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Rika TAGUCHI, Naoki OHTAKE, Hayao MIYOSHI, Ritsuko NAKANO, Tamotsu KAN ...
1997 Volume 59 Issue 5 Pages
671-674
Published: October 01, 1997
Released on J-STAGE: January 14, 2011
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Exsudative erythema developed in a 57-year-old female 5 days after surgery. It spread to both her arms and back thus suggesting drug-induced erythema multiforme. The work-ups for drug eruption were all negative and patch testing finally showed it to be caused by topically applied ethanol. The dermatitis was caused by a combination of an immediate (late phase) reaction as well as delayed type hypersensitivity.
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Hiroyoshi HANAKAWA, Norio OHTSUKI, Hiroyuki FUJII, Ryozou TATAMI, Shoi ...
1997 Volume 59 Issue 5 Pages
675-677
Published: October 01, 1997
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A case of a 68-year-old male with blue toe syndrome is reported. He first noticed painful blue toe after undergoing percutaneous transluminal coronary angioplasty (PTCA) 6 months previously. After undergoing coronary angiography (CAG), fever, myalgia on his legs, blue toe and livedo reticularis all appeared on his trunk and extremities. Histopathologically, cholesterol clefts surrounded by fibrin thrombus were recognized in the arterial lumen at the junction of the dermis and the subcutaneous fat. The same histological appearance was also observed in the kidney. Multiple cholesterol emboli were seen and probably originated from the atheromatous plaques in the aorta ascendens. LDL apheresis may thus be effective for the treatment of eruptions and renal failure. A skin biopsy was also found to be effective for making an accurate diagnosis of blue toe syndrome.
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Yasuyuki SAWADA, Kiyomi SOEJIMA, Toshiyuki YAMAMOTO, Hiroo YOKOZEKI, K ...
1997 Volume 59 Issue 5 Pages
678-682
Published: October 01, 1997
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A 51-year-old man first noticed a sore throat, followed by the development of purpura on his extremities and trunk, which then spread until it covered his face in November 1992. He visited the Dermatology Clinic of Tokyo Medical and Dental University Hospital. On March 1988 (age 47) he was admitted to undergo a work-up of right hemiplegia. A diagnosis of cerebral thrombosis, a congenitally corrected transposition and a hepatitis C virus infection was thus made. The patient thereafter underwent a heart operation at our hospital. He had many purpuric lesions with hemorrhagic bulla and ulcers on his extremities and trunk. Multiple petechiae were also scattered all over his face. A skin biopsy revealed extensive leukocytoclastic vasculitis with numerous nuclear dusts. A urinalysis showed marked hematuria and cylinduria. He was diagnosed to have allergic vasculitis caused by tonsillitis. Various antibiotics were administered but the eruptions and hematuria nevertheless did not disappear by October 1996. The cause of facial purpura and the association between the distribution of purpura and renal damage is also discussed.
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Toshiaki YANAGI, Kazumoto KATAGIRI, Toshihiro SATO, Susumu TAKAYASU, H ...
1997 Volume 59 Issue 5 Pages
683-687
Published: October 01, 1997
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A 62-year-old man with a 6-month history of progressive sclerosis presented complaining of muscle weakness. Since an elevated serum CPK and histological findings of atrophied muscle indicated active myositis, the patient was diagnosed to have overlap syndrome. Three months later, interstitial pneumonia developed and thereafter rapidly progressed to adult respiratory distress syndrome (ARDS) with a concomitant decrease in the number of blood platelets. Pulse therapy using methylprednisolone promptly improved the condition of ARDS and the number of platelets thus gradually recovered. However, two weeks after the pulse therapy, the platelet level again decreased. The patient eventually died of acute renal failure and severe hemolytic anemia. The presence of pneumonia and/or ARDS was thus considered to induce the hemolytic uremic syndrome observed in this patient.
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Yuko HANNITA, Hajime MIYASATO
1997 Volume 59 Issue 5 Pages
688-691
Published: October 01, 1997
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We report a case of erosive pustular dermatosis of the scalp (EPDS) in a 40-year-old woman. The patient had previously suffered a cephalic injury at 18 years of age and was cured, however, a cicatricial alopecia still remained at 20 years of age. At her first visit to our clinic, she presented with erosions, pustules, decalvant plaques with redness on her left temple. The histopathological findings showed a non-specific inflammation of dermis. The symptoms proved resistant antibiotic and antimycotic drugs, however, local corticosteroid therapy was found to be effective.
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—A Clinical Observation of Cutaneous Manifestation in Down Syndrome—
Ming Ching LIAO, Hajime ARAGAKI, Shigeo NONAKA
1997 Volume 59 Issue 5 Pages
692-695
Published: October 01, 1997
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We report a case of elastosis perforans serpiginosa (EPS) in a case of Down syndrome in which the incidence of EPS, as well as the clinical observation of cutaneous manifestations in Down syndrome in Okinawa prefecture were also investigated. We cooperated with 14 institutes of Mentally Retarded Care Association and 3 related hospitals to obtain 159 cases of Down syndrome. No case of EPS in Down syndrome had been previously observed, but we did find a high incidence of folliculitis (38%), tinea pedis (43%), tinea unguium (40%) in Down syndrome and a low incidence of xerosis (60%), syringoma (10%), atopic dermatitis (2%) compared with the findings of 2 reports by Terakado and Carter.
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Mitsuharu KAYABA, Noriyuki MISAGO, Yutaka NARISAWA, Hajime SUGIHARA
1997 Volume 59 Issue 5 Pages
696-700
Published: October 01, 1997
Released on J-STAGE: January 14, 2011
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We report a Japanese 65-year-old man presenting with benign symmetrical lipomatosis and who also suffered from alcohol abuse. Ten years earlier he had noticed large soft masses without pain, which gradually developed on his neck, chest and later on his upper arms and posterior neck. Biopsy specimens showed a proliferation of mature adipose tissue without encapsulation. Based on his characteristic appearance with normal endocrine functions he was diagnosed to have benign symmetrical lipomatosis. A culture of his adipose tissue showed a high proliferative potential.
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Hironori MATSUSHIMA, Kenshi YAMASAKI, Atsushi HATAMOCHI, Hiroshi SHINK ...
1997 Volume 59 Issue 5 Pages
701-704
Published: October 01, 1997
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We report a case of multiple cancers developing in chronic radiodermatitis. A 43-year-old Japanese male presented with chronic radiodermatitis on both dorsal surfaces of his fingers, following a long-term irradiation by Grenz rays for the treatment of psoriasis vulgaris. At the same site, he developed squamous cell carcinoma and Bowen’s disease 7 years after the last irradiation. Three years later, he noticed a black papule on the dorsal surface of his right middle finger. After a histological examination, this papule diagnosed to be basal cell epithelioma.
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—Which Treatment Should be Initially Chosen, for Scabies or for ATLL—
Keiko TANAKA, Masayoshi JOHNO, Tomomichi ONO
1997 Volume 59 Issue 5 Pages
705-708
Published: October 01, 1997
Released on J-STAGE: January 14, 2011
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A 56-year-old male with lymphoma-type adult T-cell leukemia/lymphoma (ATLL) complicated by crusted scabies is reported. He was initially treated for scabies, because of the possible incurability of this disease as well as to prevent the transmission of scabies to other patients on the same floor, in spite of the rapid worsening of ATLL. Fortunately, combined chemotherapy for ATLL was successfully performed following an improvement in the scabies. The present case may suggest that chemotherapy should preferably be started when there are no signs or symptoms of infection.
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Rika TAGUCHI, Shirou YOSHIFUKU, Seita FUKUMARU, Mitsuru SETOYAMA, Tamo ...
1997 Volume 59 Issue 5 Pages
709-712
Published: October 01, 1997
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A 74-year-old male was referred to our dermatological clinic because of generalized pruritus and dark brown skin at the skin folds. A physical examination revealed brown to black-colored velvety skin at the skin folds and many seborrheic keratosis-like lesions on the trunk and verruca vulgaris-like lesions on the extremities. The verrucous lesions were histopathologically compatible with verruca vulgaris and were also immunohistochemically positive for human papilloma virus antigen. No viral particles were observed electron microscopically. Further study disclosed many papillomatous lesions on both the esophagus and areas with gastric carcinoma (Borrmann III). This case showed generalized pruritus without skin eruptions, acanthosis nigricans or Leser-Trélat sign. The skin signs and symptoms moderately subsided after a gastrectomy. Seborrheic keratosis-like lesions on the trunk in Leser-Trélat sign might therefore be caused by a human papilloma virus infection.
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Izuho TAKEUCHI, Shoko NAGATA, Seita FUKUMARU, Keiko YAMAGUCHI, Ryo GUS ...
1997 Volume 59 Issue 5 Pages
713-715
Published: October 01, 1997
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A 49-year-old man was admitted for the treatment of squamous cell carcinoma which appeared on a burn scar which occurred at the age of five. He also had a history of squamous cell carcinoma on the same scar 11 years previously. A new carcinoma thus developed on the surgical scar and thus, new one was thought to have developed at the same site as the previous carcinoma 11 years later. Such a recurrence appears to be extremely unusual.
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Tomoko IZUMI, Takahiro YAMADA, Yasuo KITAJIMA, Youko SUGIYAMA, Zuiei O ...
1997 Volume 59 Issue 5 Pages
716-719
Published: October 01, 1997
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The case of a 69-year-old female presenting with lepromatous leprosy is reported. She was diagnosed as having idiopathic thrombocytopenic purpura and was thus treated with prednisolone (12.5mg/day). She began to notice numbness and pain in legs and arms since November 1994. Thereafter, in November 1995, multiple nodules appeared. We diagnosed this case to be lepromatous leprosy and treated first by diaminodiphenylsulfone, rifampisin and levofloxacine. However, a complete cure could not be achieved. We have currently stopped using levofloxacine and instead are using clofazimine to treat this patient.
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Takahiro SHIMIZU, Masahiko MUTO, Yuki MORIWAKI, Hiroko FURUMOTO, Chido ...
1997 Volume 59 Issue 5 Pages
720-722
Published: October 01, 1997
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We report a case of a 73-year-old Japanese male who presented with sporotrichosis on the dorsal surface of his left hand. The diagnosis of sporotrichosis was made based on the detection of
Sporothrix schenckii after a pus culture was taken from the ulcer on an erythematous plaque. The plaque almost disappeared after 8 weeks of treatment with itraconazole 100mg/day. The patient showed recurrence 3 weeks after the drug was discontinued. The lesion nolonger responded to itraconazole but showed a good response to sodium iodide.
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Eiko WAKEYAMA, Yasuhisa ICHINOSE, Ichiro KATAYAMA, Katsutaro NISHIMOTO
1997 Volume 59 Issue 5 Pages
723-726
Published: October 01, 1997
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A 13-year-old male with primary cutaneous aspergillosis which affected the skin adjacent to the continual injection site on his palm is reported. He was suffering from acute myeloblastic leukemia and was receiving chemotherapy with pirarubicin, cytarabine and vincristine sulfate. The affected lesion had been covered by adhesive tape for several days to fix the needle and the lesion was first noticed after removing the adhesive tape. The lesion was a necrotic mass measuring 1.5 cm in diameter. A potassium hydroxide preparation of the necrotic tissue revealed falk-shaped hyphae, while as SDA culture isolated both
A. flavus and
A. terreus. The lesion was treated with a combination of itraconazole p. o., fluconazole i. v. and amphotericin-B soaking. An improvement of the lesion was noticed only after the recovery of his peripheral neutrophilic cell count. Previously reported cases of primary cutaneous aspergillosis in Japan from which more than two species of
Aspergillus species were isolated are also summarized with a brief discussion.
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Yumiko KUBOTA, Tetsuya KOGA, Shoji TOSHITANI
1997 Volume 59 Issue 5 Pages
727-730
Published: October 01, 1997
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A 54-year-old Japanese male took ampicillin 1 tab, flurbiprofen 2 tab and piroxicum 2 cap after undergoing regular dental treatment. Several hours later, he developed a high fever and skin rash all over his body. The systemic administration of corticosteroids was effective. Patch test findings for ampicillin, flurbiprofen and piroxicum were positive. In addition, interferon-
γ was also present in the culture supernatant, after a 72-hour incubation with each drug, respectively, of the peripheral blood mononuclear cells obtained from the patient. These findings thus support the assumption that ampicillin, flurbiprofen and piroxicum were the causative drugs of the above symptoms.
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