The Nishinihon Journal of Dermatology
Online ISSN : 1880-4047
Print ISSN : 0386-9784
ISSN-L : 0386-9784
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Volume 54, Issue 5
Displaying 1-27 of 27 articles from this issue
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Color Atlas
Clinical Case Reports
  • A Case of Wells’ Syndrome
    Minoru MURAYAMA, Yoshinori SUENAGA
    1992 Volume 54 Issue 5 Pages 859-862
    Published: October 01, 1992
    Released on J-STAGE: September 29, 2011
    DOIhttps://doi.org/10.2336/nishinihonhifu.54.859
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    A case of Wells’ syndrome is reported. The patient was a 9-year-old Japanese boy. He had scattered erythematous plaques on his bilateral lower extremities. Laboratory findings showed peripheral blood eosinophilia and a high titer of serum IgE. Histological examinations showed a massive eosinophilic infiltration from the dermis to the subcutaneous fat tissue and a so-called “flame figure” in the dermis.
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  • A Case of Behçet’s Disease Showing a High Concentration of IL-1 in the Synovial Fluid
    Toshihiko TANAKA, Yasushi SUGITA, Eishin MORITA, Satoru YAMADA, Shoso ...
    1992 Volume 54 Issue 5 Pages 863-866
    Published: October 01, 1992
    Released on J-STAGE: September 29, 2011
    DOIhttps://doi.org/10.2336/nishinihonhifu.54.863
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    Both IL-1 concentration in the serum and synovial fluid was determined in a case of Behçet’s disease with severe arthritis using sandwich ELISA. There was no significant difference in the plasma levels of IL-1α and IL-1β between that found in the patient and that in normal controls. However, biologically substantial amount of IL-1 was detected in the synovial fluid of the patient(IL-1α: 40ng/ml and IL-1β: 295ng/ml). Since IL-1 is known to have pro-inflammatory properties, IL-1 may thus also play an important role in the pathogenesis of arthritis in Behçet’s disease.
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  • Five Cases of Palindromic Rheumatism
    Yuko HIGAKI, Hiroko YAMASHITA, Akira HIDANO, Kazuto SATO
    1992 Volume 54 Issue 5 Pages 867-872
    Published: October 01, 1992
    Released on J-STAGE: September 29, 2011
    DOIhttps://doi.org/10.2336/nishinihonhifu.54.867
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    Five patients were suffering from recurrent attacks of joint pain and swelling either with or without tender indurated erythema for from 2 to 20 years. The laboratory findings were normal except for the raised erythrocyte sedimentation rate, and transient positive CRP during the attacks. None of the patients showed radiological abnormalities as normally seen in rheumatoid arthritis. All patients showed one particular characteristic attack, called para-articular attack; the presence of a tender, indurated erythema on the palm and sole which appeared suddenly and then resolved spontaneously within a week. A histological examination of these indurated erythema revealed perivascular lymphocytes and neutrophil infiltration in the dermis. On the other hand, exudative erythema with a peri-articular attack around the internal malleolus histologically showed an exudation of fibrinoid material beneath the epidermis as well as perivascular and scattered cell infiltration mainly consisting neutrophils in the entire dermis. Anti-inflammatory drugs were effective in reducing the pain although the duration and the intervals of attacks remained unchanged in 4 cases.
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  • A Case of Systemic Lupus Erythematosus with Pulmonary Hypertention, Sjögren’s Syndrome and Rheumatoid Arthritis
    Yukiko OGIYAMA, Futoshi CHIHARA, Nobuyoshi HIGA
    1992 Volume 54 Issue 5 Pages 873-878
    Published: October 01, 1992
    Released on J-STAGE: September 29, 2011
    DOIhttps://doi.org/10.2336/nishinihonhifu.54.873
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    A case of SLE with pulmonary hypertension, rheumatoid arthritis and Sjögren’s syndrome is herein reported. A 29-year-old woman, who had been suffering from Raynaud’s phenomenon, polyarthralgia and proteinuria for over 10 years, complained of a high fever and annular erythema. The laboratory examination showed positive anti-RNP antibody and anti-SS-A, B antibody, as well as hyper-γ-globurinemia, and leucocytopenia. A cardiological investigation revealed that she had pulmonary hypertension, and the effect of several vasodilator agents on the patient’s cardiovascular system was investigated.
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  • Drug Eruption Following Simultaneously Administered Antimetabolite (Tegafur) and Immunomodulator (Ubenimex)
    Hidezo FUKUDA, Shuhei IMAYAMA
    1992 Volume 54 Issue 5 Pages 879-883
    Published: October 01, 1992
    Released on J-STAGE: September 29, 2011
    DOIhttps://doi.org/10.2336/nishinihonhifu.54.879
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    A 77-year-old Japanese woman, who had undergone surgical treatment for squamous cell carcinoma in the oral cavity, developed erythematous skin eruptions in the sun-exposed areas after three months’ duration of the chemotherapy with antimetabolite (tegafur) and immunomodulator (ubenimex). A photo-patch test for tegafur was positive with 4 J/cm2 of ultraviolet-A (UVA) irradiation. It was noted that the patient’s hypersensitivity to UV evaluated by her erythematous skin reaction elicited by 4 J/cm2 of UVA was no longer observed after the skin lesions had subsided. However, the re-administration of only ubenimex, without tegafur, caused edematous erythemas on her extremities. A discontinuation of the medicine was followed by a spontaneous disappearance of the eruptions. We report this case as a drug eruption sensitized by both tegafur and ubenimex. However, it is also possible to speculate that the patient was sensitized only by tegafur and possibly flared up due to ubenimex, which is known to be an immunomodulator, and facilitates host reaction by decreasing the suppressor functions of T cells.
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  • Keratosis Punctata of the Palmar Creases
    Etsuko MIZUTANI, Hitoshi MIZUTANI, Hiroaki OKADA, Masayuki SHIMIZU
    1992 Volume 54 Issue 5 Pages 884-888
    Published: October 01, 1992
    Released on J-STAGE: September 29, 2011
    DOIhttps://doi.org/10.2336/nishinihonhifu.54.884
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    We report a case of keratosis punctata of the palmar creases (KPPC). Tiny pinhead-sized hyperkeratotic papules were observed to be distributed along the palmar and solar creases. This clinical manifestation is a characteristic of KPPC independent from keratosis punctata palmaris et plantaris (KPPP). Histopathologically this hyperkeratotic plug was located in the intraepidermal sweat duct. KPPC is a relatively new clinical entity and the number of reports on KPPC have been less than 20 in all. KPPC is very rare in Caucasians. However, recently KPPC has been reported to be a relatively common disease in blacks. Our case is the first case report of KPPC in Japan. Therefore, we performed a prospective study to determine the incidence of KPPC in Japanese. We screened 300 patients in our clinic and found no KPPC patients and only one KPPP patient. This study thus suggested that in contrast to blacks, KPPC is not a common disease among Japanese as well as among Caucasians.
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  • Two Cases of Congenital Dermal Sinus with Tethered Cord
    Tsuyoshi ISHIHARA, Wakatoshi MATSUNAGA, Susumu YOSHIOKA
    1992 Volume 54 Issue 5 Pages 889-892
    Published: October 01, 1992
    Released on J-STAGE: September 29, 2011
    DOIhttps://doi.org/10.2336/nishinihonhifu.54.889
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    We report two cases of congenital dermal sinus, a 5-year-old female and a 3-year-old male. They had a tethered cord from the findings of magnetic resonance imaging, which suggested that they should undergo a radical operation in order to prevent an occurrence of the tethered cord syndrome in the future.
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  • Pyoderma in a Diabetics Leading to a Vicious Cycle
    Takahiro FUJIKI, Takehiko NAKAMURA, Tomomichi ONO
    1992 Volume 54 Issue 5 Pages 893-896
    Published: October 01, 1992
    Released on J-STAGE: September 29, 2011
    DOIhttps://doi.org/10.2336/nishinihonhifu.54.893
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    A 68-year-old diabetic developed a severe pyoderma. At the age of 66, a diagnosis of diabetes was made and treatment was advised, but he was not treated. Six months prior to his first examination, a pruritic lesion developed on the nape which had slowly expanded over the entire nape with severe pain. His general condition worsened and his diabetes became uncontrollable. His blood sugar finally stabilized after radical treatment for this pyoderma, including antibiotic treatment, surgical debridement and skin grafting. This is a good example of pyoderma in a diabetic leading to a so-called vicious cycle.
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  • Nine Cases of Fungal Infections Triggered by an Application of Adhesive Medical Tape
    Hidekazu SHINODA, Katsutaro NISHIMOTO, Kizou HONMA
    1992 Volume 54 Issue 5 Pages 897-902
    Published: October 01, 1992
    Released on J-STAGE: September 29, 2011
    DOIhttps://doi.org/10.2336/nishinihonhifu.54.897
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    Nine cases of superficial fungal infections which arose as a complication of the application of adhesive tape, which is used for the purpose of sedating muscular stiffness or joint pain, are reported. The cases were prevalent among middle-aged females especially during the summer season, and were caused by Trichophyton rubrum (6 cases) and Candida albicans (1 case). The mycotic lesions at other body sites which are normally supposed to be the infectious source of these cases were detected in only 1 case. The lesions were mainly annular erythema or a typical tinea-like form, but atypical lesions suspected of being contact dermatitis were also noticed. The importance of a careful mycological examination of the lesions which occur beneath the tape applications is also stressed.
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  • A Case of Tinea Nigra
    Rikako TORIGOE, Taku YAMADA, Keisei SHIMOE, Hiroko KANZAKI, Hisanori A ...
    1992 Volume 54 Issue 5 Pages 903-906
    Published: October 01, 1992
    Released on J-STAGE: September 29, 2011
    DOIhttps://doi.org/10.2336/nishinihonhifu.54.903
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    We report a 7-year-old boy with tinea nigra. He had an asymptomatic brown macule on his left palm, 9mm in diameter, which had been slowly enlarging since one year before. A microscopic examination of the scales stripped off from the lesion disclosed brown branching hyphae. On culture, black colonies were obtained, and hyphae and two-celled conidia were observed. Treatment with topical imidazole antifungal agent was effective. Tinea nigra is commonly seen in South Asia, Central and South America, and Africa. In Japan, 12 cases have been previously reported in Okinawa, Kyushu, and Kôchi. To our knowledge, this is the first case ever reported in Honshu.
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  • A Case of Malignant Melanoma Associated with Pre-existing Melanocytic Nevi.
    Tadashige SONODA, Kazumoto KATAGIRI, Hiroto TERASHI, Sotaro KURATA, Su ...
    1992 Volume 54 Issue 5 Pages 907-911
    Published: October 01, 1992
    Released on J-STAGE: September 29, 2011
    DOIhttps://doi.org/10.2336/nishinihonhifu.54.907
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    We report a case of malignant melanoma which possibly developed from a melanocytic nevus in a 52-year-old man. He was admitted to our hospital because of a dark brown tumor of 40 years’ duration in the interscapular region. The tumor began to increase in size about four years earlier. Bleeding from the lesion began one month earlier. The physical examination revealed a thumb’s head-sized dark brown, irregularly shaped tumor. A hard, enlarged lymph node was palpable on the left axilla. Histologically, the right half of the tumor was mostly devoid of epidermis and consisted of anaplastic cells containing small deposits of melanin and lying in solid-alveolar pattern. The lesion had attained Clark’s level V and measured 4.1mm in thickness. This part of the tumor focally showed junctional activity. The other half of the tumor was composed of benign nevus cells without any junctional activity. In almost all areas, these nevus cells were separated from atypical cells by thin collagen fibers, although these two kinds of cells had merged with each other only in very limited areas. A metastasis of atypical cells to the left axillary lymph node was detected. From these findings, we assumed that the origin of malignant melanoma in this case was nevus cells which formerly presented in the junctional area and eventually disappeared after many years.
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  • Six Cases of Malignant Melanoma and Malignant Melanoma in situ of Nail Unit
    Masanori SHIRAISHI, Osamu IYOTA, Yoshinori SUENAGA, Masakazu ASAHI
    1992 Volume 54 Issue 5 Pages 912-917
    Published: October 01, 1992
    Released on J-STAGE: September 29, 2011
    DOIhttps://doi.org/10.2336/nishinihonhifu.54.912
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    Thirty-six cases of malignant melanoma were recorded at the dermatology clinic of University of Occupational and Environmental Health Hospital from 1979 to 1991, including 3 cases of malignant melanoma of nail unit. These 3 cases along with 3 additional cases of malignant melanoma in situ of nail unit are reported. Several clinicopathological factors are also discussed, including; histopathological features, preceding coloration changes, episodes of preceding severe or repeated trauma, and the basic principle of surgical treatment.
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Clinical and Investigative Report
  • Nail Changes in Progressive Systemic Sclerosis (PSS)
    Manabu MAEDA, Yoshiro ICHIKI, Hiroko WATABE, Katutosi MATUBARA, Hisayo ...
    1992 Volume 54 Issue 5 Pages 918-921
    Published: October 01, 1992
    Released on J-STAGE: September 29, 2011
    DOIhttps://doi.org/10.2336/nishinihonhifu.54.918
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    We observed nail changes in 62 cases (M:F=8:54) of PSS for one year. As a result, longitudinal grooves (41 cases), pitting (Rosenau’s sign) (19 cases), melanonychia striata (16 cases), transverse grooves (Beau’s line) (7 cases) and others (splinter hemorrhage, onycholysis, roughness, white spots, etc.). Melanonychia striata were seen mainly in the thumbs, and index fingers as either single or multiple bands. The occurrence of melanonychia striata was significantly related to initial clinical symptoms of the disease other than Raynaud’s sign. There was no difference of nail changes between Barnett type I and Barnett type II/III, and moreover no difference was demonstrated between PSS and SLE (14 cases).
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  • An Immunohistochemical Study of Irritated Seborrheic Keratosis with Anti-Keratin Monoclonal Antibodies
    Eri KONO, Seiichi IZAKI, Keijiro KITAMURA
    1992 Volume 54 Issue 5 Pages 922-926
    Published: October 01, 1992
    Released on J-STAGE: September 29, 2011
    DOIhttps://doi.org/10.2336/nishinihonhifu.54.922
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    An immunohistochemical study with monoclonal anti-keratin antibodies was undertaken in order to compare the keratinizing pattern between seborrheic keratosis (n=12) and irritated seborrheic keratosis (n=8). Lesions of seborrheic keratosis, consisting mainly of basaloid cells, showed anti-keratin reactivity to normal basal cells (PKK 1 and PKK 2), as well as anti-keratin to whole epidermal cells (MA 903), whereas they essentially did not demonstrate any positive reaction with the antibody to the keratinizing supra-basal cells (MA 904). As the lesions were irritated, and the tumor began to consist mainly of squamous cells, anti-keratin immunoreactivity to normal basal cells was no longer detected, whereas a positive reaction to the antibody to keratinizing cells became evident. Such a change was characteristically demonstrated in squamous eddies. The results clearly indicate an alteration in the keratinization pattern after the irritation of seborrheic keratosis.
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  • Twenty Eight Cases of Subcutaneous Dermoid Cyst
    Wakatoshi MATSUNAGA, Tsuyoshi ISHIHARA, Aiko YOSHINAGA
    1992 Volume 54 Issue 5 Pages 927-931
    Published: October 01, 1992
    Released on J-STAGE: September 29, 2011
    DOIhttps://doi.org/10.2336/nishinihonhifu.54.927
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    Over the last three years, we experienced twenty eight cases of subcutaneous dermoid cysts, and observed the histopathological features of these cysts. Some differences were observed between infant cases and adult cases. In the case of infants, a cystic wall was surrounded by a squamous cell layer with immature skin appendages. But with advancing age, the squamous cell layer disappered and the cystic wall was replaced by a foreign body granuloma. We consider that this phenomenon is the result of a foreign body reaction against the keratinous material in the cyst.
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  • Clinical Study of Transthecal Digital Block
    Hiroshi YASUDA, Masanori SHIRAISHI, Kouichi MASUYUKI, Yoshinori SUENAG ...
    1992 Volume 54 Issue 5 Pages 932-935
    Published: October 01, 1992
    Released on J-STAGE: September 29, 2011
    DOIhttps://doi.org/10.2336/nishinihonhifu.54.932
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    A transthecal digital block, first described by Chiu, was carried out for the operations or skin biopsies on fingers. This method causes rapid digital anesthesia with only a single injection into the flexor tendon while other anesthesia methods require multiple injections for each digit. Moreover, this method is much less painful than other methods. As it is comparatively easy to perform, this technique is especially useful for office surgery. We used this method on 20 finger operations and only 3 cases needed additional digital blocks. No complications were observed. Transthecal digital block is a new, safe and comfortable approach for digital anesthesia.
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Review
Therapy
Dermatologists around the World
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