibrous histiocytoma, inflammatory type was made. The patient died due to tumor metastases 15 months after onset. In agreement with the previous Japanese literatures, the prognosis of the inflammatory type of malignant fibrous histiocytoma proved to be poorer than that of other types.
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  • A Fatal Case of Dermatomyositis Associated with Interstitial Pneumonitis and Pneumomediastinum
    Yuzirou ODA, Akihiko TAJIRI, Katsumi OGATA, Shouhei INOUE
    1992 Volume 54 Issue 4 Pages 722-726
    Published: August 01, 1992
    Released on J-STAGE: September 29, 2011
    DOIhttps://doi.org/10.2336/nishinihonhifu.54.722
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    A 31-year-old male with fatal dermatomyositis is herein reported. Initially, the creatine phosphokinase level returned to within normal limits with the daily administration of 30 mg of predonisolone. However, dyspnea progreseively worsened eventually leading to death despite an increased dosage of predonisolone to 60 mg as well as administering pulse therapy. Pneumomediastinum and subcutaneous bullae appeared. The entire course of the disease was approximately 8 months. A review was then made of dermatomyositis associated interstitial pneumonitis, especially that of the pneumomediastinum. Conclusively, the general prognosis of such cases is very poor.
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Clinical and Investigative Report
  • Effect of Minoxidil Sulfate on the Growth of Human Anagen Hair Follicels Grown in Collagen Gels, and on the Colony Growth of Human Cultured Outer Root Sheath Cells in vitro.
    Naoyuki UCHIDA, Takesi FUJIE, Seiji ARASE, Yosiroh NINOMIYA, Hideki NA ...
    1992 Volume 54 Issue 4 Pages 727-732
    Published: August 01, 1992
    Released on J-STAGE: September 29, 2011
    DOIhttps://doi.org/10.2336/nishinihonhifu.54.727
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    Human anagen hair follicles were cultured in collagen gel in either the presence or absence of minoxidil sulfate. In the absence (control) and presense of the chemicals at 0.1, 1, and 10μg/ml, the hair follicles and shafts continually grew for 7 days with a similar rate of increase in hair shaft length of 0.12mm/day. However, 100μg/ml of minoxidil sulfate inhibited the hair growth compared with the control, and the elongation rate was about the half that of the control, 0.06 mm/day. We also examined the effect of minoxidil sulfate on cultured human outer root sheath cells. The drug at 0.1μg/ml and 1μg/ml appeared to slightly stimulate colony growth and colony formation compared with the controls. However, there was no statistic significance among three groups. On the other hand, 10μg/ml of minoxidil sulfate significantly inhibited colony growth but did not influence colony formation. Only a few colonies were formed in 100μg/ml. Minoxidil sulfate, a metabolite of minoxidil, has been suggested to be more potent than minoxidil in pharmacological activity. All results obtained here, however, indicated that minoxidil sulfate in the concentration range of 0.1 to 10μg/ml had no influence on the hair growth of human anagen follicles or the colony growth of cultured human outer root sheath cells in vitro.
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  • Effects of Minoxidil on Epidermal Cells
    Hiroshi HACHISUKA, Osamu MORI, Keiji OKUBO, Tadashi KARASHIMA, Masahir ...
    1992 Volume 54 Issue 4 Pages 733-736
    Published: August 01, 1992
    Released on J-STAGE: September 29, 2011
    DOIhttps://doi.org/10.2336/nishinihonhifu.54.733
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    Minoxidil has been shown to stimulate hair growth, although the exact mechanism for the stimulation of hair growth is still unknown. In the present study, we used epidermal cells to investigate the mechanism of minoxidil. A topical application of minoxidil for guinea pig skin revealed that the population of the S+G2+M phase of guinea pig basal cells were greater than the controls. Minoxidil did not activate PKC activity from which the guinea pig epidermal cells were derived. Minoxidil enhanced the DNA synthesis of Pam212 cells, while it was decreased by PKC inhibitor (H-7). These results therefore suggest that minoxidil might activate hair bulbs through PKC.
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  • The Clinical Usefulness of House Dust Mite Avoidance in Atopic Dermatitis
    Masako SATO, Motoko TERASI, Susumu TAKAYASU
    1992 Volume 54 Issue 4 Pages 737-740
    Published: August 01, 1992
    Released on J-STAGE: September 29, 2011
    DOIhttps://doi.org/10.2336/nishinihonhifu.54.737
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    Forty-nine patients with moderate or severe atopic dermatitis, who either showed a positive reaction for the RAST test (score>2) or prick test using house dust mite antigen, were selected for the present study. The age of the patients ranged from 1 to 29 years old. Patients were asked to avoid mite allergen by extensive cleaning of their rooms, eliminating carpets and stuffed dolls, and also by the frequent exposure of their bedding to sunlight. Forty-three patients out of the 49 performed sufficiently well to avoid mite allergen according to our advice for at least 2 months. We assessed the results of this trial by either physical examination or a questionnaire. Three cases (7.0%) markedly improved, while in 20 patients (46.5%) the skin condition moderately improved; i. e., they were able to maintain a good skin condition with a less frequent use of topical drugs. Fifteen cases (34.5%) were judged as a slight improvement; the eruption became milder, though similar treatment was required as before trial. On the whole, in 38 patients (88.4%), the skin condition improved while it was unchanged in 5. These results suggest that mite allergen avoidance was a useful measure in the treatment of atopic dermatitis.
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  • The Detection of Sensitization to Dust Mite Antigen in Atopic Dermatitis Patients
    Tomoko TANAHASHI, Shuhei IMAYAMA, Hiroko MIYAHARA, Tamiko HASHIZUME, Y ...
    1992 Volume 54 Issue 4 Pages 741-746
    Published: August 01, 1992
    Released on J-STAGE: September 29, 2011
    DOIhttps://doi.org/10.2336/nishinihonhifu.54.741
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    In order to detect the sensitization to house dust mite antigen, specific serum IgE level, a patch test (PT) reaction and lymphocyte proliferation response to Dermatophagoides farinae (Df) antigen were studied in both atopic dermatitis (AD) patients and healthy controls. The relationship and the significance of each test were also analysed. In this study, the positive mite PT reaction and lymphoproliferative responses were more freqently observed in AD patients than in the controls. The lymphoproliferative responses were revealed to reflect IgE for Df antigen, whereas, contrary to expectations, there was no correlation between the lymphocyte response and PT. In addition, as with Dermatophagoides pteronyssinus antigen, patients with atopic dermatitis were differentiated into four subclasses on the basis of Df-IgE and Df-PT. Under this classification, the patients with a high lymphoproliferative response to Df antigen were localized to the group in which patients showed a positive patch test reaction as well as a high IgE level.
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  • Cytokine Production of Peripheral Blood Mononuclear Cells from Gold Contact Allergic Patient
    Tetsuya KOGA, Tamiko HASHIZUME, Shuhei IMAYAMA, Yoshiaki HORI, Hiromu ...
    1992 Volume 54 Issue 4 Pages 747-750
    Published: August 01, 1992
    Released on J-STAGE: September 29, 2011
    DOIhttps://doi.org/10.2336/nishinihonhifu.54.747
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    Interferon-γ and interleukin-2 were present in the culture supernatant, after a 72 hour incubation with gold sodium thiomalate of the peripheral blood mononuclear cells obtained from a patient with gold contact dermatitis who developed a positive patch test reaction to the same agent. These mononuclear cells were also strongly stimulated (stimulation index: 540%) by the same gold substrate. These findings indicate that patients with gold contact dermatitis have peripheral T-lymphocytes that produce both IFN-γ and IL-2, which are known to play a key role in the development of a delayed type allergic reaction in the skin.
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  • Pre-Operative Diagnosis of Malignant Melanoma with the Touch-Fluorescence Method
    Akihiko SHIBATA, Takafumi MORISHIMA
    1992 Volume 54 Issue 4 Pages 751-756
    Published: August 01, 1992
    Released on J-STAGE: September 29, 2011
    DOIhttps://doi.org/10.2336/nishinihonhifu.54.751
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    We developed the touch-fluorescence method using preparations from the outer surface of elevated and ulcerative lesions. This method made it possible to demonstrate the melanogenic activity of melanoma cells within 30 min. In 16 cases, which were clinically diagnosed as typical melanoma cases, 14 cases were definitively diagnosed as melanoma from the touch-fluorescence microscopic findings before operation. No fluorescent tumor cells were observed in the remaining 2 cases, and they turned out to be non-melanoma cases. There was some correlation between the type of primary melanoma and the configuration of the fluorescent melanoma cells. The main cellular configuration of superficial spreading melanoma was “round” while that of nodular melanoma and acral lentiginous melanoma were “pleomorphic”. Based on these results, this method was concluded to be extremely reliable for the preoperative diagnosis of elevated and ulcerative lesions of malignant melanomas, which are sometimes difficult to diagnose.
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Review
Statistics
  • Prognostic Study of Paget’s Disease for the Past Ten Years at Mie University Hospital
    Takayoshi SAKAMOTO, Hitoshi MIZUTANI, Masayuki SHIMIZU
    1992 Volume 54 Issue 4 Pages 765-769
    Published: August 01, 1992
    Released on J-STAGE: September 29, 2011
    DOIhttps://doi.org/10.2336/nishinihonhifu.54.765
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    We statistically studied the treatment and prognosis of 33 cases of extramammary Paget’s disese at Mie Uiversity Hospital from 1980 to 1989 and found that;
    1) The relative frequency of Paget’s disease in malignant tumor patients was 11.9%. Twenty-four of the cases were men and 9 were women (the male to female ratio was 1:0.38). The mean age of the patients was 70.3 years of age (ranging from 54 to 87).
    2) The mean duration from onset to the first visit was 33.4 months.
    3) All patients were treated with a surgical excision of the tumor and a skin graft. Over 70% of tumors were surgically removed at a level 3cm distant from the visible margin of the tumor and also at the level of the deep subcutaneous fatty tissue or fascia of the underlying muscles.
    4) The duration of follow up for the 32 patients ranged from 10 months to 8 years. Three patients died of widespread metastasis. One patient died wihtout any specific cause. Twenty-eight of the 32 patients (87.5%) are still alive and healthy.
    5) From the above data we like to stress the importance of a multiple biopsy to determine the exact excision level. If the exact margin of the lesion can be determined histologically by a multiple biopsy, then surgical excision only 3 cm distant from visible margin of the lesion can be done and provide a maximum preservation of genital organ function which has proven satisfactory prognostic results in our 28 cases.
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