The Nishinihon Journal of Dermatology
Online ISSN : 1880-4047
Print ISSN : 0386-9784
ISSN-L : 0386-9784
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Volume 54, Issue 6
Displaying 1-22 of 22 articles from this issue
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Color Atlas
Clinical Case Reports
  • Two Cases of Proteus Syndrome Characterized by Verrucous Skin Lesions on the Soles
    Mariko KATAYAMA, Shinichi IMAFUKU, Shuhei IMAYAMA, Juichiro NAKAYAMA, ...
    1992 Volume 54 Issue 6 Pages 1067-1073
    Published: December 01, 1992
    Released on J-STAGE: September 29, 2011
    DOIhttps://doi.org/10.2336/nishinihonhifu.54.1067
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    Proteus syndrome is an extremely rare, complex hamartomatous syndrome that consists of either partial or complete hemihypertrophy, macrodactyly of the hands and/or feet, plantar hyperplasia, hemangiomas, lipomas, lymphangiomas, varicosities, verrucous epidermal nevi, cranial hyperostoses and long-bone overgrowth. The syndrome was named after the Greek god Proteus (the polymorphous God who could change his shape at will to avoid capture) by Wiedemann et al in 1983. We report 2 cases of Proteus syndrome. They were a 13-year-old boy and a 37-year-old woman, presenting connective tissue nevi-like verrucous tumors on the soles. In the latter case, the hamartomatous lesions were only detected by an intensive systemic examination because of the relatively mild associated symptoms. We also discuss the variations of the extent of major and minor clinical features of this syndrome in our cases.
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  • Hailey-Hailey Disease with Hyperkeratotic Verrucus Lesions (Similar to Darier’s Disease):
    A Case Report
    Toshiki ITOH, Youichi INABA, Takehiko NAKAMURA, Tomomichi ONO
    1992 Volume 54 Issue 6 Pages 1074-1078
    Published: December 01, 1992
    Released on J-STAGE: September 29, 2011
    DOIhttps://doi.org/10.2336/nishinihonhifu.54.1074
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    We report a fifty-eight year-old-Japanese man with Hailey-Hailey disease (HHD). He had been diagnosed as Hailey-Hailey disease from the presence of macerative erythemas and papules on the intertriginous regions. A biopsy specimen from the verrucous lesion revealed dyskeratosis in the granular layer, such as corps ronds, suggestive of Darier’s disease (DD). Treatment with etretinate was effective. In addition, during the therapy of Kaposi’s varicelliform eruptions also developed. The above symptoms indicated that he had a possible defect in host immune competence, such as a decrease in cellular immunity, and positive anti HTLV-1 antibody.
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  • Identification of Extraneous Material by Analytical Electron Microscopy in Scar Sarcoidosis
    Susumu TAKAYASU, Tatsuo SHIMADA, Hiroaki KAWASATO
    1992 Volume 54 Issue 6 Pages 1079-1082
    Published: December 01, 1992
    Released on J-STAGE: September 29, 2011
    DOIhttps://doi.org/10.2336/nishinihonhifu.54.1079
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    A 42-year-old woman presented with several nodules of two months’ duration on her face, right index finger and bilateral knees. All of these nodules developed on long-standing scars which had formed 10 to 35 years earlier after striking her face against stone steps or cutting her finger with the edge of a grass leaf. Within the macrophages in epithelial granuloma of the face, doubly refractile or brown particles were found, the composition of which was shown to be an admixture of silica and aluminum by analytical electron microscopy.
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  • A Case of Pyoderma Gangrenosum with Ulcerative Colitis
    Noriko YASHIRO, Hiroyo FUSHIDA, Koichi NAKAGAWA, Toshio HAMADA
    1992 Volume 54 Issue 6 Pages 1083-1089
    Published: December 01, 1992
    Released on J-STAGE: September 29, 2011
    DOIhttps://doi.org/10.2336/nishinihonhifu.54.1083
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    A 44-year-old female case of pyoderma gangrenosum (PG) with ulcerative colitis is reported. Arthlargia and painful abscesses developed on her wrists and the PIP joints of her toes together with severe abdominal symptoms. After surgical treatment, the abscesses enlarged to form a central ulceration. The histopathological findings of the zone of erythema peripheral to the area of ulceration showed lymphocytic infiltration and endothelial swelling. Direct immunofluorescence demonstrated perivascular depositions of immunoglobulin and complement. The ulcers epithelialized along with an improvement of the general condition after treatment with oral corticosteroids, salazosulfapyridine and azathioprine. However, in order to control the recurrence of repeated abdominal attacks, a total colectomy was done which led to a complete remisssion of the skin lesion and arthlargia. We additionally discuss cases which have been reported as PG with ulcerative colitis in Japan.
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  • A Case of Acquired Zinc Deficiency during Intravenous Alimentation
    Ichiro KUROKAWA, Michiaki TANAKA, Tadayo IKEDA, Ryuichi BABA
    1992 Volume 54 Issue 6 Pages 1090-1094
    Published: December 01, 1992
    Released on J-STAGE: September 29, 2011
    DOIhttps://doi.org/10.2336/nishinihonhifu.54.1090
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    We report a case of acquired zinc deficiency during intravenous alimentation treatment. A 69-year-old man developed dysphagia due to stenosis of the esophagus induced by esophageal cancer at the end of January, 1991. After being treated with intravenous alimentation, he developed diarrhea, itchy eruptions on the scalp, the nape of the neck and the genital area, as well as brown pigmentation on the periungual region. The histological features obtained from the red papule showed deposition of fibrinoid material and clefts in the epidermis and dermoepidermal junction. In the epidermis, both neutrophilic infiltration and spongiosis were observed. Laboratory findings revealed mild anemia, a very low level of serum zinc (23μg/dl) and low alkaline phosphatase, serum albumin, and total protein. A negative PPD suggested decreased cellular immunity. By supplying trace minerals including zinc, the eruptions subsided remarkably within two weeks, and an increased serum zinc level was obtained.
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  • Loss of Split-Thickness Skin Graft by Herpes Simplex Virus Infection in a Child Burn Patient
    Kohei OTA, Shinichiro YASUMOTO, Shonosuke NAGAE, Yoshiaki HORI
    1992 Volume 54 Issue 6 Pages 1095-1097
    Published: December 01, 1992
    Released on J-STAGE: September 29, 2011
    DOIhttps://doi.org/10.2336/nishinihonhifu.54.1095
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    A 1-year and 6 month old boy with burns over 15% of his body surface area developed a herpes simplex virus (HSV) infection at the site of a split-thickness skin graft. The HSV infection eventually caused the loss of the grafts and necessitated a re-operation. The complications of HSV infection, as well as various bacterial infections, thus require careful observation in burn patients especially of children.
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Clinical and Investigative Report
  • The Significance of Actin Filament Organization of Endothelial Cells in Angiogenesis
    —A Study Using Endothelial Cell Culture—
    Shoko ARISAWA, Tomiyasu ARISAWA, Junpei ASAI
    1992 Volume 54 Issue 6 Pages 1098-1104
    Published: December 01, 1992
    Released on J-STAGE: September 29, 2011
    DOIhttps://doi.org/10.2336/nishinihonhifu.54.1098
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    We studied the significance of actin cytoskeleton organization in endothelial cells on angiogenesis using an endothelial cell culture derived from a bovine aorta. Prominent actin filarnents running longitudinally to the cell axis were observed in the endothelial cells at the proliferative stage. With the addition of cytochalasin B, the dose dependent prevention of both cell extension and of actin filament organization were observed. At a dose of 10-6M cytochalasin B, cell rounding and a condensation of actin were observed in almost all the cells. On the other hand, in the three dimension cultures of endothelial cells using matrigel, net work formation of endothelial cells was observed in all the culture plates 7 days after the cell plantation. The addition of cytochalasin B thus significantly inhibited the network formations. Cell proliferation was also inhibited at a dose of 10-6M, but a cobble stone pattern of cell proliferation was observed at a dose of 10-8M. From these results, we concluded that actin cytoskeleton organization might play an important role in angiogenesis.
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  • Isolation of Methicillin Resistant Staphylococcus Aureus and Bacteriological Study on these MRSA Isolates in the Dermatology Ward of Gifu University Hospital
    Tadashi NANBA, Yoshiro ICHIKI, Hajime TAKAGI, Yuji URATA, Shunji MORI, ...
    1992 Volume 54 Issue 6 Pages 1105-1110
    Published: December 01, 1992
    Released on J-STAGE: September 29, 2011
    DOIhttps://doi.org/10.2336/nishinihonhifu.54.1105
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    Survey of methicillin resistant Staphylococcus aureus (MRSA) strains indicated that the isolation frequency of MRSA strains had rapidly increased during last few years at the department of dermatology of Gifu University Hospital. In 1990, 37% of S. aureus strains isolated from outpatients and 78% of S. aureus strains from inpatients were methicillin resistant, although in 1989, the isolation ratio from outpatients and from inpatients was 24%, and 63%, respectively. To carry out an epidemiological study at our dermatology department, we attempted to isolate the MRSA strains from our ward (15 different floors, five attendant furnishings) and medical staff (11 doctors, 13 nurses, and one nurse assistant). Only one strain of MRSA was isolated from the floor of the visitor’s room, and three strains were isolated from the noses of three medical staff members (one, from a doctor and two, from nurses). The bacteriological characterization of these isolates revealed that the strain from the doctor produced enterotoxin C, toxic shock syndrome toxin-1, and coagulase type III. The two strains from nurses also produced enterotoxin C and toxic shock syndrome toxin-1, but also produced coagulase type II. The MRSA strains from inpatients had similar bacteriologic traits to those are strains from the nurses and from our dermatology ward. The antibiotic resistant profiles of the strains from inpatients were also similar to those of both the environmental and nurses’ strains. Trials to eliminate MRSA strains from the noses of medical staff members by 10% popidoneiodine treatment often turned out to be unsuccessful. Recent MRSA strains from our inpatients often demonstrated multiple drug resistance and vancomycin was the only effective drug of choice for treatment. The appearance of these multiple drug resistant MRSA strains therefore poses a new serious problem at our department.
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  • Measurement of Dust Mite Antigens in the Homes of Patients with Atopic Dermatitis
    Yumiko KUBOTA, Shuhei IMAYAMA, Tamiko HASHIZUME, Hiroko MIYAHARA, Tomo ...
    1992 Volume 54 Issue 6 Pages 1111-1117
    Published: December 01, 1992
    Released on J-STAGE: September 29, 2011
    DOIhttps://doi.org/10.2336/nishinihonhifu.54.1111
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    We measured the amount of dust mite antigens (DMA) on the surface of “futon” mattresses as well as on bedroom and living room floors in the homes of 55 atopic dermatitis (AD) patients and 16 normal individuals, using an enzyme-linked immunosorbent assay (ELISA) technique. By investigating the correlation between DMA and the development of skin lesions of AD, we found that,
    1) DMA were contained at a higher density (with a significant difference) in the dust collected from the AD patients’ homes than that from non-AD patients’ homes,
    2) most AD patients who developed a positive patch test reaction to the DMA were living in homes with higher DMA,
    3) as in previous reports, a significantly higher amount of DMA was observed on floors covered with carpets than on those furnished with “tatami” or wooden floors,
    4) a reduction in the amount of DMA produced clinical improvement in a subset of AD patients who showed contact hypersensitivity to the DMA with lower serum IgE. However, a simple reduction of DMA in the environment was not accompanied by a clinical improvement in AD patients with an elevated serum IgE specific for DMA.
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  • A Study of Surgical Maneuvers of Basal Cell Epithelioma on Nasal Ala
    Ryoji HIROSE, Makoto HORI, Minoru HONDA, Jun-ichi HAKUGAWA, Keiichi TA ...
    1992 Volume 54 Issue 6 Pages 1118-1124
    Published: December 01, 1992
    Released on J-STAGE: September 29, 2011
    DOIhttps://doi.org/10.2336/nishinihonhifu.54.1118
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    The incidence of basal cell epithelioma (BCE) is becoming much higher than before. The number of patients with BCE and the total number of tumors during the recent five-year period, 1986 to 1990, at the Nagasaki University Hospital, was 105 and 133 respectively. Eighty-one percent (103) of them occurred on either the face or head, while fifteen percent (20) appeared on the nasal ala. In general it is accepted that BCE can be perfectly excised with a four millimeter surgical margin when the tumor is less than twenty millimeters in diameter. It has also reported that most BCEs do not recur even when a two millimeter surgical margin is performed. When a tumor on the nasal ala exceeds five millimeters, it is often impossible to excise the whole tumor without reconstructing the nasal ala because the defect is so large as a result of an adequate excision. Though the principle of surgery for a BCE of more than five millimeters on the nasal ala is a four millimeter surgical margin, a two or three millimeter margin is often acceptable when either the nasofacial groove or alar margin can thus be preserved and provided that a periodic follow-up is necessarily guaranteed. As to the depth of surgery, all layers of the nasal ala invalving the mucosa must be excised because an insufficient operation often causes a recurrence of the tumor or a circulatory disturbance. The usual repair of the defect is a nasolabial cheek flap, which is most convenient for reconstructing the nasal ala, along with a transposition or subcutaneous pedicle flap with an addition of frequent hinge formation to give a natural appearance of the alar margin. Elderly patients normally did not require any repair work, however, young people were often recommended to undergo another later operation due to a bulge formation caused by the tough texture of the base of flap.
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Therapy
Dermatologists around the World
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