The Nishinihon Journal of Dermatology
Online ISSN : 1880-4047
Print ISSN : 0386-9784
ISSN-L : 0386-9784
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Volume 58, Issue 4
Displaying 1-31 of 31 articles from this issue
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Clinical Case Reports
  • A Case of Allergic Contact Dermatitis with Diffuse Secondary Eruptions
    Tetsuya KOGA, Kenichi SHIBUE, Akihiko SHIMIZU, Mizuha ARIYOSHI, Shoji ...
    1996 Volume 58 Issue 4 Pages 567-569
    Published: August 01, 1996
    Released on J-STAGE: July 12, 2011
    DOIhttps://doi.org/10.2336/nishinihonhifu.58.567
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    We herein describe a 73-year-old man, who developed diffuse secondary eruptions associated with allergic contact dermatitis. He had applied Astat® lotion to his feet for tinea pedis. One week later, diffuse secondary eruptions appeared on his trunk. In this patient, the primary lesions became clinically manifest after the development of secondary eruptions. Both a patch test and a lymphocyte stimulation test to Astat® lotion were positive. In addition, peripheral blood mononuclear cells from the patient also released IFN-γ and IL-5 in response to stimulation with the causative drug. The possible involvement of cytokines in the development of secondary eruptions are also discussed.
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  • A Case of Erythema Exsudativum Multiforme Developed in Association with Internal Dental Fistula
    Yasunori KUSABA, Shun’ichi KOIKE, Yoshitaka YAMADA, Satoshi DEKI ...
    1996 Volume 58 Issue 4 Pages 570-573
    Published: August 01, 1996
    Released on J-STAGE: July 12, 2011
    DOIhttps://doi.org/10.2336/nishinihonhifu.58.570
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    A 58-year-old Japanese woman had been suffering for three years from refractory erythema multiforme on the bilateral lower legs. In addition, she had also been suffering from internal dental fistula of the #1 true molar tooth on the left upper jaw which had been noticed before the appearence of the skin lesions on the legs. Since an association between the erythema multiforme lesions and internal dental fistula was suggested, this tooth was extracted. Thereafter, the skin lesions temporarily became exacerbated, but soon thereafter disappeared completely leaving only pigmentation. These findings indicate that in our patient, the skin lesions developed in association with the dental lesion, probably by means of a focal infection.
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  • Toxic Epidermal Necrolysis due to Omeprazole
    Toshiko MIYATA, Atsushi YAGUCHI, Akihiko HASHIMOTO, Toshiya ASAI, Kens ...
    1996 Volume 58 Issue 4 Pages 574-577
    Published: August 01, 1996
    Released on J-STAGE: July 12, 2011
    DOIhttps://doi.org/10.2336/nishinihonhifu.58.574
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    Toxic epidermal necrolysis by omeprazole is described. A 78-year-old man developed generalized erythema over the skin and erosion on both the oral and genital mucosa 25 days after taking omeprazole for the treatment of a gastric ulcer. Nikolsky phenomenon was positive. A histological examination showed complete epidermal necrosis in bullous lesion with a sparse perivascular mononuclear cell infiltrate. He was treated with intravenous betamethasone, but unfortunately died from MRSA sepsis 10 days after onset. We also analyzed another 7 patients with toxic epidermal necrolysis treated at Kitasato University Hospital. One case, in which the histopathological features were similar to this case, also died from sepsis. The other 6 cases all survived and histopathologically showed a lichenoid tissue reaction with many necrotic keratinocytes. Based on our findings, we thus conclude that the prognosis of toxic epidennal necrolysis might therefore be related to the degree of epidermal damage and the management of bacterial infection.
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  • A Case of Pustular Vasculitis with Acute Colitis Caused by Methicillin Resistant Staphylococcus aureus (MRSA)
    Tadashi KINOSHITA, Tomomichi ONO
    1996 Volume 58 Issue 4 Pages 578-580
    Published: August 01, 1996
    Released on J-STAGE: July 12, 2011
    DOIhttps://doi.org/10.2336/nishinihonhifu.58.578
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    A case of 25-year-old male with pustular vasculitis was reported. The patient presented with many sterile pustules on erythematous plaque which were scattered over his entire body, in addition to general symptoms including fatigue and fever. Histopathologically, pustular formations in the epidermis and vasculitis in the dermis were observed. The clinical symptons including eruptions improved after the intravenous administration of corticosteroid. Thereafter, no recurrence of either the eruptions or general symptoms was observed. In addition to the pustular vasculitis, acute colitis caused by methicillin resistant Staphylococcus aureus (MRSA) was also involved. The oral administration of minocyclin proved to be effective for this infectious disease. It was thus suggested by his clinical course that colitis by MRSA might therefore be related to the occurrence of pustular vasculitis.
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  • Neonatal Pemphigus
    Tatsurou TANAKA, Haruhiko OHTUBO, Yutaka NARISAWA, Hiromu KOHDA
    1996 Volume 58 Issue 4 Pages 581-583
    Published: August 01, 1996
    Released on J-STAGE: July 12, 2011
    DOIhttps://doi.org/10.2336/nishinihonhifu.58.581
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    We report a case of neonatal pemphigus. A female infant was born to a 37-year-old gravida 1, para 0 mother who had been regularly treated for pemphigus vulgaris for the past 13 years. In the 2 years prior to the birth, she had been well controlled with predonisone, 15 mg daily. After becoming pregnant, the mother developed erosive lesions in her mouth and on her trunk. The infant also had bullous lesions on her extremities and also showed low titers of epidemal intercellular antibodies in her sera. The skin lesions resolved within 2 weeks, but the pemphigus antibody continued to be positive for 2.5 years.
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  • Three Cases of Bullous Pemphigoid Treated with Minocyclin and Niacinamide
    Yuko OHNISHI, Koji HASHIMOTO
    1996 Volume 58 Issue 4 Pages 584-587
    Published: August 01, 1996
    Released on J-STAGE: July 12, 2011
    DOIhttps://doi.org/10.2336/nishinihonhifu.58.584
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    We report three cases of bullous pemphigoid treated with minocyclin and niacinamide without oral corticosteroid. All three patients showed a marked improvement. Minocyclin appeared to be more effective than niacinamide in treating these case. Minocyclin therapy is therefore considered to be the first choice of treatment for bullous pemphigoid.
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  • A Case of Pemphigoid Nodularis
    Takehito ISHIKAWA, Masako MURATA, Kazue NISHIOKA, Chizuko ISHIKAWA
    1996 Volume 58 Issue 4 Pages 588-592
    Published: August 01, 1996
    Released on J-STAGE: July 12, 2011
    DOIhttps://doi.org/10.2336/nishinihonhifu.58.588
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    A case of pemphigoid nodularis is reported. A 42-year-old woman with an 11-year history of pruritic prurigo nodularis-like eruptions on her trunk and extremities developed annular edematous erythema on her thighs and pea-sized tense blisters on her soles. Direct immunofluorescence studies of a prurigo nodularis-like lesion and peribullous skin showed the deposition of IgG and C3 in a linear pattern at the basement membrane zone. Indirect immunofluorescence studies revealed IgG circulating anti-basement membrane zone antibodies. Systemic examinations did not reveal any association with internal malignancies. The systemic administration of cyclosporin A and predonisolone proved to be effective in treating these prurigo nodularis-like eruptions.
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  • A Case of Nodular Scleroderma with Large Annular Plaques on the Trunk
    Fumiaki SHIRASAKI, Yuji YAMAGISHI, Norio OHTSUKI
    1996 Volume 58 Issue 4 Pages 593-597
    Published: August 01, 1996
    Released on J-STAGE: July 12, 2011
    DOIhttps://doi.org/10.2336/nishinihonhifu.58.593
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    A case of systemic sclerosis with firm cutaneous nodules and large plaque lesions on the trunk is reported. A 53-year-old woman noted swelling in her fingers, along with arthralgia and Raynaud’s phenomenon at the age of 49. Several firm nodules and large annular plaques with severe itching had also appeared in the one year period before consultation. Physical examination revealed proximal scleroderma on the forearms, painful ulcers on the fingertips and periungual teleangiectases. Firm nodules ranging from 10∼15mm diameter in size and reddish brown, firm, annular plaques were also observed on her trunk. The largest plaque measured 110×40mm in size. A laboratory examination showed positive for anti-nuclear, anti-RNP, anti-Sm, anti-SS-A, and anti-thyroglobulin antibodies. A biopsy specimen from the plaque revealed a thickened dermis with a fibrous proliferation. In addition, an increased number of fibroblastic cells and disoriented collagen bundles were observed. We thus considered the patient’s unusually large plaques to be a rare manifestation of nodular scleroderma.
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  • A Case of Laugier-Hunziker Syndrome
    Kyoko HATTORI, Yoshitaka HAGARI, Motoyuki MIHARA, Michiko NORIMOTO
    1996 Volume 58 Issue 4 Pages 598-600
    Published: August 01, 1996
    Released on J-STAGE: July 12, 2011
    DOIhttps://doi.org/10.2336/nishinihonhifu.58.598
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    We report a 76-year-old Japanese woman who presented with Laugier-Hunziker syndrome. She had widespread, reticular, brown-black macules on the mucous membrane of the mouth and the lip and several slate-brown pigmented spots scattered on her tongue. In addition, all her fingernails had one or more longitudinal pigmented bands. There was no intestinal polyposis or adrenal dysfunction which would have suggested the presence of Peutz-Jeghers syndrome or Addison’s disease, respectively. A biopsy of a pigmented macule of the lip revealed hyperpigmentation in the basal layer with a normal number of melanocytes, thus indicating an increased production of melanin in melanocytes of the pigmented lesions.
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  • A Reconstruction Case of Nose Basal Cell Epithelioma Using a Scalping Flap
    Yasunobu HIBI, Hiroki ONO, Chihiro HIOKI
    1996 Volume 58 Issue 4 Pages 601-603
    Published: August 01, 1996
    Released on J-STAGE: July 12, 2011
    DOIhttps://doi.org/10.2336/nishinihonhifu.58.601
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    We describe a reconstruction case using a scalping flap after undergoing a wide excision of a malignant skin tumor on the nose. In this report we emphasize both the successful results of this case and technical application.
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  • Genital Paget’s Disease:
    Report of a Case Which Developed after Prostatic Carcinoma and was Followed by Hepatocellular Carcinoma
    Sakae HONDA, Eiichi KAKIZOE, Shun’ichi KOIKE, Joji JIDOI, Satosh ...
    1996 Volume 58 Issue 4 Pages 604-607
    Published: August 01, 1996
    Released on J-STAGE: July 12, 2011
    DOIhttps://doi.org/10.2336/nishinihonhifu.58.604
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    A 65-year-old Japanese man developed genital Paget’s disease four years after undergoing an operation for prostatic carcinoma. Estramustine phosphate sodium (Estracyt®, 4 cap/day) had been administered to him as adjuvant chemotherapy for the prostatic carcinoma. Furthermore, he was also found to have hepatocellular carcinoma one year after the operation for genital Paget’s disease. Since both estrogen and nitrogen mustard, which are contained in estramustine phosphate sodium, are possible carcinogens, estramustine phosphate sodium is thus considered to have possibly induced genital Paget’s disease and hepatocellular carcinoma.
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  • Successful Treatment of Malignant Hemangioendothelioma of the Scalp with the Combined Therapy of a Partial Resection, rIL-2, Anticancer Drugs and Radiation
    Tomiko YAMAGUCHI, Kazumoto KATAGIRI, Toshihiro SATOU, Hiroto TERASHI, ...
    1996 Volume 58 Issue 4 Pages 608-611
    Published: August 01, 1996
    Released on J-STAGE: July 12, 2011
    DOIhttps://doi.org/10.2336/nishinihonhifu.58.608
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    A 70-year-old woman presented with well-defined erythematous plaques and several nodules on her scalp which first developed three months previously after a minor trauma from a comb. X-ray studies and a CT scan did not reveal any metastatic lesions. The tumorous lesions were resected after a local injection of rIL-2. Although an intra-arterial injection of rIL-2 through the temporal artery given for over six months caused a gradual disappearance of the erythematous plaques, another tumor later developed on the occipital area. Therefore, instead of rIL-2, an intra-arterial injection of 5-FU and CYVADIC chemotherapy were administered. For the newly developed tumor, radiotherapy of 100Gy, using 6 MeV electrons, was given on the whole scalp. These treatments resulted in a complete remission over the three year period of treatment. The serum levels of endothelin and factor VIII-related antigen closely paralleled the size of the tumorous lesion, and continued to be relatively high even after the tumorous lesions disappeared as a result of radiotherapy.
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  • A Case of Giant Hanging Neurofibroma
    Yuichi YOSHIDA, Hiromaro KIRYU, Shonosuke NAGAE
    1996 Volume 58 Issue 4 Pages 612-614
    Published: August 01, 1996
    Released on J-STAGE: July 12, 2011
    DOIhttps://doi.org/10.2336/nishinihonhifu.58.612
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    A 47-year-old female had a small nodule on her right upper chest since birth, which thereafter gradually increased in size. On her first visit to our hospital, a large hanging mass measured 11×9×2.5cm was observed, while adjacent to it a small café-au-lait spot-like macule was also seen. Histopathologically, the tumor exhibited the features of neurofibroma. Initially, von Recklinghausen’s disease was suspected, but the diagnosis could not be proven due to the absence of any family history or other clinical and diagnostic features. Since this case also failed to meet the diagnostic definitions of either neurofibromatoses or the “mosaic” variant of von Recklinghausen’s disease, the diagnosis of “solitary giant hanging neurofibroma” was thus considered to be most appropriate.
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  • An Aged Case of Scrofuloderma on the Thorax over the Old Lesion of Pulmonary Tuberculosis
    Michio SASAKI, Toshihiko NUMAHARA, Kazue SASAKI, Masayoshi NISHIMOTO, ...
    1996 Volume 58 Issue 4 Pages 615-618
    Published: August 01, 1996
    Released on J-STAGE: July 12, 2011
    DOIhttps://doi.org/10.2336/nishinihonhifu.58.615
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    A 77-year-old woman with scrofuloderma who had a past history of pleurisy and suspected intestinal tuberculosis at the age of 30 and 70, respectively, is reported. She developed a recalcitrant ulcer and fistule on the right chest reaching the hypochondriac muscle over the old tuberculosis lesion which was detected on the chest tomography. Treatment with RFP 300 mg and INH 400 mg daily for 10 months proved effective and resulted in some residual scar formation. We also reviewed 69 cases of scrofuloderma previously reported in the Japanese dermatological literatures over the last 20 years (from 1975 to 1994) concerning the current shift of predilection age and sites.
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Clinical and Investigative Report
  • The Effect of Souhakuhi-Extract on the Hair Cycle of New Zealand White Rabbits and its Topical Therapy in Male Pattern Baldness
    Ryuichiro KUWANA, Masafumi MORIOKA, Akemi DATE, Yutaka SAWAMURA, Osami ...
    1996 Volume 58 Issue 4 Pages 619-624
    Published: August 01, 1996
    Released on J-STAGE: July 12, 2011
    DOIhttps://doi.org/10.2336/nishinihonhifu.58.619
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    The hair cycle of the New Zealand white rabbit shows a synchronous pattern and it turns into a telogen stage at the age of 22 weeks. This rabbit is an appropriate model animal for the evaluation of drugs which are expected to stimulate hair growth. Using this animal model, we studied the effect of Souhakuhi-extract on the hair cycle. If the topical application of this extract accelerates new hair growth, then the extract could thus be considered to have the potential to shorten the duration of the telogen stage. Souhakuhi-extract was prepared from Souhakuhi (Morus alba, Linne) through ethanol and ethyl ether and applied to the back of 22-week-old rabbits once a day for 6 weeks. On the applied area, new hair growth was observed only after an application of 2 weeks whereas the same hair growth occurred after on 7 weeks in the control area. Histologically, large anagen hairs appeared on the applied area, but only small telogen follicles were seen in the control area after an application for 3 weeks. These results suggest that the Souhakuhi-extract thus appears to shorten the duration of the telogen phase and while inducing the growth of anagen follicles. In addition, clinical trials also confirmed an excellent efficacy of this extract in the treatment of male pattern baldness.
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  • An Immunohistochemical Analysis of Keratoacanthomas and Squamous Cell Carcinomas
    Yoshiko EGAMI, Toshihiko MASHINO, Shuhei IMAYAMA, Yoshiaki HORI
    1996 Volume 58 Issue 4 Pages 625-628
    Published: August 01, 1996
    Released on J-STAGE: July 12, 2011
    DOIhttps://doi.org/10.2336/nishinihonhifu.58.625
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    It is sometimes difficult to distinguish keratoacanthomas (KAs) from squamous cell carcinomas (SCCs). Recently, it has become possible to detect the proliferating activity of tumor cells and the expression of tumor suppressor genes, by utilizing paraffin-embedded specimens. We therefore tried to differentiate KAs and SCCs immunohistochemically, using antibodies for PCNA, Ki 67 and p53. Stained with PCNA and Ki 67, SCCs exhibited either a diffuse or peripheral distribution of positive cells. In contrast, KAs showed only a peripheral pattern. It was only in SCCs that P53-staining revealed a diffuse pattern. It is therefore suggested that a specimen exhibiting a diffuse pattern of positive cells in PCNA, Ki 67 or p53 staining is thus more likely considered to be SCC than KA. The positivity of p53 was also found to be higher in SCCs which developed on sun-exposed areas of the skin than in those which developed on non-sun-exposed areas. P53 may therefore play a more crucial role in the development of malignant tumors in the sun-exposed skin than in the non-sun-exposed skin.
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  • Skin Irritation Study of Terbinafine Solution, A Topical Antifungal Agent, on Healthy Volunteers
    Akinobu SHOJI
    1996 Volume 58 Issue 4 Pages 629-634
    Published: August 01, 1996
    Released on J-STAGE: July 12, 2011
    DOIhttps://doi.org/10.2336/nishinihonhifu.58.629
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    The patch test and photopatch test findings were evaluated in accordance with both the previous world standards and the standard for the International Contact Dermatitis Research Group, respectively. The results of the patch test showed that skin irritation due to terbinafine solution was similar to its reference drug, econazole solution, however, no primary sensitization was observed. In addition, the results of the photopatch test revealed no photoirritation or primary-photosensitization due to the terbinafine solution. The above results thus confirmed the safety of terbinafine solution, and we therefore concluded that a clinical trial of terbinafine solution in patients with dermatomycosis would thus be appropriate.
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Review
Statistics
  • A Descriptive Epidemiological Study of Systemic Scleroderma in Gifu Prefecture
    Setsuya FUJITA, Ryoichi INABA, Hirotoshi IWATA, Shigenori MAKINO, Hide ...
    1996 Volume 58 Issue 4 Pages 640-648
    Published: August 01, 1996
    Released on J-STAGE: July 12, 2011
    DOIhttps://doi.org/10.2336/nishinihonhifu.58.640
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    A descriptive epidemiological study on systemic scleroderma in Gifu prefecture was undertaken in 1986 and 1990, based on application forms for financial aid in patients with intractable diseases. In 1986, information on a total of 102 patients, including 13 males and 89 females was obtained with a total prevalence rate of 4.9 per 100,000. In 1990, information on a total of 197 patients, including 18 males and 179 females was obtained with a total prevalence rate of 11.7 per 100,000. The ratio of males to females was about 1:7∼10, and agewise most of the patients were in their 40’s, 50’s and 60’s. Regarding the main subjective symptoms, the rate of pigmentation decreased in 1990 compared to that of 1986. The first symptom to appear in patients was Raynaud’s phenomenon and was noticed in both males and females during the survey. The positive rate of anti-nuclear-antibody among the patients ranged from 68.9∼83.3%, and this value increased in 1990. When the analysis was confined to new applicants, it was noticed that many years had often passed since the initial diagnosis of systemic scleroderma, and many of patients were not even notified until more than 5 years after the first symptoms had appeared.
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  • Incidence of Dermatophytoses and Dermatophytes Seen at a Private Dermatology Clinic between 1985 and 1994
    Takeshi IMAFUKU
    1996 Volume 58 Issue 4 Pages 649-653
    Published: August 01, 1996
    Released on J-STAGE: July 12, 2011
    DOIhttps://doi.org/10.2336/nishinihonhifu.58.649
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    The incidence of dermatophytoses and dermatophytes in the Imafuku Dermatology Clinic in Nagasaki city since 1985 to 1994 was studied. A total of 6,038 patients with dermatophytoses, 11.1% of all outpatients, were observed. They included 4,601 patients with tinea pedis, 605 with tinea corporis, 314 with tinea cruris, 378 with tinea unguium, 126 with tinea manus, 10 with tinea capitis, 2 with tinea scroti and 2 with tinea barbae. The species most frequently isolated was T. rubrum (2,305 strains, 57.4%), followed by T. mentagrophytes (1,619 strains, 40.3%), M. canis (61 strains, 1.5%), E. floccosum (8 strains), T. glabrum (8 strains), M. gypseum (3 strains) and 2 strains of T. violaceum. The ratio of T. rubrum to T. mentagrophytes was 1.42 (2,305/1,619) in all the tinea patients and 0.92 in the tinea pedis patients.
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