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Volume 62, Issue 1
Displaying 1-25 of 25 articles from this issue
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Color Atlas
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Ayako MATSUMURA, Tetsuya KOGA, Juichiro NAKAYAMA2000 Volume 62 Issue 1 Pages 1-2
Published: February 01, 2000
Released on J-STAGE: September 02, 2010
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Mini Review
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Hirotsugu TAKIWAKI2000 Volume 62 Issue 1 Pages 3-8
Published: February 01, 2000
Released on J-STAGE: September 02, 2010
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Clinical Case Reports
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Eijun ITAKURA, Masaru YASUDA, Ken MORIMOTO, Masahiro YAMAMOTO, Kouko S ...2000 Volume 62 Issue 1 Pages 9-13
Published: February 01, 2000
Released on J-STAGE: September 02, 2010
JOURNAL RESTRICTED ACCESSWe report the case of a 40-year-old woman with amyopathic dermatomyositis associated with Sjögren’s syndrome. She was initially diagnosed to have dermatomyositis based on the typical appearance of her skin lesions, but thereafter she developed multiple skin ulcers that were refractory to conventional treatments for dermatomyositis. A pathological examination of the skin lesion indicated cutaneous vasculitis. Methylprednisolone pulse therapy was able to successfully treat these cutaneous ulcers.View full abstractDownload PDF (1381K) -
Maiko YOKOYAMA, Tatsuro TANAKA, Yutaka NARISAWA2000 Volume 62 Issue 1 Pages 14-17
Published: February 01, 2000
Released on J-STAGE: September 02, 2010
JOURNAL RESTRICTED ACCESSWe report a 27-year-old woman with acute generalized exanthematous pustulosis. Following the birth of her second child, she exhibited generalized erythematous pustular eruptions on her trunk and intertriginous areas of the limbs with a high fever after receiving minocycline and tiaramide for a perineal laceration. Her white blood cell count was elevated at 11,200/mm3 with 86.5% neutrophils on admission. The biopsy specimens of the erythematous pustular lesions showed a subcorneal abscess with spongiform of Kogoj and mild irregular acanthosis. In the superficial dermis, a mild perivascular infiltration of lymphocytes and neutrophils was mixed with a small number of eosinophils. Both a patch test and the drug lymphocyte stimulation tests with minocycline and tiaramide were negative. No peroral challenge tests were performed.View full abstractDownload PDF (1287K) -
Yuki KIMOTO, Wataru RIKIHISA, Osamu YAMAMOTO, Masakazu ASAHI, Kunio IZ ...2000 Volume 62 Issue 1 Pages 18-22
Published: February 01, 2000
Released on J-STAGE: September 02, 2010
JOURNAL RESTRICTED ACCESSWe report three cases of intramuscular granuloma. Case 1: A 61-year-old woman developed subcutaneous tumors on her extremities and lower jaw, which gradually increased in size. Histopathologically, the tumors showed granulomatous structures composed of multinucleated giant cells and epithelioid cells in the muscle. Coupled with the laboratory findings, the patient was diagnosed to have sarcoidosis. Case 2: A 53-year-old woman developed a subcutaneous tumor on the left side of her lower jaw. Histopathologically, a granuloma composed of epithelioid cells was noted in the muscle. In addition, Actinomyces israelii was also isalated from the tissue fragments. We treated the patient with oral benzyl penicillin postassium. Case 3: A 33-year-old man developed a subcutaneous tumor on the right side of forehead. Histopathologically, the tumor showed the features of a granuloma composed of epithelioid cells and multinucleated giant cells. Some crystalline silicas were observed in the granuloma. Intramuscular granulomas have so far been sporadically reported in the orthopedic field, but seldom in the dermatological field.View full abstractDownload PDF (1255K) -
Yoshiko NAGATA, Yuko HIGASHI, Hisashi KAWABATA, Yuki FUKUDOME, Tamotsu ...2000 Volume 62 Issue 1 Pages 23-27
Published: February 01, 2000
Released on J-STAGE: September 02, 2010
JOURNAL RESTRICTED ACCESSWe herein report a five-year-old boy who presented with a congenital ichthyosis, vasculizing keratitis, neurosensory deafness, and diffuse alopecia. His family history was negative for any similar skin disease or consanguinity. His parents and brother were normal. In addition, he had recurrent cutaneous fungal and bacterial infections. All nails were turbid and dystrophic. His palms and soles showed severe hyperkeratosis. The histopathological findings of his palms showed hyperkeratosis and papillomatosis. PAS staining of a biopsy from a well-demarcated, keratotic nodule on his lower leg showed numerous pseudohyphae within the horny layer. As a result of culture, Candida albicans grew out. Treatment was difficult and only symptomatic relief could be achieved by keratolytic agents and therapy for skin infections. Since there have been reports of squamous cell carcinoma in KID syndrome, a regular follow up is thus called for.View full abstractDownload PDF (2176K) -
Masako MIZOGUCHI, Atsushi HATAMOCHI, Hiroshi SHINKAI, Makoto GOTO2000 Volume 62 Issue 1 Pages 28-30
Published: February 01, 2000
Released on J-STAGE: September 02, 2010
JOURNAL RESTRICTED ACCESSA 54-year-old woman was diagnosed to have Werner’s syndrome based on her short height and light body weight, slender extremities with a stocky trunk, characteristic bird-like appearance in the face with a beak-shaped nose, gray hair and baldness, cataracts, high-pitched voice, thinning of the entire skin and hyperkeratoses on the soles, calcification of soft tissue, hyperlipidemia, and diabetes mellitus. In addition, six of her nine siblings also suffered from malignant tumors.View full abstractDownload PDF (1396K) -
Kayo TAIRA, Tatsuro TANAKA, Noriyuki MISAGO, Yutaka NARISAWA2000 Volume 62 Issue 1 Pages 31-34
Published: February 01, 2000
Released on J-STAGE: September 02, 2010
JOURNAL RESTRICTED ACCESSA 42-year-old man presented crusted plaques covering his entire body surface, which had been diagnosed as tinea corporis by Trichophyton rubrum. The patient also had adult T-cell leukemia (ATL) which had been diagnosed based on the histopathological findings of a mass lesion on his right thigh. In addition, the patient also tested positive for anti-HTLV-I antibody, and showed a monoclonal integration of proviral DNA in the peripheral blood. In addition, this patient was also diagnosed to have Werner’s syndrome based on his generally aged appearance, skin atrophy, and a reduced lifespan of his cultured skin fibroblasts. He was treated with chemotherapy and phototherapy, but died from ATL 21 months later. This is a rare case of Werner’s syndrome complicated by ATL.View full abstractDownload PDF (1078K) -
Emiko SATO, Kazutomo TOYOFUKU, Eijun ITAKURA, Hiromaro KIRYU, Masutaka ...2000 Volume 62 Issue 1 Pages 35-39
Published: February 01, 2000
Released on J-STAGE: September 02, 2010
JOURNAL RESTRICTED ACCESSWe report a 6-year-old boy with rudimentary meningocele (RMC) on the midline of the occipital area since birth. To the best of our knowledge, only 9 cases of RMC have been reported in Japan. RMC has been reported as a variant of primary cutaneous meningioma, but has recently been described as a histologically isolated entity. Some reports have referred to bone defects beneath the lesion and a connection with the underlying dural tissue through the defect. Therefore, a careful preoperative evaluation, including imaging studies such as computed tomography or magnetic resonance image, to rule out the possibility of a lesion being RMC, whenever we encounter an infant or a child presenting with a midline lesion of the scalp, such as a nodule or an alopecia.View full abstractDownload PDF (1293K) -
Kaoru ICHIKAWA, Akira MUKUNO, Yoshie YAMAGAMI, Hikaru ETO, Michitoshi ...2000 Volume 62 Issue 1 Pages 40-43
Published: February 01, 2000
Released on J-STAGE: September 02, 2010
JOURNAL RESTRICTED ACCESSA case of porphyria cutanea tarda (PCT) with multiple ulcers on the scalp occurring in a 63-year-old man is reported. The first biopsy specimen from the purpura on the scalp revealed no diagnostic findings. We treated him with the standard topical therapy consisting of oral antibiotics, however, painful symptoms continued for another 6 months. 3 months after his first visit, he developed a few small bean sized bulla on the dorsal aspects of the hands. His urinary excretion of uroporphyrin and coproporphyrin was also excessive. The clinical, biochemical and histological features of this case closely match the diagnosis of PCT. We considered that the slow healings observed in this case was due to the fragility of the scalp skin, repeated microtrauma, previously improper treatment and complication due to secondary infections.View full abstractDownload PDF (1151K) -
Yoshihiro UMEBAYASHI2000 Volume 62 Issue 1 Pages 44-46
Published: February 01, 2000
Released on J-STAGE: September 02, 2010
JOURNAL RESTRICTED ACCESSCase 1. A 41-year-old man noticed a tumor measuring about 7.5 mm in diameter on his nose 6 months prior to presentation. Case 2. A 49-year-old man noticed a tumor about 16 mm in diameter on his upper lip a few years previously. A histopathological examination showed the tumor to be mainly composed of tubular structures. Some of the tubules displayed decapitation secretion. The stroma was edematous and myxoid. In addition cystic structures could be observed which contained eosinophilic amorphous material in case 2. Immunohistochemical examination using monoclonal antikeratin antibodies showed most of the tumor cells of case 1 to differentiate towards transitional portions between the dermal ducts and secretory segments of the sweat glands, whereas luminal cells with decapitation secretion differentiate toward the secretory regions. The keratin expression suggested tumor cells of case 2 to differentiate toward various regions ranging from dermal ducts to the secretary portions, while the cystic structures were observed to differentiate towards the dermal ducts.View full abstractDownload PDF (743K) -
Hiroshi MATSUURA, Atsushi HATAMOCHI, Hiroshi SHINKAI2000 Volume 62 Issue 1 Pages 47-49
Published: February 01, 2000
Released on J-STAGE: September 02, 2010
JOURNAL RESTRICTED ACCESSA 35-year-old female presented with a nodule on the edge of her sole which had first appeared about 5 years previously. The lesion measured 10×10mm in size, was a firm, erythematous, elevated and painless nodule with a smooth surface. A histologic examination revealed typical features of angioleiomyoma. We diagnosed this to be a case of angioleiomyoma which demonstrated atypical clinical manifestations.View full abstractDownload PDF (522K) -
Akira TAKAHASHI, Ayako MATSUMURA, Yukiko NONAKA, Yumiko KUBOTA, Tetsuy ...2000 Volume 62 Issue 1 Pages 50-53
Published: February 01, 2000
Released on J-STAGE: September 02, 2010
JOURNAL RESTRICTED ACCESSWe herein report a 69-year-old man with erythroplasia of Queyrat. He noticed a red plaque on his glans penis one year ago. The plaque gradually became enlarged and erosion occurred within the lesion. Histopathologically, disorganization of the epithelium, atypical cells, and several individually keratinized cells appeared throughout the full thickness of the epidermis. No invasion was observed beyond the basement membrane. He was successfully treated by chemotherapy (peplomycin i.m., total 60mg) in combination with radiotherapy (electron beam, total 55Gy) and no recurrence has been observed. A survey of HPV DNA in the lesion was carried out using the in situ hybridization technique, however, no HPV DNA was detected in our patient.View full abstractDownload PDF (1516K) -
Hideto TAKAHAMA, Shigemitsu NOTO, Kazuo AIZAKI, Yoshiro CHISHIMA, Yosh ...2000 Volume 62 Issue 1 Pages 54-57
Published: February 01, 2000
Released on J-STAGE: September 02, 2010
JOURNAL RESTRICTED ACCESSA 73-year-old Japanese female presented with a small nodule in her left axilla which had first been observed seven years previously. This nodule gradually increased in size and began to bleed, and, as a result she was sent to our hospital. An examination revealed a mass with a rough surface, measuring 35×32 mm in diameter in the left axilla which adhered to the skin but not to the bottom. A biopsy of the axillary nodule suggested adenocarcinoma, and other general examinations were done, but no other masses were found. The mass was suspected to be apocrine carcinoma because of the apocrine secretion from tumor cells. An excision of the tumor and a dissection of lymph nodes were performed. A diagnosis of mammary carcinoma was made based on the histopathological and immunohistochemical findings. We describe this case of aberrant breast cancer together with a review of the pertinent literature.View full abstractDownload PDF (1307K) -
Chiharu WATANABE, Tomoki OKUDA, Yukihiko KATO, Tsunao OH-I, Michiyuki ...2000 Volume 62 Issue 1 Pages 58-61
Published: February 01, 2000
Released on J-STAGE: September 02, 2010
JOURNAL RESTRICTED ACCESSWe treated a case of adenocarcinoma which was suggested to possibly have an apocrine origin. It occurred in the right axilla of an 83-year-old man as an erythematous nodule. A histological examination revealed adenocarcinoma composed of atypical cells with abundant eosinophilic cytoplasm and finding of decapitation in some parts of the tumor. The tumor cells were PAS (+) (with resistance to diastase), CEA (-), EMA (+), secretory-component (+), GCDFP-15 (+), BRST-3 (+). No abnormal laboratory data and no evidence of metastasis to other organs were observed. We excised the lesion and regional lymph nodes en bloc and metastatic cells were detected in the lymph nodes. According to our review of the literature, about 30% of such cases do have metastasis to the regional lymph nodes. Based on these findings, we believe that a broad excision and radical lymph node dissection are necessary in the treatment of this disease.View full abstractDownload PDF (1854K) -
Yasuhiro NAKAMURA, Atsushi HATAMOCHI, Keiko ISHII, Hiroshi MATSUURA, H ...2000 Volume 62 Issue 1 Pages 62-65
Published: February 01, 2000
Released on J-STAGE: September 02, 2010
JOURNAL RESTRICTED ACCESSCase 1: A 78-year-old man noticed eight blackish macules and tumors on his nose, eyelid, upper neck and waist. A histopathological examination revealed all lesions to be basal cell epithelioma (BCE), and five of them were solid type. He had previously used tar while working at a steel mill. Case 2: An 88-year-old woman presented with eight BCEs on her forehead, back and right thigh. Six of them were superficial type. Case 3: An 80-year-old man had five BCEs on his right shoulder, waist, nape, right ear and submandibular region. They showed a histopathological variety including solid, superficial, keratotic and adenoid types.View full abstractDownload PDF (1007K) -
—Report of Two Cases and a Review of the Literature—Kei FUJIWARA, Takeshi KONO, Naoki MAEKAWA, Koichi NAKAGAWA, Masamitsu ...2000 Volume 62 Issue 1 Pages 66-70
Published: February 01, 2000
Released on J-STAGE: September 02, 2010
JOURNAL RESTRICTED ACCESSWe report two cases of cutaneous metastasis from hepatocellular carcinoma (HCC). Case 1: A 62-year-old man presented with a reddish nodule on his right eyebrow. Case 2: A 67-year-old man presented with a cutaneous tumor on the chest. Both of them suffered from HCC for 10 years and for 3 months, respectively. They were referred to our clinic and the cutaneous lesions were excised. A histopathological examination revealed tumor cells which had similar characteristics to those of HCC. We review 24 cases of HCC previously reported in Japan.View full abstractDownload PDF (1303K) -
Nahoko KOMATSU, Chihiro SHIMIZU, Norio OHTSUKI, Shuji TOKUNAGA, Tsutom ...2000 Volume 62 Issue 1 Pages 71-76
Published: February 01, 2000
Released on J-STAGE: September 02, 2010
JOURNAL RESTRICTED ACCESSWe herein report two cases of tuberculid, one patient with penis tuberculid and another with erythema induratum Bazin. Case 1: a 44-year-old Japanese man with no history of tuberculosis, presented with an ulcer and induration on his penis. The patient was treated with minocycline. Case 2: a 57-year-old Japanase man with a past history of lung tuberculosis, presented with ulcerating plaques and indurations occuring on his lower limbs. The patient was treated with a double anti-tuberculosis regime, isoniazid and rifampicin. No mycobacterial DNA was identified from both cases of skin lesions based on an amplification of the specific DNA sequences using the polymease chain reaction (PCR) with formalin-fixed and paraffin-embedded tissues. We also reviewed previous reports of cutaneous tuberculosis and tuberculid including a DNA analysis and discuss the results. Eight patients (100%) of scrofuloderma and 3/3 patients of lupus vulgaris were positive based on the PCR assay. However, only one out of 4 patients with erythema induratum Bazin, 0/2 cases of papulonecrotic tuberculid, and no patients of penis tuberculid (0/2) were positive.View full abstractDownload PDF (2325K) -
Yoko YAHATA, Shinji MURAKAMI, Koji SAYAMA, Koji HASHIMOTO, Shunji MIYA ...2000 Volume 62 Issue 1 Pages 77-79
Published: February 01, 2000
Released on J-STAGE: September 02, 2010
JOURNAL RESTRICTED ACCESSA 23-year-old woman developed abscesses and several red nodules on her right upper extremity. She had been breeding tropical fish for several years. A histological examination of one of these red nodules revealed epithelioid cell granuloma. and Mycobacterium marinum was detected from the same biopsy specimen, as well as from the tropical fish and the water from the fish tank. The administration of oral minocycline (200 mg/day) was started. However minocycline was discontinued 9 months later because of its ineffectiveness. Thereafter, oral clarithromycin 800 mg daily was given, eventually resulting in complete resolution of the lesions 4 months later. One hundred and fifty cases of M. marinum infection have been reported in Japan from 1964 to 1997. However, no case was treated with clarithromycin alone. Therefore, this is the first report of the successful treatment of atypical mycobacterial infection with clarithromycin alone.View full abstractDownload PDF (658K) -
Yoshihiro UMEBAYASHI2000 Volume 62 Issue 1 Pages 80-82
Published: February 01, 2000
Released on J-STAGE: September 02, 2010
JOURNAL RESTRICTED ACCESSA 68-year-old man with ischemic heart disease, who had taken mexiletine and diltiazem for 3 weeks, developed exfoliative dermatitis with a fever. A few days after the initial administration, a laboratory examination showed a slight increase in the GOT and GPT levels. Thereafter, oral prednisolone was administered and the condition improved. However, even though the drug was discontinued the exanthema recurred six weeks later. The patient was successfully treated by systemic corticosteroid therapy. Patch tests using 1%, 10%, 30% mexiletine and diltiazem in petrolatum showed positive results. A lymphocyte stimulation test was negative. In addition to this case, 37 cases of drug eruption due to mexiletine and 39 cases of drug eruption due to diltiazem have been reported in Japan. Several common clinical features were observed in these drug eruptions. First, the interval between the start of the drug and onset of the eruption was relatively long (48∼88days). Second, the positive percentage of the patch test was high (86∼97%), whereas positive percentage of the lymphocyte stimulation test was low (23∼27%). Third, the patients frequently showed systemic symptoms, e.g., fever (93∼94%) and liver dysfunction (43∼78%). Fourth, some patients including this case had multiple drug eruptions.View full abstractDownload PDF (694K)
Clinical and Investigative Reports
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Classification of the Treatments and a Questionnaire StudyMichihiro HIDE, Yumi YAMAMURA, Eishin MORITA, Osamu KORO, Shoso YAMAMO ...2000 Volume 62 Issue 1 Pages 83-88
Published: February 01, 2000
Released on J-STAGE: September 02, 2010
JOURNAL RESTRICTED ACCESSRecently, an increasing number of alternative treatments are now being used by many patients with atopic dermatitis. These often interfere with the standard treatments administered by doctors, but there have so far been few comprehensive studies made concerning such treatments. We have studied the contents of alternative treatments for atopic dermatitis in Japan as widely as possible and categorized them from the view point of conventional medicine. Most of the alternative methods can be classified into the following: 1) external applications to skin, 2) drinking, 3) eating, 4) bathing and 5) washing, with at least 146 essences or constituents being presented as ingredients of the materials for these treatments. We also studied the efficacies and problems of the treatments taken by 203 (67.4%) out of 301 patients who answered our questionnaire. The more severe the cases were, the greater the number of therapies patients tended to try. “Steroid-phobia” was a major reason for 94 patients (46.3%) taking alternative treatments. However, there was no difference in the degree of overall satisfaction with ordinary hospitals and clinics between the patients who tried alternative treatments and those who did not. Eighty-five patients (41.9%) felt that the alternative medicines they tried were effective, but 20 patients (9.9%) felt that their symptoms became worse. Moreover, there is no apparent difference in the efficacy among these treatments, thus suggesting that the clinical improvements felt by patients were not necessarily due to the direct effects of the alternative medicines. In conclusion, alternative treatments may appear to be effective in certain conditions, but none of them should be taken as a standard treatment for atopic dermatitis.View full abstractDownload PDF (1579K) -
Ichiro KATAYAMA2000 Volume 62 Issue 1 Pages 89-94
Published: February 01, 2000
Released on J-STAGE: September 02, 2010
JOURNAL RESTRICTED ACCESSWe performed an inquiry analysis on patients with urticaria who had been treated at the Department of Dermatology, Nagasaki University to evaluate the prognoses and clinical responses to the treatment. Questionnaires were sent to the patients with acute urticaria (73 cases), chronic urticaria (61 cases), cold urticaria (13 cases), solar urticaria (9 cases), and dermographism (18 cases). Sixty-nine cases with answered letters and 23 cases with unanswered letters were enrolled in this study and the latter were evaluated based on personal clinical records. Eighty per cent of the patients with acute urticaria stated that they were free of urticaria at the time of evaluation while only 32 per cent of chronic urticaria and other types of urticaria stated that they were free of urticaria. Most of the patients with acute urticaria reported that the urticarial attack subsided within one year after the onset of urticaria, while more than 50 per cent of the patients with chronic urticaria still suffered from urticaria more than one year after onset. Most of the patients were treated with oral anti-histamines or anti-allergic drugs and topical ointment. No medications were prescribed in 16-20 per cent of the patients. In addition, several provocating factors were demonstrated in some patients with physical urticaria.View full abstractDownload PDF (1478K)
Review
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Jiro ARATA2000 Volume 62 Issue 1 Pages 95-98
Published: February 01, 2000
Released on J-STAGE: September 02, 2010
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Therapy
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Shigeruko IIJIMA, Miho MIYATA2000 Volume 62 Issue 1 Pages 99-106
Published: February 01, 2000
Released on J-STAGE: September 02, 2010
JOURNAL RESTRICTED ACCESSDeep wounds resulting in exposed bones or tendons are difficult to treat with skin grafts and are often repaired by a musculocutaneous or other conventional skin flaps. We tried to treat such cases using an artificial dermis “Terudermis” (AD-T) without skin flaps. The cases included an 81-year-old woman with malignant hemangioendothelioma exposed scalp bone after a wide excision of the tumor and an 87-year-old man with necrotizing fasciitis exposed muscles and tendons after undergoing extensive debridement. The skin defects could be covered with autologous split-thickness skin grafts on the 25th and the 21th days after applying AD-T, respectively. We further used this method on two cases with moderate skin defects after an excision of both eccrine poroma on the sole and acquired digital fibrokeratoma on the third finger. We confirmed that the application of AD-T can accelerate well vascularized granulation on poor wound beds, allowing us to easily treat deep defects with skin grafts and reduce mental and physical stress for older patients who need to undergo an operation. By expanding the adaptability of AD-T, dermatologists will surely be able to operate on a larger number of cases with skin defects.View full abstractDownload PDF (1636K)
Dermatologists around the World
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Kazuhiko TAKEHARA2000 Volume 62 Issue 1 Pages 115-116
Published: February 01, 2000
Released on J-STAGE: September 02, 2010
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