The Nishinihon Journal of Dermatology
Online ISSN : 1880-4047
Print ISSN : 0386-9784
ISSN-L : 0386-9784
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Volume 64, Issue 3
Displaying 1-22 of 22 articles from this issue
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Color Atlas
Mini Review
Clinical Case Reports
  • Allergic Contact Blepharoconjunctivitis due to Phenylephrine Hydrochloride Eye Drops
    Kayo OKAHARA, Satoko HIHARA, Mari KATSURA
    2002 Volume 64 Issue 3 Pages 281-283
    Published: June 01, 2002
    Released on J-STAGE: September 02, 2010
    DOIhttps://doi.org/10.2336/nishinihonhifu.64.281
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    A 68-year-old man developed conjunctival hyperemia, pruritus and bilateral palpebral edema, whenever he underwent an ophthalmologic examination with Mydrin®-P eye drops as a mydriatic agent. Similar symptoms arose an hour after the administration of Neosynesin® eye drops. The conjunctivitis continued for over a month despite treatment with Tarivit®, Ecolicin® and Sulperin® eye drops, and resolved a week after all eye drop medication was stopped. Skin prick tests and patch tests showed positive reactions to phenylephrine hydrochloride, which was a major ingredient of Mydrin®-P and Neosynesin®. Positive patch test reactions to phenylephrine hydrochloride were stronger after 7 days than after 72 hours, and persisted for more than 3 weeks. Our findings suggest that the allergic contact reactions due to phenylephrine hydrochloride in our patient were related to not only delayed-type hypersensitivity reactions but also to immediate-type hypersensitivity reactions.
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  • A Case of Contact Dermatitis with a Black Henna (?) Tattoo
    Yuji INOUE, Maiko YOKOYAMA, Takashi GYOTOKU, Tomomichi ONO
    2002 Volume 64 Issue 3 Pages 284-286
    Published: June 01, 2002
    Released on J-STAGE: September 02, 2010
    DOIhttps://doi.org/10.2336/nishinihonhifu.64.284
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    A 23-year-old Japanese female presented with erythema and swelling with severe itching on her left upper arm. Ten days before her first visit to our clinic, she had received a tattoo with black henna (?) in Bali Island, Indonesia. Six months later, there was a recurrence of these same symptoms on the site delineating the figure of the tattoo after the use of a common hair dye. Natural henna was negative for a patch test, but positive reaction was observed for paraphenirendiamine (PPD). We diagnosed the patient to have contact dermatitis due to the PPD in the black henna used for body painting and tatoos.
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  • Cholinergic Urticaria Associated with Hypohidrosis
    Yoichi SHINTANI, Shigeru SUGANO, Noriyuki SAKAKIBARA, Akimichi MORITA, ...
    2002 Volume 64 Issue 3 Pages 287-289
    Published: June 01, 2002
    Released on J-STAGE: September 02, 2010
    DOIhttps://doi.org/10.2336/nishinihonhifu.64.287
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    A 31-year-old man developed wheals surrounded by diffuse erythema associated with burning symptoms whenever he took a bath or exercised. He had a positive acetylcholine skin test with numerous satellite lesions. Hypohidrosis was also found using a resistance hydrometer. As a result, a diagnosis of hypohidrotic cholinergic urticaria was made. We attempted to inhibit the positive reaction against acetylcholine by such oral medicines as ketotifen fumarate, oxatomide and propanthelin bromide. Ketotifen fumarate worked most effectively to inhibit the positive reaction. We, thus, used ketotifen fumarate which demonstrated a good therapeutic effect.
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  • A Case of Adult Still’s Disease
    Aiko TAKI, Yayoi NAGAI, Yoko SOGABE
    2002 Volume 64 Issue 3 Pages 290-293
    Published: June 01, 2002
    Released on J-STAGE: September 02, 2010
    DOIhttps://doi.org/10.2336/nishinihonhifu.64.290
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    A 16 year-old girl presented with a one week history of skin rash, joint pain and sore throat. A maculopapular erythematous rash was present over her extremities and back. In addition, her ankle joints were swollen. After 3 weeks a spiking high fever and liver dysfunction were noted with a high elevation of serum ferritin level. Oral steroid therapy with a dose of 20 mg of prednisolone was effective. In addition, the ferritin concentration level rapidly normalized after adequate treatment.
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  • A Case of Aortitis Syndrome Complicated by Cutaneous Polyarteritis Nodosa
    Yukie WATANABE, Akimichi MORITA, Yoichi SHINTANI, Takuo TSUJI
    2002 Volume 64 Issue 3 Pages 294-297
    Published: June 01, 2002
    Released on J-STAGE: September 02, 2010
    DOIhttps://doi.org/10.2336/nishinihonhifu.64.294
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    We report the case of a 15-year-old woman with aortitis syndrome complicated by cutaneous polyarteritis nodosa. She developed painful erythematous skin nodules and ulcers in her lower extremities. A biopsy specimen from her leg revealed necrotizing vasuculitis of the small arteries at the dermal-subcutaneous border. There was a coexistense of two different types of vasculitis in the same patient. This case was thus considered to fulfill the criteria for polyangiitis overlap syndrome.
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  • A Skin Manifestation due to the Intraarterial Infusion of Epirubicin
    Kenjiro TERASAKI, Yukari MERA, Chiaki BABA, Tamotsu KANZAKI
    2002 Volume 64 Issue 3 Pages 298-300
    Published: June 01, 2002
    Released on J-STAGE: September 02, 2010
    DOIhttps://doi.org/10.2336/nishinihonhifu.64.298
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    We report the findings of 56-year-old woman who experienced skin lesions on the regions corresponding to the arteries that had been infused with epirubicin for advanced breast cancer. The patient visited our department after developing erythema on her right anterior thorax after undergoing three weekly single arterial infusions of 70 mg of epirubicin into her right subclavian and internal thoracic arteries as preoperative therapy for right breast cancer. Well-demarcated erythema, pigmentation and necrotic ulcers were seen on the regions near the arteries. A biopsy of the erythema revealed necrotic changes in both the epidermis and sweat glands. Epirubicin is a doxorubicin (ADM) derivative developed to alleviate the side effects of ADM. In addition, it has recently been used in place of ADM in arterial infusions for local advanced breast cancer. The use of arterial chemotherapy is continually increasing due to advances in the development of intravascular catheters and arterial infusion reservoirs. We therefore believe that such cases, as the one described will increase in the near future.
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  • A Case of Anhidrotic Ectodermal Dysplasia
    Saori MIYAWAKI, Akimichi MORITA, Takuo TSUJI
    2002 Volume 64 Issue 3 Pages 301-303
    Published: June 01, 2002
    Released on J-STAGE: September 02, 2010
    DOIhttps://doi.org/10.2336/nishinihonhifu.64.301
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    A ten month-old baby suffered from hypohidrosis and hyperpyrexia. He was referred to our Dermatology clinic. The clinical feature showed a depressed nasal bridge, hypotrichosis, a protruding thick upper and lower lip, anodontia, and fine scaly erythema of the trunk. The skin specimens revealed a total absence of eccrine glands. Based on these findings, he was diagnosed to have anhidrotic ectodermal dysplasia. As a result, air-condition surroundings, wet clothing and the consumption of frequent cool drinks should be included in the therapeutic regimen for heat intolerant patients to avoid sudden death and brain damage.
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  • A Case of Basal Cell Nevus Syndrome with Enlarged and Ulcerated Basal Cell Epithelioma
    Kaoru MURATA, Atsushi HATAMOCHI, Mari KAKUTA, Takashi KOBAYASHI, Hiros ...
    2002 Volume 64 Issue 3 Pages 304-307
    Published: June 01, 2002
    Released on J-STAGE: September 02, 2010
    DOIhttps://doi.org/10.2336/nishinihonhifu.64.304
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    We report a case of basal cell nevus syndrome (BCNS) with enlarged and ulcerated basal cell epithelioma. A 44-year-old Japanese woman presented with an enlarged and ulcerated tumor and some pigmented papules on her face. The histological examination revealed the tumor and papules to be basal cell epithelioma. In addition, some pits were also observed on her palms. X-ray examinations showed multiple jaw cysts, and the calcification of the falx cerebri. According to these findings, this case was diagnosed to be BCNS. To prevent the development of basal cell epithelioma, BCNS should be diagnosed at an early stage and observed for a long follow-up.
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  • An Infant Case of Lymphomatoid Papulosis
    Mahito KOMATSU, Shirou KOSEKI
    2002 Volume 64 Issue 3 Pages 308-310
    Published: June 01, 2002
    Released on J-STAGE: September 02, 2010
    DOIhttps://doi.org/10.2336/nishinihonhifu.64.308
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    A 12-year-old male was referred to us with a half-month history of two nodules on his face. Biopsy spicemens showed the presence of a diffuse infiltrate of atypical lymphocytes which were CD30 (+). These lesions were diagnosed to be Lymphomatoid Papulosis.
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  • Marked Eosinophilia Induced by Recombinant Human Interleukin-2
    Junichi FURUTA, Yoshihiro UMEBAYASHI
    2002 Volume 64 Issue 3 Pages 311-314
    Published: June 01, 2002
    Released on J-STAGE: September 02, 2010
    DOIhttps://doi.org/10.2336/nishinihonhifu.64.311
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    A 79-year-old man developed a red tumor measuring about 2cm in diameter on his left lower leg. A biopsy specimen showed typical features of angiosarcoma. Magnetic resonance imaging revealed five additional tumors in his left thigh muscles. We resected the tumor in the lower leg and performed radiotherapy for the intramuscular tumors on his thigh. In addition, we started the intravenous infusion of recombinant human interleukin-2 (rIL-2) at a daily dose of 400,000U. Ten days later the dosage was doubled. Twenty-five days after the start of treatment with rIL-2, the eosinophil counts increased to 68% (9452/μl) of the WBC counts. The serum IL-5 level was 15.6pg/ml, and the eosinophil cationic protein (ECP) was 77.2μg/l: which both exceeded the upper limits of normal variation. The serum IL-4 level was within the normal range. After the cessation of rIL-2, the eosinophil counts, IL-5 and ECP returned to the normal level. The IgE values remained unchanged. These findings suggest that the eosinophilia during rIL-2 therapy was associated with an elevation in the serum IL-5 level, while rIL-2 did not induce the IL-5-producing-cells to produce IL-4.
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  • Eccrine Porocarcinoma
    —Immunohistochemical Analysis of Keratin Expression—
    Mikako MORIYA, Yoshihiro UMEBAYASHI, Eiko ICHIKAWA
    2002 Volume 64 Issue 3 Pages 315-317
    Published: June 01, 2002
    Released on J-STAGE: September 02, 2010
    DOIhttps://doi.org/10.2336/nishinihonhifu.64.315
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    A 73-year-old woman noticed a reddish tumor measuring 23×24mm on her right leg. A histological examination showed the tumor to be connected to the epidermis while it also proliferated into the reticular dermis. It was mainly composed of atypical poroid cells forming many tubular structures. An immunohistochemical examination using monoclonal antikeratin antibodies showed the tumor cells to express both differentiated keratins (34βB4, DE-K10) and simple epithelial keratins (CY-90, M20, RCK108). This keratin expression pattern is differrent from the immunoreactivities of eccrine poroma, and eccrine porocarcinoma that have been previously reported. Presumably, this tumor developed this unique keratin expression pattern during malignant transformation.
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  • A Fatal Case of “Mamushi” Viper (Agkistrodon Halys Blomhoffii) Bite
    Takashi GYOTOKU, Atsusi KAGUTHI, Kihou KIYOI, Atsusi NAKAMURA, Youko S ...
    2002 Volume 64 Issue 3 Pages 318-322
    Published: June 01, 2002
    Released on J-STAGE: September 02, 2010
    DOIhttps://doi.org/10.2336/nishinihonhifu.64.318
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    We report a fatal case of “Mamushi” viper bite. A 70-year-old woman was bitten by a “Mamushi” viper while she was picking flowers in the mountains. She went to the nearest hospital and was diagnosed to have an “insect bite”. She came to our hospital 34 hours later. Her right arm was swollen and she demonstrated hypothermia and oliguria. She was treated by antivenin, cephalantine, artificial hemodialysis, plasma exchange, and so on. However, she died on 8th day. We thereafter performed an autopsy. The patient showed signs of enterobrosis. We concluded that the cause of her death was MOF due to DIC by the venom. We also discuss and describe the standard therapy for “Mamushi” viper bites.
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  • A Case of Trichophytia Profunda Acuta of the Terminal Hair
    Seiji WATANABE, Masako KAWASAKI, Takashi MOCHIZUKI, Hiroshi ISHIZAKI
    2002 Volume 64 Issue 3 Pages 323-326
    Published: June 01, 2002
    Released on J-STAGE: September 02, 2010
    DOIhttps://doi.org/10.2336/nishinihonhifu.64.323
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    We report a case of trichophytia profunda acuta of the genitals, the groin and the lower abdomen in regions with thick body hair. The patient, a 49-year-old man, had applied fluocinonide ointment to the affected areas for 6 months. Tinea pedis was also noticed. From cultivation of a biopsy specimen and from scales removed from the infected areas, the fungus was identified as Trichophyton rubrum. The symptoms resolved after 4 weeks of oral administration of Terbinafin at a dose of 125mg/day.
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Review
Statistics
  • Statistical Analyses of Skin Diseases in Children over the Past Twenty Years at the Department of Dermatology, Asahikawa Medical University
    Yumi SASAJIMA, Hajime IIZUKA
    2002 Volume 64 Issue 3 Pages 337-343
    Published: June 01, 2002
    Released on J-STAGE: September 02, 2010
    DOIhttps://doi.org/10.2336/nishinihonhifu.64.337
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    Statistical analyses were performed on skin diseases in children presenting over the past twenty years (1977-1996) at the Department of Dermatology, Asahikawa Medical University. The subject consisted of 8,374 children who were under fifteen years of age who visited the outpatient dermatology clinic of Asahikawa Medical University. Childern accounted for about 26% of all new outpatients. The overall male-female ratio was 1 : 1.1 but it was 1 : 1.4 in childern over eleven years of age. Primary school and junior high school children visited the outpatient clinic more frequently in January, March and August, which corresponded with the school vacation seasons. Eczema/dermatitis was most frequently observed and the overall incidence was 54.4%. Among the eczema/dermatitis atopic dermatitis was most frequently seen and the percentage was about 46% of the eczema/dermatitis child outpatients over age five. Viral infectious skin diseases were more frequently seen in primary school children. In junior high school children, nevus/phacomatosis and acne vulgaris were more frequently seen. The relationship between school health and non-infectious skin diseases is also discussed.
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  • Frequency of Infection Caused by Staphylococcus Aureus and Its Antimicrobial Susceptibility in Dermatology Compared with Other Clinics
    Shigeruko IIJIMA, Yoshikazu NANNO, Masako TAKEDA, Masaru SUZUKI
    2002 Volume 64 Issue 3 Pages 344-350
    Published: June 01, 2002
    Released on J-STAGE: September 02, 2010
    DOIhttps://doi.org/10.2336/nishinihonhifu.64.344
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    We analyzed Staphylococcus aureus (S. aureus) isolated at the Mito Saiseikai General Hospital from January to December 2000, in order to understand the frequency of infection caused by this pathogen and its antimicrobial susceptibility in both dermatology clinics and other respective clinics. A total of 728 strains of S. aureus were cultured during this period, when we counted one strain per patient. Among them, 259 strains (35.6%) were MRSA. Of the 259 strains, 72 (27.8%) were cultured from dermatology patients, 67 (25.9%) in internal medicine patients and 41 (15.8%) in neurosurgery patients. The susceptibility ratio to MRSA for each antibiotic was quite different among the respective clinics. The ratio of GM was more than 60% in internal medicine, neurosurgery and surgery, while the ratio of MINO was more than 70% in dermatology, orthopedics and surgery. The ratios of LVFX, OFLX and CLDM were more than 50% only in dermatology. We further analyzed 102 strains of S. aureus isolated in the dermatology outpatient clinic from July to September 2000. A total of 68 strains were from patients with impetigo contagiosa, whose isolation ratio of MRSA was 32.4%. The susceptibility ratios of GM, CAM and MINO in impetigo contagiosa were 30.4%, 37% and 100% in MSSA, whereas, those in MRSA were 4.5%, 9.1% and 95.5%. In addition, 12 strains of MRSA showed a 100% susceptibility ratio to co-trimoxazole.
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