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A 63-year-old female with bilateral lipodermatosclerosis is reported. The patient had been suffering from erythema for six months and a painful and tender induration for several weeks on the right lower leg. A biopsy specimen from the right leg showed a fibrosis of the deep dermis and the lobular panniculitis with moderate inflammatory infiltrates, composed predominantly of lymphocytes. Treatment with systemic non-steroid anti-inflammatory drugs, as well as an application with either an elastic bandage or diode laser yielded no beneficial effects, although ultrasound therapy showed some successful effects in the remission of this disease. Lipodermatosclerosis often occurs in patients with venous insufficiency, and there are increasing evidences that lipodermatosclerosis, hypodermitis sclerodermiformis, and sclerosing panniculitis are related conditions, which perhaps only appear in different stages.

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A case of photosensitive drug eruption induced by sparfloxacin was reported. A 69-year-old man experienced pruritic, erythematous vesicular eruptions on his face, neck, and the dorsa of both hands. These eruptions appeared after taking sparfloxacin, 100 mg a day for a month. The minimal erythema dose (MED) to UVA was markedly reduced at the initial examination. After healing, the MED to UVA was found to be within the normal range. Sparfloxacin showed a positive reaction in the provocation test by oral administration and UVA irradiation. Several similar cases have also been reported in the last few months. Since this drug is presently widely used, further similar cases are likely to be seen. We should therefore pay close attention to the side effects of photosensitive drug eruptions.

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We report a 17-year-old Japanese female with a cutaneous cyst on the right lower leg adjacent to the knee joint which initially developed at the age of 11, and thereafter had slowly been enlarging with a slight tenderness around the cyst. The cyst was excised with an overlying skin ellipse under local anesthesia. Histopathologically, this lesion was a rare tumor, consisting of a cutaneous ciliated cyst. This case was the 27th report of a patient presenting with a cutaneous ciliated cyst.

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We report the case of a 76-year-old man who presented with adenoid basal cell epithelioma (adenoid BCE) on the right cheek. The tumor was characterized by its clinical appearance which resembled an adnexal tumor. Histologically, most of the tumor nests showed gland-like structures, but some solid masses were also observed around them. The eosinophilic materials in the stroma appeared to be amyloid based on a positive reaction by dylon staining. We also discuss the gland-like formation and amyloid deposition seen in BCE reported in previous studies.

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Case 1, a 24-year-old female: A folliculitis-like papule appeared on her left side of external genital region six days before her first visit. Thereafter, erythema and swelling gradually spread to the lower part of the abdomen and developed necrosis. Case 2, a 32-year-old male: He had a slight injury on his right sole a week before his first visit. His sole developed necrosis, which spread to the dorsum of his right foot and lower extremitiy. Both cases had diabetes as the underlying disease. A radiological examination revealed subcutaneous gas in the infected area, and crepitant was also found to be present. From these points and based on the clinical course, we diagnosed both cases as non-clostridial gas gangrene. Extensive debridement was performed on the case 1, and a below-knee amputation was required in the case 2.

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A case of an 86-year-old man with localized cutaneous cryptococcosis was reported. The main clinical symptom was a cutaneous ulcer on the head. There was no regional lymphadenopathy. The histopathological specimen showed a chronic granulomatous reaction with many spores which existed either freely in the tissue or inside the giant cells. These histopathologic changes were consistent with Moore’s type 1. The chest X-ray examination revealed no abnormal findings and the laboratory data were within normal limits. Diagnosis of cutaneous cryptococcosis was confirmed by an isolation of the organism, Cryptococcus neoformans, from a biopsy specimen. PAS staining revealed some spores. The patient was successfully treated by a resection of the ulcer.

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We investigated 50 patients with atopic dermatitis (AD) regarding ophthalmic lesions, especially cataracts. Cataracts were found in patients who had been suffering from AD for 10-20 years since their early childhood. The clinical parameters of the patients, including the serum IgE levels (RIST), specific IgE levels for Dermatophagoides pteronyssinus (Dp) and for Dermatohagoides farinae (Df), and a patch test (PT) reaction to the Dp and Df antigens were evaluated in relation to the ophthalmic lesions. The patients with high serum IgE levels were more frequently accompanied with cataracts than the patients with low serum IgE levels, although there was no relationship between a positive PT reaction and ophthalmic complications. These results suggested that cataracts were one of the most important complications associated with AD, and thus should be carefully observed with the skin lesions.

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Kojic acid, a pyrone derivative obtained from the fermentation process of Japanese liquor, was found to be an excellent whitening agent in 1982. At that time, it was applied at 1% concentration in cream to melasma, secondary pigmentation and other types of superficial melanosis for several months. In this study, Kojic acid at 0.5% in milky lotion, 0.5% lotion, 0.5% essence and 1% cream with adding liquiritin at 0.03% were clinically evaluated by a simple application twice a day on various pigmentary disorders mainly on the face. The rates of effectiveness were 86.9%, 84.2%, 78.5% and 86.5%, respectively. These results were as good as the previous findings using 1% Kojic acid cream. However, the addition of liquiritin seems to have speeded up the effect of Kojic acid. Therefore, Iiquid preparations are sometimes more suitable than cream for application over wide areas of pigmentary disorders.

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A statistical study on atopic dermatitis (AD) was carried out during a periodic health examination for children ranged in age from 3 to 15 years old school students in Hirosaki. A total of 1,470 children were examined paying careful attention to AD and other allergic diseases such as asthma, allergic rhinitis and allergic conjunctivitis. A diagnosis of AD was based on the criterion proposed by the committee on AD organized by the Japanese Dermatolugical Association with slight modifications. The average prevalence rate of AD for all examined children was 10.5%. A significant correlation was observed between AD and asthma. It was also confirmed that dry skin, white papule and white dermographism were observed with significant frequency in AD. Our results indicate that about 10% of the children living in Hirosaki, a middle class city located in northern Japan, suffered from AD. The prevalence rate of AD may be different in each region depending on the location and circumstances in which the inhabitants live. Further studies to compare our results with those of other regions are thus still needed.

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In order to evaluate the prevalence rate of progressive systemic sclerosis (PSS) among the general population, we made inquiries and dermatological examinations related to PSS. One thousand and sixty-three subjects (consisting of 332 males and 731 females) aged ≥30 years who underwent a public medical examination in 1990 at Kawashima town near Gifu city in Japan were included in this study. The prevalence rate of Raynaud’s phenomenon (RP) was 3.0% in males and 4.2% in females. In 34 cases with RP who participated in blood tests, the rates of antinuclear antibody (ANA) were 23.5% and in the 51 cases without RP, they were 31.4%. The prevalence rates of sclerodactylia, pitting scars in the fingertips, brown pigmentation of the body, a shortened frenulum of the tongue, nail-fold elongation & bleeding, periungual erythema, arthralgia and morning stiffness in females with RP were significantly higher than those subjects without RP. Nineteen cases with PSS underwent a capilloscopic examination of the nail-folds, and 4 cases of 12 cases with RP and 3 of 7 cases without RP demonstrated specific features for PSS.

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Several methods have been described for the surgical treatment of ingrown toenails. The results of all these operations, however, seem to be unsatisfactory from an esthetic viewpoint. We describe a new device which is able to provide a more satisfactory esthetic result. The crucial points of our operation method are; (1) the resected mass of the lateral nail bed (the incurved nail area) is very limited, (2) the lateral nail-bed area of the nail matrix, on the other hand, is resected completely, and (3) nail-bed plasty is finally performed. This operation caused almost no narrowing of the width of the treated nail plate and, esthetically, its results were considered to be better than those obtained from previous procedures. We treated 12 cases of ingrown toenail with our method and the results were; 8 cases good, 3 cases fair, and one case poor.

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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