The Nishinihon Journal of Dermatology
Online ISSN : 1880-4047
Print ISSN : 0386-9784
ISSN-L : 0386-9784
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Volume 60, Issue 6
Displaying 1-23 of 23 articles from this issue
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Color Atlas
Clinical Case Reports
  • A Case of Anaphylactoid Purpura with a Clinical Appearance of Annular Purpura
    Keisuke MORITA, Kazunori URABE, Shin-hong LIN, Juichiro NAKAYAMA, Masu ...
    1998 Volume 60 Issue 6 Pages 751-753
    Published: December 01, 1998
    Released on J-STAGE: October 15, 2010
    DOIhttps://doi.org/10.2336/nishinihonhifu.60.751
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    A 51-year-old woman visited our hospital in 1996 because of painful annular purpuric patches on her lower limbs. The eruptions spread centrifugally and did not respond to antibiotics. A skin biopsy of the marginal ridge of the annular purpura revealed leukocytoclastic vasculitis in the upper dermis and a blood examination revealed a slightly elevated serum IgA level. She was diagnosed to have anaphylactoid purpura. The eruptions showed a good response to corticosteroid therapy and eventually resolved within a few weeks. No recurrence has been observed after the therapy.
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  • A Case of Epidermolysis Bullosa Hereditaria
    Hiromichi TAKESHITA, Masutaka FURUE, Hiromaro KIRYU
    1998 Volume 60 Issue 6 Pages 754-756
    Published: December 01, 1998
    Released on J-STAGE: October 15, 2010
    DOIhttps://doi.org/10.2336/nishinihonhifu.60.754
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    A newborn male with recessive dystrophic epidermolysis bullosa hereditaria is presented. The patient developed excoriation, blisters, erosion, and milia formations mainly on his extremities after birth. Histopathologically, sections from the eroded skin revealed a loss of the epidermis and probable subepidermal blister formation as evidenced by the presence of preserved dermal papillae associated with mild lymphocytic infiltrate in the dermis. He was treated with oral tocopherol acetate and phenytoin from the fifth day after birth. However, this therapy proved to be ineffective. In addition, he also developed progressive fusion of the toes by severe scarring with a loss of his toe nails.
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  • A Case of Class II Histiocytosis (Adult Xanthogranulomatosis) Associated with Acute Lymphocytic Leukemia
    Yoshihide HONDA, Tsunao OHI, Michiyuki KOGA
    1998 Volume 60 Issue 6 Pages 757-760
    Published: December 01, 1998
    Released on J-STAGE: October 15, 2010
    DOIhttps://doi.org/10.2336/nishinihonhifu.60.757
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    Acute lymphocytic leukemia (ALL) was diagnosed in a 17-year-old girl in November 1989. Treatment induced remission. Yellowish papules developed on her face in January 1990 and thereafter gradually spread to other areas. At her first visit to our clinic, numerous nodules and papules were seen on her face, trunk, arms and thighs. A few papules were also found on the flexure surfaces. Histologically dense cellular infiltration mainly composed of histiocytes and foam cells were observed from the upperdermis directly under the epidermis to the middermis, and Touton type giant cells were also scattered in some areas. The infiltrating cells were positive for Sudan IV stain and lysozyme and negative for PAS stain, iron stain, NCA and S-100 protein. No Langerhans cell granules were observed electron-microscopically. From the above findings, she was diagnosed to have adult xanthogranulomatosis. Only 3 cases of adult xanthogranulomatosis associated with ALL have so far been reported including our case in Japan, and all of them first appeared during ALL remission.
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  • Napkin Psoriasis
    Michio OGASAWARA, Yoshihiro UMEBAYASHI
    1998 Volume 60 Issue 6 Pages 761-762
    Published: December 01, 1998
    Released on J-STAGE: October 15, 2010
    DOIhttps://doi.org/10.2336/nishinihonhifu.60.761
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    A 1-month-old male infant presented at our clinic on October 14th, 1996. One week previously, his mother had noticed erythema on the napkin area. The topical use of betamethasone valerate was not effective. The trunk and limbs became thereafter affected with psoriatic patches. Skin biopsy specimens taken from the thigh showed elongated rete ridges, a thin granular layer, and Munro’s microabscess suggestive of psoriasis. No Candida albicans was found in either scrapings or a culture. He was treated with topical fluocinonide. Two weeks later, the skin lesions gradually improved. The eruptions lasted for 3 months. No relapses or orthodox psoriasis have developed since remission.
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  • A Case of Cushing Syndrome
    —Misdiagnosed Due to Long-Term Atypical Skin Symptoms—
    Takehiko NAKAMURA, Yoshihiro ARAKI, Takaaki YAMANE, Tomomichi ONO
    1998 Volume 60 Issue 6 Pages 763-767
    Published: December 01, 1998
    Released on J-STAGE: October 15, 2010
    DOIhttps://doi.org/10.2336/nishinihonhifu.60.763
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    A 57-year-old female, who was diagnosed to have a cystic tumor of the pancreas, was referred to our division for an analysis of skin symptoms. The skin on her face and neck had erythema and teleangiectasia. A low grade of moon face and buffalo hump also developed and the skin of the extremities was thin. In addition, hypertension and hyperlipidemia were present. Although these symptoms had been observed for six years, she had been diagnosed as having solar dermatitis and idiopathic hypertension. The diagnosis of Cushing syndrome was verified based on a depression test using dexamethazone and the findings of abdominal CT scanning. Her tumors (pancreas and left adrenal lesions) were removed and the left adrenal tumors disclosed cortical adenoma. One year after surgery, her skin symptoms are slowly disappearing.
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  • A Case of Chronic Myelomonocytic Leukemia with Skin Infiltration
    Yoshiyuki MURAKAMI, Shinichiro YASUMOTO, Masutaka FURUE, Eijyo MATSUIS ...
    1998 Volume 60 Issue 6 Pages 768-771
    Published: December 01, 1998
    Released on J-STAGE: October 15, 2010
    DOIhttps://doi.org/10.2336/nishinihonhifu.60.768
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    We report the case of a 63-year-old Japanese woman who was hospitalized for the diagnosis and treatment of a fever of unknown origin. Based on several laboratory findings including a bone marrow and peripheral blood check, she was diagnosed to have chronic phase chronic myelomonocytic leukemia (CMMoL). Thereafter the patient simultaneously developed palpable purpuras on both thighs with blastic transformation of CMMoL. Histopathological examination showed a leukemic infiltration in the reticular dermis with an extravasation of red blood cells.
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  • A case of Proliferating Trichilemmal Tumor
    Kana KURITA, Takao KONDO, Kazuo HARA
    1998 Volume 60 Issue 6 Pages 772-775
    Published: December 01, 1998
    Released on J-STAGE: October 15, 2010
    DOIhttps://doi.org/10.2336/nishinihonhifu.60.772
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    We report the case of a female patient (age 59) presenting with an ulcerative tumor on her parietal region. The lesion was highly suspected of being malignant based on the clinical features, however, it was thereafter histologically determined to be a proliferating trichilemmal tumor (PTT). In addition, we also collected previous Japanese case-reports on both PTT and malignant PTT, and we discuss the differential diagnosis of both.
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  • A Case of Dematofibrosarcoma Protuberans (DFSP) and a Statistical Survey on the 197 Reported Cases of DFSP in Japan
    Taiji KAWAKAMI, Minoru MURAYAMA, Yoshinori SUENAGA, Masakazu ASAHI
    1998 Volume 60 Issue 6 Pages 776-779
    Published: December 01, 1998
    Released on J-STAGE: October 15, 2010
    DOIhttps://doi.org/10.2336/nishinihonhifu.60.776
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    The patient was a 46-year-old woman who noticed a nodule 5 years previously on the occipital region after receiving a traumatic blow. The tumor had been surgically removed, but recurred twice at the same place. At our clinic, two fingertip-size nodules were noted on the occipital area. We excised the tumor including a part of the underlying muscle and bone 3 cm away from the tumor margin. Histologically, a subcutaneous nodule was noted with typical features of DFSP. The tumor cells were CD34 positive. Statistical surveys were also done on the previously reported 197 cases of DFSP in Japan from 1986 to 1997.
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  • A Case of Guttate Psoriasis Associated with Perianal Streptococcal Dermatitis
    Junko HIGO, Takashi IWAMOTO, Masato KITO, Tomomichi ONO
    1998 Volume 60 Issue 6 Pages 780-783
    Published: December 01, 1998
    Released on J-STAGE: October 15, 2010
    DOIhttps://doi.org/10.2336/nishinihonhifu.60.780
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    A 60-year-old Japanese woman with az three-year history of red scaly eruptions on her trunk and scalp had been repeatedly treated by topical corticosteroid application. The patient failed to improve and, when initially seen by us, demonstrated both small psoriasiform lesions on her trunk and scalp, as well as perianal erythema. A swab was used to obtain a perianal specimen and then was tested for group A streptococcal antigen by a direct antigen-testing procedure. The antigen study was positive. The throat swab culture was negative, and laboratory investigations such as ASLO, ASK and ASP were all within the normal limits. A skin biopy specimen showed changes compatible with psoriasis. Based on these data, we diagnosed guttate psoriasis associated with perianal streptococcal dermatitis. The patient was treated with amaxicillin for ten days. At follow-up she had still demonstrated some eruptions, she was therefore treated with roxithromycin for 4 weeks, after which the perianal erythema disappeared completely and guttate psoriasis was observed to decrease.
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  • Perianal Streptococcal Dermatitis
    Tomomichi ONO, Ken-ichi KAYASHIMA, Takashi IWAMOTO, Junko HIGO, Masato ...
    1998 Volume 60 Issue 6 Pages 784-787
    Published: December 01, 1998
    Released on J-STAGE: October 15, 2010
    DOIhttps://doi.org/10.2336/nishinihonhifu.60.784
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    We report three cases of perianal streptococcal dermatitis (PSD). The first case was observed in a 6-month-old boy with erythema on the perianal region. The second case occurred in a 7-year-old girl with general fatigue, high grade fever up, erythema multiforme-like lesion on her knees, elbows and the ankle joint region, and erythema in the perianal region. The third case was seen in a 3-year-old girl with strawberry tongue, vulvitis, vaginitis, erythema on the axilla, thighs, and perianal region. Using swab cultures from the perianal regions, group A, β streptococci were detected in all three cases. Based on these findings, the diagnosis of PSD was made. All three cases showed an improvement with the oral administration of antibiotics. Three important characteristics of PSD were observed; the possibility that PSD may be misdiagnosed as child abuse and inflammatory skin diseases such as contact dermatitis, candidiasis and enterobiasis, the importance of the perianal region as a streptococcal carrier and the possibility of a focal infection for such types of inflammatory dermatosis as psoriasis guttata. PSD should thus be considered when erythematous lesions are observed in the perianal region, and that if necessary, a swab culture should be performed.
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  • A Case of Leprosy (Paucibacillary Type)
    —Availability of Sparfloxacin and Other New Anti-leprosy Drugs—
    Masumi SUGIMOTO, Norihisa ISHII, Yasuyuki SUGITA, Hiroshi NAKAJIMA, Ak ...
    1998 Volume 60 Issue 6 Pages 788-791
    Published: December 01, 1998
    Released on J-STAGE: October 15, 2010
    DOIhttps://doi.org/10.2336/nishinihonhifu.60.788
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    A 33-year-old male presented with well-demarcated, infiltrating erythematous plaques on his knees and lower legs, with a loss of sensation in the plaques. He was diagnosed as having leprosy (paucibacillary type) based on the clinical symptoms, skin smears, Mitsuda reaction, pathological findings, and PCR test. Chemotherapy with sparfloxacin (SPFX), 100mg daily, was also administered for 20 weeks. Two weeks later, the eruptions began to subside, and eight weeks after beginning chemotherapy, the skin infiltration disappeared. During therapy, no leprosy reactions nor other side effects appeared. We were thus able to ascertain that chemotherapy with SPFX was successful. A number of researchers have reported new drugs such as ofloxacin, minocycline, clarithromycin, and others to be effective against M. leprae. Among these anti-leprosy drugs, SPFX is the strongest bactericidal agent. But further cases must be evaluated before the optimal dosage and duration therapy can be determined. SPFX and other new anti-leprosy drugs should also be tested as a combination therapy with a multidrug therapy regimen in the future.
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  • A Case of Myositis Ossificans Traumatica
    Michinori KURISAKI, Takehiko NAKAMURA, Syoji UMEKI, Tomomichi ONO
    1998 Volume 60 Issue 6 Pages 792-794
    Published: December 01, 1998
    Released on J-STAGE: October 15, 2010
    DOIhttps://doi.org/10.2336/nishinihonhifu.60.792
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    A 44-year-old male presented with a myositis ossificans traumatica. Six months before the first examination, he gradually noticed a subcutaneous nodule on his right upper back. This nodule increased in size. A histopathological examination revealed a circumscribed nodule, which was composed of several islands surrounded by collagenous fiber and endchondral bone formation. The nodule was clinically and histopathologically diagnosed to be myositis ossificans traumatica. No recurrence has been seen over four years after performing a local resection.
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