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Volume 67 (2005)
- Issue 6 Pages 561-
- Issue 5 Pages 447-
- Issue 4 Pages 317-
- Issue 3 Pages 195-
- Issue 2 Pages 91-
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Volume 67, Issue 6
Displaying 1-19 of 19 articles from this issue
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Color Atlas
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Yuichi YOSHIDA, Noriko YASAKA, Ayako NAKAZONO, Noriko SATO, Minao FURU ...2005 Volume 67 Issue 6 Pages 561-562
Published: 2005
Released on J-STAGE: April 14, 2006
JOURNAL RESTRICTED ACCESSDownload PDF (996K)
Clinical Case Reports
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Takeshi ISHIGAMI, Koji TSUJIGAMI, Kiyoshi TATARA, Keisuke SAEKI2005 Volume 67 Issue 6 Pages 563-565
Published: 2005
Released on J-STAGE: April 14, 2006
JOURNAL RESTRICTED ACCESSA 38-year-old woman with spina bifida was referred to our clinic because she had developed a painful, rapidly enlarging ulcer around a stoma. She had undergone a temporary descending colostomy for ileus at 6 years of age and was diagnosed as having ulcerative colitis in October 2000. Physical examination revealed a 15×30cm ulceration around the stoma. The border of the ulcer was erythematous and well demarcated. The diagnosis of peristomal pyoderma gangrenosum (PG) was made clinically. She was treated with prednisone (40mg/day) and topical wound care. Dramatic improvement was observed in a week, and the ulcer was completely healed in 40 days. Although reports of peristomal PG are rare in the Japanese literature, dermatologists should keep it in mind.View full abstractDownload PDF (825K) -
Takashi IWAMOTO, Masato KIDOU, Tomomichi ONO2005 Volume 67 Issue 6 Pages 566-568
Published: 2005
Released on J-STAGE: April 14, 2006
JOURNAL RESTRICTED ACCESSMany diseases, such as bullous diseases or blood dyscrasias, can cause blood blisters or bullas on the oral mucosa. In 1967, Badham used the term “angina bullosa haemorrhagica” (ABH) to describe blood blisters on the oral mucosa unrelated to such diseases. This paper presents a case of ABH in a 48-year-old man. Though ABH is benign and not life-threatening, and in our case the lesion healed without scarring within 5 days, there is a report in which ABH caused respiratory obstruction. Therefore, we must be careful when a patient presents with this condition.View full abstractDownload PDF (398K) -
Tessin WATANABE, Masahisa SHINDO, Yoshitaka HAGARI, Osamu YAMAMOTO, Mo ...2005 Volume 67 Issue 6 Pages 569-571
Published: 2005
Released on J-STAGE: April 14, 2006
JOURNAL RESTRICTED ACCESSWe report Japanese sisters (2-year-old and 4-year-old girls) presenting with a linguiform spindle-shaped, small nodule at the base of the perianal area. The nodule in each infant appeared just after birth. Based on the history and characteristic clinical features, we diagnosed the nodule as infantile perianal pyramidal protrusion (IPPP). The lesions have been gradually disappearing without any treatment. Cases of IPPP in sisters are thought to be very rare. It is suggested that the occurrence of IPPP is related to hereditariness or habits with regard to hygiene in infant care.View full abstractDownload PDF (429K) -
Yoshiko MATSUSHITA, Makoto INAOKI, Wataru FUJIMOTO2005 Volume 67 Issue 6 Pages 572-575
Published: 2005
Released on J-STAGE: April 14, 2006
JOURNAL RESTRICTED ACCESSFolliculosebaceous cystic hamartoma (FSCH) is a recently recognized cutaneous hamartoma comprising follicular, sebaceous, and mesenchymal elements. We report a 27-year-old male with FSCH. Since the age of 11 years, the patient had had two soft, cystic nodules, one composed of several small brown papules on the left thigh and the other comprised of small reddish brown nodules on the left inguinal region. Occasionally these lesions ruptured with some discharge. Histopathological examination of the excised nodules showed an infundibular cystic structure surrounded by numerous sebaceous lobules, laminated fibroplasia around it, and an increased number of small venules, adipocytes and eccrine duct-like structures in the mesenchyme. FSCH usually presents as a solitary nodule on the face or head. Our case is rare in that FSCH presented as inguino-crural nodulocystic lesions.View full abstractDownload PDF (900K) -
Akari TASHIRO, Shinichi IMAFUKU, Hiromaro KIRYU, Mari NAKAMORI2005 Volume 67 Issue 6 Pages 576-579
Published: 2005
Released on J-STAGE: April 14, 2006
JOURNAL RESTRICTED ACCESSWe describe a 68-year-old man who presented with a gradually growing nodule on the right cheek. Upon examination, the nodule was sharply demarcated, 1.5×1 centimeter in size with partial erosion on its surface. The nodule was totally resected with a clinical diagnosis of sebaceous adenoma. Histologically, the lesion was sharply circumscribed and had a symmetrical silhouette. The nodule was mainly composed of basophilic cells and sebocyte-like cells with vacuolated cytoplasm, both showing nuclear atypia and frequent mitoses. Immunohistochemical studies revealed the tumor cells to be positive for AE1/AE3, EMA, and MIB1 and negative for S-100 protein. Based on these findings, we diagnosed our case as sebaceous carcinoma. Classification of neoplasms with sebaceous differentiation has not been established yet. However, it is judicious to consider that our case should be included in the category of low-grade sebaceous carcinoma that was proposed in 2002.View full abstractDownload PDF (1629K) -
Ryutaro YOSHIKI, Koji MURATA, Yoshiki TOKURA, Hiroshi YASUDA, Masanori ...2005 Volume 67 Issue 6 Pages 580-583
Published: 2005
Released on J-STAGE: April 14, 2006
JOURNAL RESTRICTED ACCESSA 70-year-old woman was noticed to have a bald area on the right temporal scalp on birth. A crusty and ulcerative change occurred on the area at the age of 62 years. The ulcer was gradually enlarged with exudates and odor. On our first examination, the patient had a large ulcer, 30×20 cm in diameter, on the right temporal scalp. From a biopsy specimen, a tentative diagnosis of basal cell carcinoma was made. The tumor was totally excised and the defect was reconstructed with the anterolateral-anteromedial thigh flap. The excised specimen revealed that there were clear cells possessing vaculoles in the tumor lobules, suggestive of the diagnosis of sebaceous carcinoma. One year and 4 months after the operation, the tumor recurred locally.View full abstractDownload PDF (1023K) -
Tadamasa YAMAMOTO, Sachiko TAKEICHI, Daisuke FUKUMOTO, Hirotsugu TAKIW ...2005 Volume 67 Issue 6 Pages 584-589
Published: 2005
Released on J-STAGE: April 14, 2006
JOURNAL RESTRICTED ACCESSWe report two cases of giant basal cell carcinoma (BCC) arising on the vulva. Case 1: An 84-year-old woman presented with a black-to-brown, ulcerated pigmented tumor, 8 cm in diameter, around the vulva. The tumor invaded into the vagina and distal part of the rectum. After partial excision, the residual tumor was irradiated with 40 Gy of X-ray in total. No recurrence has been observed thus far for 17 months. Case 2: An 81-year-old woman had a black-to-red, ulcerated huge tumorous lesion on the area from the genitalia to the anus, which was composed of many various-sized small tumors. Swelling of lymph nodes was also noted in the bilateral inguinal regions. Following her wish for non-surgical treatment, a total dose of 60 Gy of X-ray was irradiated. No recurrence had been found, although she died of septic DIC of unknown origin 15 months after her first visit to our clinic. We also review previous reports of giant BCC on the vulva in terms of size, metastasis, and radiation therapy administered.View full abstractDownload PDF (1218K) -
Mitsutaka NAKAMURA, Yumiko UMEBAYASHI, Takao UCHIHIRA, Toshiaki KAMEI, ...2005 Volume 67 Issue 6 Pages 590-593
Published: 2005
Released on J-STAGE: April 14, 2006
JOURNAL RESTRICTED ACCESSWe report two cases of angioleiomyoma. The first patient was a 74-year-old female who noticed a tender nodule on her left fifth finger three months prior to the presentation. There was a 4 mm subcutaneous nodule and the mobility was good. The second patient was a 63-year-old male who noticed a nodule on his right sole four months prior to the presentation which had no pain and no growth in size. There was a 12 mm subcutaneous nodule which had no pain and the mobility was good. Tumorectomy was performed under local anesthesia to both patients and both were diagnosed angioleiomyoma histopathologically. No recurrence has been seen in both patients. We discuss the reason of the pain in two cases histopathologically, and report statistical findings from cases in Japan.View full abstractDownload PDF (816K) -
A Case of Staphylococcal Scalded Skin Syndrome and Septicemide in a Woman with Chronic Renal FailureMiho OGATA, Junji NAKAFUSA, Kotaro NAGASE, Yoshihiro MIURA, Noriyuki M ...2005 Volume 67 Issue 6 Pages 594-598
Published: 2005
Released on J-STAGE: April 14, 2006
JOURNAL RESTRICTED ACCESSA 53-year-old woman with chronic renal failure presented with erubescence surrounding the mouth, erosion on the lips, an erubescent erosion on the axilla, and erythema and flaccid pustules on the right hand. Nikolsky sign was present. Palpable purpura was also noted on the legs. We assigned the diagnosis of septicemia based on constitutional symptoms, fever and active inflammation. Staphylococcus aureus producing exfoliative toxin A was isolated from a focus of infection on the forehead. Because a biopsy taken from a pustule on the right hand showed epidermal cleavage through the granular layer, we diagnosed staphylococcal scalded skin syndrome (SSSS). A biopsy taken from a purpura on the leg showed thrombi within the lumen of the venules and cellular infiltration within the wall of the venules. We diagnosed the patient as having septicemia. We discuss the influence of renal insufficiency, hemodialysis and non-steroidal anti-inflammatory drug administration on risk factors for SSSS and septicemia.View full abstractDownload PDF (1319K) -
Sanae KAWAI, Shinya YAMANAKA, Tomomi FUJISAWA, Mariko SEISHIMA, Hiroki ...2005 Volume 67 Issue 6 Pages 599-603
Published: 2005
Released on J-STAGE: April 14, 2006
JOURNAL RESTRICTED ACCESSThe patient is a 61-year-old woman who lives in Ogaki City, Gifu Prefecture. After she was back from her trip in Gunma Prefecture, she noticed annular erythema with red papule centrally on her left shoulder, and then the annular erythema gradually expanded. On the first consultation, annular erythema with 40×30cm in size and the red papule at the center was found on the left shoulder. By enzyme-linked immunosorbent assay, her serum showed positive anti-Borrelia antibody. Other laboratory examination revealed no abnormal findings. The diagnosis of Lyme disease due to Borrelia garinii and/or Borrelia afzelii was made on the basis of Western blot analysis. Skin lesion disappered after 3 days by the treatment with oral doxycycline 100mg/day. In Japan, 64 cases of Lyme disease have been reported since April 1999. Although Hokkaido is the most endemic area, there are also some reports from non-epidemic area including Tokyo and Kanagawa. Therefore, it is important to consider the possibility of Lyme disease even in the non-endemic area, when the patients have annular erythema.View full abstractDownload PDF (986K) -
Kazuki YAMAGUCHI, Yumiko KUBOTA, Ryota TOKUMARU, Minao FURUMURA, Juich ...2005 Volume 67 Issue 6 Pages 604-610
Published: 2005
Released on J-STAGE: April 14, 2006
JOURNAL RESTRICTED ACCESSA 40-year-old woman was diagnosed as having systemic lupus erythematosus (SLE) in January 2004. She was then treated with prednisolone, trimethoprime-sulfamethoxazole, etc. Swelling of the lips and erosion of the oral mucosa appeared after sun exposure on May 23, 2004. Antiviral therapy was not effective, and erythemas with bulla and erosions developed on the face, palms and soles. She was admitted to our hospital on June 9 with the diagnosis of either drug-related eruptions or exacerbation of SLE. Histopathological examination revealed many necrotic keratinocytes with lymphocyte infiltration in the epidermis accompanied by liquefactive degeneration. Direct immunofluorescent findings of both the lesional and non-lesional areas showed linear staining of the epidermal-dermal junction with both IgM and C3. Systemic steroid therapy was started and the eruption subsided temporarily. Since this patient had been taking steroids for a long time, we resumed giving her one tablet of trimethoprime-sulfamethoxazole to prevent respiratory infection. Six hours after her first dose, she again developed generalized erythematous macules. Therefore, we made the diagnosis of Stevens-Johnson syndrome caused by trimethoprime-sulfamethoxazole. It is known that both anti-SS-A antibodies and ultraviolet light are sometimes associated with skin lesions of SLE. Anti-SS-A antibodies may be a risk factor for drug eruption. Anti-SS-A antibody was positive in our patient, so we suspected that the antiantibody might be associated with her eruptions.View full abstractDownload PDF (2261K) -
Nobutake YAGI, Takeo AOKI, Masamoto NAKAMURA, Shigeo NONAKA2005 Volume 67 Issue 6 Pages 611-614
Published: 2005
Released on J-STAGE: April 14, 2006
JOURNAL RESTRICTED ACCESSWe describe herein a case of toxic epidermal necrolysis resulting from ingestion of a NSAID (Phenbufen) over a duration of 2 weeks. An 81-year-old Japanese female was admitted to our hospital on 26th January 2000 with complaints of fever and erythematous and bullous skin lesions involving the whole body. Based on clinical observation, we diagnosed this case as toxic epidermal necrolysis (TEN) following a drug reaction. Consequently, systemic steroid therapy was started. After 24 hours of steroid therapy, leukocytosis was observed by examination of peripheral blood. Steroid therapy was withdrawn at once. Immunoglobulin (20g/day) therapy was administered for 5 consecutive days. The skin lesions were observed to be remarkably healed after institution of immunoglobulin therapy. In addition to immunoglobulin therapy, we provided proper aseptic surgical care, nutrition and hydration to prevent any secondary infection and maintain the patient's general condition. During her illness, the patient had also developed severe respiratory complications, and, accordingly, intensive respiratory care was provided. She was followed medically, and one month later all the skin lesions had almost healed. We reviewed our case in comparison to other reported cases in Japan with regard to immunoglobulin therapy for toxic epidermal necrolysis. Only 5 Japanese cases were reported during the past 10 years and the investigators noted that immunoglobulin therapy was the most effective therapy in their cases. Considering the above observations, we suggest that immunoglobulin therapy would be effective in treating this disease, especially in complicated cases.View full abstractDownload PDF (919K)
Review
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Shinichi SATO2005 Volume 67 Issue 6 Pages 615-623
Published: 2005
Released on J-STAGE: April 14, 2006
JOURNAL RESTRICTED ACCESSDownload PDF (994K)
Therapy
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Norito ISHII, Takashi HASHIMOTO2005 Volume 67 Issue 6 Pages 624-628
Published: 2005
Released on J-STAGE: April 14, 2006
JOURNAL RESTRICTED ACCESSWe have treated 3 pemphigus vulgaris patients who were refractory to corticosteroid monotherapy with combination therapy of prednisolone and mizoribine. The skin lesions of all 3 patients responded well, and we have been able to reduce the dose of predonisolone. Concerning the dose of mizoribine, we think that 150 mg administered in two unequal doses daily (100-50 mg) increases the concentration of mizoribine in the blood and is more effective than 150 mg administered in three equal doses (50-50-50 mg) daily.View full abstractDownload PDF (280K) -
Hiroko GOMI, Itsuro MATSUO2005 Volume 67 Issue 6 Pages 629-633
Published: 2005
Released on J-STAGE: April 14, 2006
JOURNAL RESTRICTED ACCESSatopico® oil lotion is a milky lotion-type moisturizer for use on the entire body formulated from a Camellia oil base containing no perfumes or dyes. To investigate its safety and efficacy a clinical test was performed for 4 weeks on 26 patients with dry skin. Skin symptoms such as dryness, squama, erubescence, keratotis pilaris and itching that were observed prior to the start of treatment were significantly improved on the last observation day (p<0.01). In the clinical test the formulation was found to be very useful in 38.5% of cases and useful or better in 100% of cases. No side effect was observed in any case; therefore, safety was indicated. Subjects reported this formulation to be pleasantly moist, to spread well over the skin and feel comfortable on the skin. In fact, 96.2% of patients wanted to continue to use this formulation. These results indicate that atopico® Oil Lotion is a safe and useful moisturizer for patients with dry skin diseases to use as part of normal daily skincare.View full abstractDownload PDF (410K) -
Takatoshi SHIMAUCHI, Ryosuke HINO, Yoshiki TOKURA2005 Volume 67 Issue 6 Pages 634-637
Published: 2005
Released on J-STAGE: April 14, 2006
JOURNAL RESTRICTED ACCESSNarrowband ultraviolet (UV) B (311 nm) phototherapy is effective in the treatment of psoriasis. The combination of topical agents, such as calcipotriol and steroid, with narrowband UVB enhances clearance of psoriatic plaques. Seven patients with psoriasis vulgaris were treated with narrowband UVB one to 3 times a week. Simultaneously, topical calcipotriol was applied twice daily to one half of the body whereas the other side was treated twice daily with a strong class of steroid ointment. Both treatment modalities reduced the severity score, and there was no statistical significance between these two therapies. However, in 3 of 7 patients, therapeutic effectiveness was better by calcipotriol than steroid. Superiority of steroid was not shown in any patient. No patient had an abnormal serum calcium value during the therapies. These results demonstrated that the combination of narrowband UVB with calcipotriol is safe and at least equally as effective as narrowband UVB in combination with a strong class steroid.View full abstractDownload PDF (482K) -
Yumiko KUBOTA, Juichiro NAKAYAMA2005 Volume 67 Issue 6 Pages 638-643
Published: 2005
Released on J-STAGE: April 14, 2006
JOURNAL RESTRICTED ACCESSClinical effectiveness and improvement in quality of life (QOL) were studied in 88 patients with chronic urticaria treated with an antiallergic drug, olopatadine hydrochloride. They were aged 15 years or more and treated at medical institutions in the neighborhood of Fukuoka City from July 2003 to November 2004. The severity of itching and skin symptoms were significantly reduced from day 3 after starting the medication. The treatment was effective in 80% for itching and in 86% for skin symptoms when evaluated after 2 weeks. Thereafter, maintenance treatment was started with half the dose,and it was effective in 87% for itching and in 91% for skin symptoms when evaluated after 2 weeks. The symptoms were significantly alleviated also at the maintenance dose. The questionnaire to patients on stress in daily life before and after treatment revealed the improvement of QOL with time after starting the medication. Olopatadine hydrochloride was effective to improve QOL in patients with chronic urticaria.View full abstractDownload PDF (353K) -
Hirotsugu TAKIWAKI, Yuki MIYAOKA2005 Volume 67 Issue 6 Pages 644-647
Published: 2005
Released on J-STAGE: April 14, 2006
JOURNAL RESTRICTED ACCESSASA-M2 is an instrument that measures admittance of the skin when low and high frequency alternating voltages are applied to the skin surface. This instrument records three parameters for the water content (W μS),barrier function (P%), and thickness of the stratum corneum (T μm), of which the latter two are theoretical values based on a unique equivalent circuit skin model. We evaluated the reliability of this instrument by measuring these parameters on various skin lesions (30 sites), such as atopic dermatitis, and their normal skin controls (30 sites) and tape-stripped skin (24 sites) using this instruments and two other standard machines, skin surface hygrometer SKIKON®, and DERMALAB® for transepidermal water loss (TEWL) measurement. As a result, a good correlation (r=0.76, P<0.001) was found between W and admittance values by SKIKON® on all measured data. There was also a weak but significant correlation (r=0.28, P<0.01) between P and TEWL measured with DEMALAB®. This correlation coefficient became far better (r=0.55, P<0.001) when only data on skin lesions and tape-stripped skin were selected. No significant correlation was found between P and TEWL concerning the data measured on the normal control skin, indicating that the parameter P is not so sensitive to be able to evaluate barrier function of normal skin, although it may be useful for detecting damaged barrier function in skin lesions. The absolute values of T seemed to be unreliable because of the gap between obtained data and expected values, although it tended to roughly change as it would be expected. This parameter value, therefore, should be regarded as a relative or arbitrary unit. This instrument may be suitable when a researcher who needs both skin hydration and TEWL data but cannot afford two types of instruments.View full abstractDownload PDF (488K)
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