The Nishinihon Journal of Dermatology
Online ISSN : 1880-4047
Print ISSN : 0386-9784
ISSN-L : 0386-9784
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Volume 60, Issue 2
Displaying 1-27 of 27 articles from this issue
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Color Atlas
Clinical Case Reports
  • A Case of Intractable Leg Ulcer Successfully Treated with Topical Hemotherapy
    Hiroshi UCHIMIYA, Kenjiro TERASAKI, Mitsuhiro SEKIYAMA, Takuro KANEKUR ...
    1998 Volume 60 Issue 2 Pages 127-129
    Published: April 01, 1998
    Released on J-STAGE: October 15, 2010
    DOIhttps://doi.org/10.2336/nishinihonhifu.60.127
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    A case of intractable leg ulcer, which was successfully treated with topical hemotherapy (THT), is herein described. After 7 applications of THT, new granulation tissue covered the surface of the ulcer that had previously resisted various treatments including various topical treatments, PGE1, systemic steroids and a hyperbaric oxygen chamber. THT is an easy and inexpensive treatment of chronic intractable ulcers.
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  • Progressive Systemic Sclerosis (CREST Type) with an Intestinal Pseudoobstruction
    Junko TSUJI, Tetsuo SASAKI, Takafumi NISHIYAMA, Satoshi YAMAMOTO, Hiro ...
    1998 Volume 60 Issue 2 Pages 130-133
    Published: April 01, 1998
    Released on J-STAGE: October 15, 2010
    DOIhttps://doi.org/10.2336/nishinihonhifu.60.130
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    A 41-year-old woman became aware of Raynaud’s phenomenon at 30, skin sclerosis at 33 and skin calcification at 38 years of age, respectively. A physical examination also showed typical telangiectasia. Dysmotility of the esophagus was found by esophageal scintigraphy. A laboratory examination revealed high titers of serum antinuclear antibodies and antimicrosome antibodies. She was thus diagnosed to have CREST type of progressive systemic sclerosis. She demonstrated repeated abdominal pain and vomiting which were considered to be due to the intestinal pseudoobstruction, however, these symptoms all improved with conservative treatments. The pseudoobstruction in this patient appeared to have been caused by the acceleration of the intestinal hypomobility of PSS due to a hypothyroid condition resulting from Hashimoto’s thyroiditis.
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  • Hypereosinophilic Syndrome
    Yuka TAKAMATSU, Tomomi SODO, Fumiaki SHIRASAKI, Hideaki SAKAI, Kazuhik ...
    1998 Volume 60 Issue 2 Pages 134-136
    Published: April 01, 1998
    Released on J-STAGE: October 15, 2010
    DOIhttps://doi.org/10.2336/nishinihonhifu.60.134
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    A 49-year-old man developed edematous erythemas and blisters on his face, trunk, and extremities, along with an elevated fever, arthralgia, and muscle pain. Histologically, three biopsy specimens taken from the edematous erythema and vesicle showed a dermal diffuse infiltration of eosinophils without vasculitis nor granuloma. The laboratory data revealed marked peripheral blood eosinophilia, bone marrow eosinophilia, elevated serum eosinophil cationic protein, and serum Interleukin-5 (IL-5). Corticosteroid therapy improved both the symptoms and the laboratory data. IL-5 may thus play an important role in the develoment of hypereosinophilic syndrome.
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  • Two Cases of Idiopathic Urticarial Vasculitis with Complete Remission after Long-Term Treatment
    Masahide YAMAGUCHI, Hiroaki UEKI
    1998 Volume 60 Issue 2 Pages 137-141
    Published: April 01, 1998
    Released on J-STAGE: October 15, 2010
    DOIhttps://doi.org/10.2336/nishinihonhifu.60.137
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    We report two female cases with idiopathic urticarial vasculitis which completely improved after the long-term treatment (12 years and 20 years) by the systemic administration of corticoid hormones. No underlying diseases or autoimmune phenomena were detected. In the course of the treatment, first the urticarial lesions disappeared, next the general symptoms (slight fever, arthralgia, abdominal pain, diarrhea etc.) improved, however, the serum hypocomplementemia continued for many years. As one of the provocating factors of these patients, previous therapeutic drug administrations were suggested. The laboratory examinations revealed hypocomplementemia, circulating immune complexes of an unknown nature, and also a slightly elevated CRP reaction. However, neither HCV nor HBV antibodies were detected. The prolonged course of this disease may thus have been due to some undetectable viral infections or persistent circulating immune complexes of an unknown nature. The activation of endothelial cells and leukcocytic infiltrates may also have been involved. In particular, the activation of FcγR on the endothelial cell surfaces may play an important role in localizing the circulating immune complexes on the local vascular areas. The elimination of immune complexes may have also been impaired in both cases.
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  • A Case of Dermatomyositis with Incurable Facial Erythema and Edema of the Upper Eyelids which was Successfully Treated with Kikyo-Sekko (Herbal Medicine)
    Yoshie YAMAGAMI, Akira MUKUNO, Kaoru ICHIKAWA, Hikaru ETO, Michitoshi ...
    1998 Volume 60 Issue 2 Pages 142-145
    Published: April 01, 1998
    Released on J-STAGE: October 15, 2010
    DOIhttps://doi.org/10.2336/nishinihonhifu.60.142
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    We report a case of dermatomyositis with incurable erythema of the face and edema of the upper eyelids which subsided after treatment with oral kikyo-sekko herbal medicine. A 51-year-old female presented with edema of the upper eyelids and erythema. Other manifestations of the skin showed erythema of the trunk, periungual erythema with petechia and erythema of dorsa of the finger joints. She also showed muscle weakness. After treatment with an oral administration of 20 mg/day prednisolone, a reduction in the periungual erythema and muscle symptoms was observed, however, the erythema of the face and edema of the upper eyelids remained and proved resistant to treatment. Since no recurrence of the systemic symptoms was detected during the course, the dosage of prednisolone was gradually decreased. Nevertheless, 20 months later, the facial erythema has still not improved, we thus tried to treat the patient with oral kikyo-sekko. Immediately after starting the oral kikyo-sekko, such subjective symptoms as flushing of the face improved. One month later, the edema of the upper eyelids and erythema of the face also showed a gradual improvement. These findings thus suggest kikyo-sekko to be an effective treatment for telangiectasia with inflammation and edema on the face.
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  • A Case of Acrodermatitis Continua of Hallopeau Successfully Treated with Low-Dose Etretinate
    Gozo MURAMOTO, Takao UCHIHIRA, Toshiaki KAMEI
    1998 Volume 60 Issue 2 Pages 146-149
    Published: April 01, 1998
    Released on J-STAGE: October 15, 2010
    DOIhttps://doi.org/10.2336/nishinihonhifu.60.146
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    Acrodermatitis continua of Hallopeau is considered to be a variant of pustular psoriasis. We present a 60-year-old woman with localized acrodermatitis continua of Hallopeau, who complained of pustular eruptions on her fingers. The findings of a skin biopsy specimen demonstrated acanthosis, an elongation of the rete ridges and spongiform pustule of Kogoj. The eruptions were resistant to conventional therapy, such as topical and oral steroids and antibiotics. Etretinate (10 mg/day=0.25 mg/kg/day), however, was able to arrest the pustulation within 2 weeks, and also induced a persistent remission without any side effects. We herein describe the beneficial effect of low-dose etretinate in this patient with acrodermatitis continua of Hallopeau.
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  • A Case of Self-Healing Epidermolysis Bullosa Simplex Suspected to be a New Type
    Hiroshi HAMADA, Mitsuru SETOYAMA, Tamotsu KANZAKI, Gisaburou MORI
    1998 Volume 60 Issue 2 Pages 150-152
    Published: April 01, 1998
    Released on J-STAGE: October 15, 2010
    DOIhttps://doi.org/10.2336/nishinihonhifu.60.150
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    We report a case of self-healing epidermolysis bullosa simplex. The patient was a 1-day-old female who was referred to our clinic with erosion on her soles and foot joints bilaterally. On physical examination, deep ulcer-like erosions from the inside of the sole to the medial foot joint were bilaterally observed resulting in abnormal position of both great toes. The level of bullae could not be determined light microscopically, but an electron microscopic examination revealed the bullae to be caused by a degeneration of the basal cells in the epidermis. This was thus determined to be a type of epidermolysis bullosa simplex. The patient has been entirely free from disease for 3 years and no scarring nor deformity remain on the large toes. The findings of this case differed from the previously reported instances and thus may be a new type of epidermolysis bullosa simplex.
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  • A Case of Dowling-Meara Type Epidermolysis Bullosa Simplex
    Kimiko OGATA, Yasuhiko HIRATA, Kayo YASUDA, Mitsunori IKEDA, Hajime KO ...
    1998 Volume 60 Issue 2 Pages 153-155
    Published: April 01, 1998
    Released on J-STAGE: October 15, 2010
    DOIhttps://doi.org/10.2336/nishinihonhifu.60.153
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    A 2-year-old boy with Dowling-Meara type epidermolysis bullosa simplex is reported. A blister first appeared on his right foot at five days of age. Multiple blisters thereafter spread over his trunk and thighs and then spontaneously disappeared without leaving any scars. A biopsy specimen obtained from a blister showed subepidermal bulla on light microscopy. Electron microscopy revealed cytolysis of the basal cells and round tonofilament clumps in their cytoplasm. Oral vitamin E administration was not effective in treating the blister formation. Cessation of his blistering is expected in his childhood, for his father had similar symptoms which regressed from 10 years of age. Recent advances in the molecular biologic findings of this disease are also discussed.
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  • Netherton’s Syndrome
    Hiroki ONOUCHI, Yoshinao MURO, Yoshinari MATSUMOTO
    1998 Volume 60 Issue 2 Pages 156-159
    Published: April 01, 1998
    Released on J-STAGE: October 15, 2010
    DOIhttps://doi.org/10.2336/nishinihonhifu.60.156
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    A 7-year-old girl developed persistent generalized, erythematous, scaling eruptions after birth. The eruptions were characterized by scaling, annular, serpiginous and migratory lesions, which showed a characteristic superficial peeling double edged scale at the advancing border. Moreover, she also had trichorrhexis invaginata, which is also called “bamboo hair”. Based on these findings we diagnosed her to have Netherton’s syndrome (ichthyosis linearis circumflexa with trichorrhexis invaginata).
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  • Secondary Cryofibrinogenaemia with Leukocytoclastic Vasculitis
    Naoko TAKEO, Kazumoto KATAGIRI, Tomoko ISE, Toshihiro SATO, Susumu TAK ...
    1998 Volume 60 Issue 2 Pages 160-164
    Published: April 01, 1998
    Released on J-STAGE: October 15, 2010
    DOIhttps://doi.org/10.2336/nishinihonhifu.60.160
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    A 65-year-old Japanese woman, with a history of deep vein thrombosis on her left leg, developed arterial thrombosis on her right lower leg following an episode of muitiple ecchymotic lesions and wheals on her lower extremities. Her right lower leg became necrotic in spite of the anti-coagulation therapy with heparin and urokinase and finally an amputation of diseased leg had to be performed below knee. After the operation, she received warfarin and ticlopidine hydrochloride and additionally prednisolone 10 mg daily for urticaria and thrombophlebitis. Since then. she has developed purpuric lesions several times on her left lower leg, but no sign of thrombosis has been observed. The laboratory findings did not reveal any abnormalities which were related to deep venous and arterial thrombosis, including anti-phospholipid antibody and lupus anti-coagulant except for the presence of cryofibrinogen. A histological examination of the purpuric or urticarial lesions revealed features of leukocytoclastic vasculitis. Urticarial and ecchymotic lesions developed concomitantly with the above described episode of thrombosis. Taken together, urticaria, ecchymosis and petechiae were thus considered to be caused by cryofibrinogen which was produced as a consequence of thrombosis.
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  • A Case of Mycosis Fungoides with Brain Involvement
    Takaaki AIKOH, Kentaro OMORI, Keisuke WATANABE, Mamoru KOHDA, Hiroaki ...
    1998 Volume 60 Issue 2 Pages 165-168
    Published: April 01, 1998
    Released on J-STAGE: October 15, 2010
    DOIhttps://doi.org/10.2336/nishinihonhifu.60.165
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    A 46-year-old man who had been suffering from itchy erythema over his whole body since 1991 was referred to our hospital in 1992. Based on his clinical course and a histological examination, a diagnosis of mycosis fungoides was made. Tumors of the face, body and extremities appeared 4 months after being referred to our hospital, and the involvement of the gingiva appeared 16 months later. He was treated with PUVA, topical steroids, interleukin-1β, and electron beam therapy. Two years later, however, metastatic lesions appeared in the lung, spleen and bone marrow, and VEPA-M chemotherapy was carried out. The metastatic lesions responded remarkably to chemotherapy, but his eyesight began to fail and his field of vision gradually worsened. Finally, he developed convulsions, a loss of consciousness, and died in 1994. The postmortem findings revealed brain metastasis. Mycosis fungoides involving the brain is relatively rare and only a few cases have so far been reported in Japan.
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  • A Case of Primary Cutaneous Anaplastic Large Cell Lymphoma Occurring on the Upper Leg
    Shih-hong LIN, Juichiro NAKAYAMA, Tetsuo MATSUDA, Akito TOSHITANI, Shi ...
    1998 Volume 60 Issue 2 Pages 169-172
    Published: April 01, 1998
    Released on J-STAGE: October 15, 2010
    DOIhttps://doi.org/10.2336/nishinihonhifu.60.169
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    A 53-year-old male patient presented at our out-patient clinic with erythematous piaques on the right ventral femoral region. The eruptions had started with an asymptomatic erythema with a couple of nodules 3 months before he visited our clinic. A skin biopsy specimen showed a diffuse proliferation of atypical lymphoid cells throughout the entire dermis. Immunohistochemically, the lymphoid cells were CD2(+), CD3(+), CD4(+), and CD30(+). The patient was thus diagnosed to have primary cutaneous anaplastic large cell lymphoma (Ki-1 lymphoma) and admitted to our hospital far treatment. The patient was first treated with a resection of the erythematous plaque, however, it unfortunately recurred 6 weeks after the operation. The patient was again admitted and treated with chemotherapy by the VEPA regimen, and in addition, with local electron beam irradiation with a total dose of 80Gy. The patient is presently free from lymphoma lesions. It should be noted that not all so-called primary cutaneous Ki-1 lymphoma are as slowly progressive or self-healing as observed in our present case.
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  • A Case of Lepromatous Type Hansen’s Disease
    Fumiaki SHIRASAKI, Tomomi SADO, Hideaki SAKAI, Minoru TAKATA, Kazuhiko ...
    1998 Volume 60 Issue 2 Pages 173-176
    Published: April 01, 1998
    Released on J-STAGE: October 15, 2010
    DOIhttps://doi.org/10.2336/nishinihonhifu.60.173
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    A 68-year-old male presented with painful swelling in the extremities and disseminated small brownish nodules over his entire body. A histological examination of the skin nodules showed multiple granuloma and a thickened peripheral nerve bundle surrounded with foamy macrophages and a few lymphocytes. Fite stain revealed numerous acid fast bacilli within the cytoplasm of the foamy cells. A diagnosis of lepromatous leprosy was thus made and multi-drug therapy with DDS, rifampicin and clofazimine was started. The clinical features improved, and the morphological index and serum level of IgM phenolic glycolipid-I antibody both decreased after undergoing chemotherapy. However, a severe type 1 reaction developed after four months of treatment.
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  • A Case of Photosensitive Dermatitis Induced by Flutamide
    Yumie HOSHIYAMA, Shigeo NONAKA, Hiroko IRIFUNE
    1998 Volume 60 Issue 2 Pages 177-179
    Published: April 01, 1998
    Released on J-STAGE: October 15, 2010
    DOIhttps://doi.org/10.2336/nishinihonhifu.60.177
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    A 66-year-old man developed a photosensitivity reaction due to flutamide administration. He had been administered flutamide for metastatic prostatic carcinoma for 2 months before he first developed papulovesicular erythema and swelling to sun-exposed skin areas 2 hours after exposure to sun light. A positive photo test was obtained with UVA. The administration of flutamide was thus immediately stopped. The eruptions disappeared within one week after treatment with topical corticosteroids and the UVA reaction returned to normal. A challenge test after 3 days administration of 375mg flutamide revealed a positive UVA photosensitivity. This is the tenth known case of flutamide photosensitive dermatitis reported in Japan.
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  • Notalgia Paresthetica
    Mika KINOSHITA, Takashi IWAMOTO, Junko HIGO, Masato KITOH, Tomomichi O ...
    1998 Volume 60 Issue 2 Pages 180-183
    Published: April 01, 1998
    Released on J-STAGE: October 15, 2010
    DOIhttps://doi.org/10.2336/nishinihonhifu.60.180
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    We herein report six cases consisting of 74, 62, 29, 52, 41 and 67 year-old females who presented with notalgia paresthetica. Notalgia paresthetica is the name given to a form of localized itching that occurs either on the upper midback or to one side or the other of the midscapular area. Secondary changes in the skin caused by rubbing and scratching may also develop. We also discussed about the possibility that macular amyloidosis, which localized on the back with pruritus, might also develop in association with this disease.
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Clinical and Investigative Report
  • The Effect of the Topical Application of Vidarabine Cream in Mice Inoculated Intradermally with Herpes Simplex Virus-1
    Hiroko MINAGAWA
    1998 Volume 60 Issue 2 Pages 184-187
    Published: April 01, 1998
    Released on J-STAGE: October 15, 2010
    DOIhttps://doi.org/10.2336/nishinihonhifu.60.184
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    The efficacy of vidarabine (ara-A) cream was compared with that of both vidarabine ointment (Arasena A® ointment) and placebo cream in reducing the mortality rate of mice inoculated with herpes simplex virus-1 (HSV-1). Depilated female BALB/c mice were inoculated intradermally at the midflank with the HSV-1 7401H strain. Treatment with either vidarabine cream or vidarabine ointment was then initiated 3h after inoculation and was thus found to be effective in reducing the mortality rate. There was no significant difference in the mortality rate, the rate of the skin lesion formation, or in the survival time between the two groups. Both the vidarabine cream-treated group and the vidarabine ointment-treated group showed an equally significantly lower mortality rate and a longer survival time in comparison with the placebo cream-treated group and the untreated HSV-1-inoculated control group. The protective effect of vidarabine cream was therefore found to be equivalent to that of vidarabine ointment and was also significantly greater than that of placebo cream.
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  • Malassezia furfur in Seborrheic Keratosis and Nevus Sebaceus
    Yoko NOMA, Shunji MIYAUCHI, Koji HASHIMOTO
    1998 Volume 60 Issue 2 Pages 188-190
    Published: April 01, 1998
    Released on J-STAGE: October 15, 2010
    DOIhttps://doi.org/10.2336/nishinihonhifu.60.188
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    A saprophytic proliferation of Malassezia furfur was investigated in patients with seborrheic keratosis and nevus sebaceus. Among 623 histologic specimens of seborrheic keratosis, 162 (26.0%) showed a saprophytic proliferation of Malassezia furfur in the acanthotic horny layer. As a result significantly more Malassezia furfur was found in the male specimens (36.3%) than the female ones (13.0%). Malasezzia furfur was also observed predominantly in the facial, head and neck lesions. The presence of Malassezia furfur was confirmed in the lesional horny layer in 89 (47.6%) out of 187 specimens of nevus sebaceus; 47 (46.1%) in the male specimens and 42 (49.4%) in the female specimens. It is thus speculated that lesional sebum secretion plays an important role in the non-virulent, in situ proliferation of Malassezia furfur, and which results in the histologic saprophytism of Malassezia furfur.
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