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Volume 71, Issue 1
Displaying 1-17 of 17 articles from this issue
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Color Atlas
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Ai MEMEZAWA, Takashi MASU, Katsuko KIKUCHI, Setsuya AIBA2009 Volume 71 Issue 1 Pages 1-2
Published: February 01, 2009
Released on J-STAGE: April 21, 2009
JOURNAL RESTRICTED ACCESSDownload PDF (1190K)
Mini Review
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The Penetration through Blood-brain Barrier Measured by PETKazuhiko YANAI, Manabu TASHIRO, Nobuyuki OKAMURA2009 Volume 71 Issue 1 Pages 3-6
Published: February 01, 2009
Released on J-STAGE: April 21, 2009
JOURNAL RESTRICTED ACCESS
Clinical Case Reports
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Kae ASAO, Yasuko KOJO, Atsushi NAKAMURA2009 Volume 71 Issue 1 Pages 7-10
Published: February 01, 2009
Released on J-STAGE: April 21, 2009
JOURNAL RESTRICTED ACCESSThe patient was a 33-year-old male with chronic nephritis and hypertension. He had been administered an antiplatelet agent and calcium antagonist. Painful subcutaneous indurations appeared on his extremities in June 2000. He was diagnosed as having thrombophlebitis and treatment with warfarin was begun. However, after two months of such treatment, there was no improvement. Therefore, he was referred to our hospital. Many funicular subcutaneous indurations were observed, and histopathological examination supported the diagnosis of thrombophlebitis. No ocular lesion was observed. One month later, he gradually developed arthralgia, stomatitis, glans penis erosion and erythema nodosum. At that time, he was diagnosed as having Behçet's disease. Treatment with oral colchicine was very effective. However, because of liver dysfunction, we reduced the dose of colchicine and used it in combination with prednisolone. At present, his symptoms are still being controlled with this drug regimen.View full abstractDownload PDF (1224K) -
Yukako TAKANO, Takao TUBONE, Mizuki GOTO, Aiko KATO, Kazumoto KATAGIRI ...2009 Volume 71 Issue 1 Pages 11-16
Published: February 01, 2009
Released on J-STAGE: April 21, 2009
JOURNAL RESTRICTED ACCESSA 56-year-old man with bilateral erythema on his cheeks, presented at our hospital in 1996. He was diagnosed as having discoid lupus erythematosus. Since then, he has not presented with the complaint. In 2005, subcutaneous nodules appeared on his right cheek and left thigh. Because the thigh lesions gradually become painful, he consulted a nearby orthopedist. MRI results suggested localized myositis of his left thigh that might be related to the subcutaneous nodule, and he was referred to our hospital. We diagnosed both the lesions of his right cheek and his left thigh as lupus erythematosus profundus, based on biopsy and MRI findings. The biopsy from his left gracilis muscle showed that the muscle and the fascia were gray in color, and revealed myositis and fibrotic changes of the muscle. Although the levels of creatinine kinase, aldolase, and myoglobin were high intermittently, muscle weakness of the bilateral upper limbs and right lower leg, dysphagia, and other general symptoms were not found. In 2007, tests for anti-Sm antibody and anti-U1-RNP antibody became positive. However, systemic involvement of the lung or kidney were not detected. The deep inflammatory changes of lupus erythematosus profundus reached to the underlying muscle, which resulted in the fibrotic changes.View full abstractDownload PDF (1521K) -
Mutsumi OHMORI, Kazunori URABE, Jun TSUJITA, Hiroshi UCHI, Futoshi KOH ...2009 Volume 71 Issue 1 Pages 17-20
Published: February 01, 2009
Released on J-STAGE: April 21, 2009
JOURNAL RESTRICTED ACCESSA 73-year-old female presented with an 8-month history of blue-gray discoloration of her skin. Discoloration first appeared on the median region of the face, and gradually expanded to the body and palms. Physical examination revealed blue-gray discoloration on her face, chest, upper back, and lateral region of her palms. Histopathological examination showed small black granules scattered in the basal lamina of the eccrine sweat glands and hair follicles. Through careful history taking, she was found to have used a mouthwash containing silver nitrate daily for 3 years for the treatment of oral ulcers. These findings led us to diagnose this case as argyria. The generalized discoloration did not change during the 3-year follow-up period.View full abstractDownload PDF (1246K) -
Ai KURAOKA, Toshihumi YAMAOKA, Fumihide OGAWA, Shinichi SATO, Hanako S ...2009 Volume 71 Issue 1 Pages 21-25
Published: February 01, 2009
Released on J-STAGE: April 21, 2009
JOURNAL RESTRICTED ACCESSWe report a 32-year-old female patient with palmoplantar pustulosis (PPP) accompanied by severe osteoarthropathy. Chronic sinusitis had been detected 3 months before her visiting our hospital. She had red papules on her palms and severe pain in her right buttock 3 weeks before her visiting our hospital. Because of the ambulation difficulty caused by severe pain in her buttock and the pustules appeared on her palms, she consulted our hospital for further investigation in April, 2007. MRI findings and sterile pustules on her palms indicated the diagnosis of pustulotic arthroosteritis (PAO). At first, the symptoms of skin and osteoarthropathy improved by oral administrations of antibiotics for the treatment of chronic sinusitis and salazosulfapyridine for the arthralgia. Because of the exacerbation of arthralgia after muscle rehabilitation, additional tonsillectomy was performed, resulting in improvement of walking. It has been reported that PPP patients who had severe sacroiliitis or spodylitis with ambulation difficulty were almost 30-year-old females. The treatment of PAO has not been established yet. However, in many cases, tonsillectomy has been shown to be effective, even if the oral administration of drugs do not relieve the symptoms of arthralgia that interrupt their daily life. Therefore, tonsillectomy should be considered for the treatment of PAO with severe and refractory symptoms.View full abstractDownload PDF (1252K) -
Arifumi MITANI, Yoichi SHINTANI, Iwao ISOMURA, Akimichi MORITA2009 Volume 71 Issue 1 Pages 26-29
Published: February 01, 2009
Released on J-STAGE: April 21, 2009
JOURNAL RESTRICTED ACCESSA 72-year-old woman who experienced palmar erythema 2 months earlier presented at her first visit with fever and erythema that had expanded to her whole body. Based on the clinical and pathologic findings, the patient was diagnosed with generalized pustular psoriasis. Treatment with psoralen plus ultraviolet A photochemotherapy (PUVA therapy), etretinate, and cyclosporine resulted in clinical and symptomatic improvement and the skin eruptions were well controlled with only topical Vitamin D3 for 5 years. The patient then experienced a sudden relapse of the disease with multiple pustules extending over the whole trunk and legs. Due to the patient's impaired liver function, treatment with etretinate and cyclosporine were discontinued upon hospitalization. We thus selected PUVA therapy, which resulted in only partial improvement. Narrowband ultraviolet B (NB-UVB) therapy was used for further treatment. After 17 sessions of NB-UVB therapy, the eruptions were well regressed. These results indicate that NB-UVB therapy is effective for patients with generalized pustular psoriasisView full abstractDownload PDF (1181K) -
Sachiko ODA, Hiroshi OKITA, Yoichiro HAMASAKI, Atsushi HATAMOCHI, Soji ...2009 Volume 71 Issue 1 Pages 30-32
Published: February 01, 2009
Released on J-STAGE: April 21, 2009
JOURNAL RESTRICTED ACCESSA 10-year-old boy had a 2-year history of a mobile subcutaneous nodule on his right lower leg. He had no pain or tenderness. He and his family agreed to resection of the nodule, which was removed easily. Histopathologically, the nodule was composed of mature fat tissue encapsulated by a thick collagenous capsule. All previous cases under the age of 20 years had a history of trauma related to sports. Our case belonged to a soccer team, and repeatedly had injuries to his lower legs. This may be related to the appearance of this disease.View full abstractDownload PDF (1116K) -
Ikumi NAKAMURA, Kiyohito TAIRA, Yutaka ASATO, Yoshiko MINE, Shigetaka ...2009 Volume 71 Issue 1 Pages 33-37
Published: February 01, 2009
Released on J-STAGE: April 21, 2009
JOURNAL RESTRICTED ACCESSA 57-year-old man had been aware of a verrucous nodule, 2-3 cm in size, on the left buttock since childhood. The nodule increased in size and formed an ulcer in November 2006. He ignored it for a while. Then in March 2007 he visited a nearby physician because of difficulty in sitting. Biopsy revealed a well-differentiated squamous cell carcinoma (SCC), and he was referred to our hospital immediately. Physical examination revealed a tumor on his left buttock, 130×90×15 mm in size, with ulcerations and an irregular surface. It bled easily and was surrounded by a scar. He had complained of general fatigue recently. Results of laboratory examination indicated hypercalcemia and elevations of parathyroid hormone-related protein (PTH-rP) and SCC-related antigen. QuantiFERON-TB2G (QFT) was positive. Administration of pamidronate (bisphosphonate) and elcatonin with fluid infusion normalized serum calcium values. The tumor was excised, and chemotherapy was performed. No recurrence or metastasis of the tumor has been detected 11 months after the operation. Postoperative histopathological examination revealed caseation granuloma with Langhans giant cells in the lymph nodes in the pelvic cavity. This fact, together with the atrophic scar around the tumor, suggested the diagnosis of tubercular lymphadenitis and tuberculosis cutis. We considered that the etiological factors of the SCC in this patient might involve tubercular diseases.View full abstractDownload PDF (1398K) -
Takeo SHIGA, Maki YOKOGAWA2009 Volume 71 Issue 1 Pages 38-41
Published: February 01, 2009
Released on J-STAGE: April 21, 2009
JOURNAL RESTRICTED ACCESSCase 1: A 65-year-old woman had had a subcutaneous tumor in her right breast for two years. The tumor had enlarged slowly and disintegrated, with bleeding and fetor. She was diagnosed as having stage IV breast cancer with multiple lung and bone metastases. The tumor was inoperable, and she consulted our clinic for treatment of the skin lesion. We treated her with Mohs' paste, resulting in successful relief of bleeding, pain, exudation and fetor from the tumor. Metronidazole ointment was also effective for the exudation and fetor. Case 2: A 61-year-old woman presented with skin invasion of breast cancer. The skin lesion also dramatically improved following treatment with Mohs' paste and metronidazole ointment. In both cases, the tumor was not only reduced in volume but exudation and fetor were suppressed. Skin cancer or metastatic skin cancer with exudation, bleeding, and fetor greatly diminishes patients' QOL. Thus, treatment with Mohs' paste and metronidazole ointment can improve QOL for patients with devastating skin cancer.View full abstractDownload PDF (1170K) -
Michifumi KAWAMOTO, Shuei SATO, Tomoko YASUMATSU, Masaki OISHI, Mizuki ...2009 Volume 71 Issue 1 Pages 42-47
Published: February 01, 2009
Released on J-STAGE: April 21, 2009
JOURNAL RESTRICTED ACCESSA 76-year-old man with chronic renal failure underwent resection of malignant melanoma on his left shoulder and lymphadenectomy (Stage IIIC) followed by DAV-Feron therapy. Four and half years after surgery, serum levels of 5-S-cysteinyldopa (CD) increased. Intensive examinations by positron emission tomography-CT and CT scan revealed no metastatic lesions. Six months later, he felt general fatigue due to ascites. Cytology of the ascites revealed S-100 protein and HMB-45 positive atypical cells containing melanin granules, which indicated peritoneal dissemination of malignant melanoma. The level of 5-S-CD was 9598 ng/ml. He was treated with a combination of paclitaxel and carboplatin (PC therapy), which would be protective for his residual renal function. PC therapy relieved his symptoms, and the 5-S-CD levels were decreased for a one-year period without adverse effects on renal function. However, PC therapy was discontinued due to a decrease in effectiveness and an intolerable peripheral neuropathy, which is a side effect of paclitaxel. The subsequent treatment, which was based on DAC-Tam therapy in which carboplatin was used instead of cisplatin, had little effect. The patient died 18 months after the diagnosis of peritoneal dissemination. At no time before his death was metastasis found anywhere except in the peritoneal cavity. Metastasis to the peritoneal cavity should be considered in patients with malignant melanoma who have high levels of 5-S-CD when metastatic lesions cannot be found by routine examination.View full abstractDownload PDF (1299K) -
Hiromi SHIBUYA, Susumu TAKAYASU, Takashi SATO2009 Volume 71 Issue 1 Pages 48-52
Published: February 01, 2009
Released on J-STAGE: April 21, 2009
JOURNAL RESTRICTED ACCESSA 50-year-old male presented with abrupt onset of abdominal pain. Enhanced CT scan of the abdomen revealed dissection of the proximal superior mesenteric artery (SMA), but no obstruction of the distal SMA. He received infusions of normal saline and glucose, and antibiotic therapy with CEZ was commenced. On the sixth day of admission, the distal portions of his extremities became cyanotic, with a systolic arterial blood pressure of 60 mmHg. He was ventilated, and transferred to the intensive care unit. Although he remained hemodynamically stable during the following 24 h, blue hemorrhagic lesions appeared on the bilateral hands and feet. Fingers, toes and tip of the nose became gangrenous. Hemorrhagic bullae appeared on his left forearm. Cultures of blood, skin and stool yielded Citrobacter freundii. The cutaneous lesions were considered to be induced by sepsis, probably due to bacterial translocation. Forearms and right lower leg eventually became gangrenous. Amputation of these three extremities was performed on the 19th day of admission. Histological examination of the hemorrhagic skin revealed swelling and necrosis of endothelial cells of capillaries and thrombus of small blood vessels with extravasation of erythrocytes. Both the posterior tibial artery and vein were thrombosed. Two months after admission, he died of multiple organ failure and cytomegalovirus infection. Autopsy confirmed dissection of the SMA without necrosis of intestines. To our knowledge this is the first case of purpura fulminans with sepsis caused by Citrobacter freundii.View full abstractDownload PDF (1401K)
Statistics
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Hidekazu SHINODA, Hanako SEKIYAMA, Katsutaro NISHIMOTO2009 Volume 71 Issue 1 Pages 53-56
Published: February 01, 2009
Released on J-STAGE: April 21, 2009
JOURNAL RESTRICTED ACCESSIn this paper, we review the 100 cases of infection with Trichophyton tonsurans presented at our clinic between January 2004 and April 2008. The patients were 9 schoolchildren, 33 junior high school students, 52 high school students, and 6 sports instructors. The male : female ratio was 92 : 8. Most patients were practitioners of martial arts (Judo 85, wrestling 8, Sumo 1), but two patients did not belong to any sports organization and had the fungus transmitted from a friend or an older brother. Clinical types were as follows: 29 cases of tinea capitis (16, black dot ringworm (BDR); 8, pityriasis-like, and 5, inflammation), 75 of tinea corporis, 2 of tinea manum, and 8 carriers. Patients with tinea corporis mainly displayed light red freckles or annular erythema. Compared to cases with singular lesions, tinea corporis patients with multiple lesions had a larger degree of comorbidity with tinea capitis and hairbrush (HB) positivity. Among the latter, those who had more than 90 colonies (90 is the maximum number of bristles on the hairbrush we used) determined by the HB method had a greater tendency to have tinea capitis. All cases were successfully treated with oral administration of griseofulvin.View full abstractDownload PDF (1019K)
Therapy
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Yumiko KUBOTA, Juichiro NAKAYAMA, A-DERMA EXOMEGA® Cre ...2009 Volume 71 Issue 1 Pages 57-62
Published: February 01, 2009
Released on J-STAGE: April 21, 2009
JOURNAL RESTRICTED ACCESSThis study was conducted to evaluate the usefulness and safety of A-DERMA EXOMEGA® cream, a skin cream containing Avena Rhealba® (Oat) kernel extract, evening primrose oil and niacinamide. The present study enrolled 68 patients suffering from dry skin disorders such as xeroderma and asteatotic dermatitis. The results showed improvement in dry skin, pruritus and scales was observed in -98% of the patients after four weeks of use, while the visual analog scale (VAS) scores for dryness and pruritus were significantly improved after two weeks of use (p < 0.001). Overall improvement after four weeks was 98.4%, general safety was 100%, and usefulness was evaluated as somewhat useful or better by 100% of the patients. In a survey of dermal sensation during use, nearly all of the patients evaluated the preparation as not causing a taut sensation, leaving a moist feeling on the skin, working easily into the skin and being free of any undesirable odor, and 96.0% of the patients indicated a desire to continue using the preparation. On the basis of these findings, this preparation was determined to be a skin care product that is both safe and useful for treatment of dry skin and pruritus among patients with dry skin disorders while also having a pleasant feel during use.View full abstractDownload PDF (1813K) -
Hidetoshi TAKAHASHI, Hitomi TSUJI, Hajime IIZUKA2009 Volume 71 Issue 1 Pages 63-69
Published: February 01, 2009
Released on J-STAGE: April 21, 2009
JOURNAL RESTRICTED ACCESSWe compared results of the application of cyclosporine A (NEORAL®) 3 mg/kg/once per day (group A) and 4 mg/kg/twice per day (group B) in 15 patients in group A and 15 patients in group B with severe or moderate psoriasis vulgaris. Rapid improvement of psoriatic skin lesions was achieved in both groups, and significant improvement was observed at 2 weeks. Although the PASI score in each group was below 5 at the end of the study, there was no significant difference between the two groups. A questionnaire administered to patients regarding skin manifestations, QOL, and satisfaction before and after the study indicated that the patients recognized a significant improvement after cyclosporine A treatment. No severe side effects occurred during this study. Thus, we concluded that treatment with 3 mg/kg/once per day of cyclosporine A was effective and was more economical than the larger dose for severe and moderate psoriasis vulgaris.View full abstractDownload PDF (1417K) -
—Based on the Results of Post-marketing Surveillance—Toshio KUSUNOKI, Kaori HOZUMI, Tatsuya OGURA, Takumi KOBAYASHI, Fumiya ...2009 Volume 71 Issue 1 Pages 70-78
Published: February 01, 2009
Released on J-STAGE: April 21, 2009
JOURNAL RESTRICTED ACCESSItraconazole (Itrizole® Capsule 50) is a triazole antifungal agent that is synthesized by the Belgian company, Janssen Pharmaceutica. In February 2004, itraconazole pulse therapy was approved for the treatment of onychomycosis in Japan. Itraconazole pulse therapy consists of a cycle of 400 mg/day for 1 week, followed by a three-week cessation period, and the cycle is repeated three times. A post-marketing surveillance study of patients with onychomycosis was conducted to assess the efficacy and safety of itraconazole pulse therapy. The overall efficacy rate in 1,051 patients included in the efficacy analysis was 84.3%. An efficacy rate of 80% or more was shown in infected site, primary/recurrent infection, thickness, opacity ratio, etc., regardless of the condition or severity of onychomycosis. Among the 2,394 patients included in an analysis of the completion of therapy rate, 93.0% of the patients completed three cycles of itraconazole administration. Among 2,532 patients included in the safety analysis, adverse drug reactions were reported in 288 cases (11.4%), but most adverse drug reactions were expected mild abnormalities in laboratory test values. Based on these results, we confirmed the favorable efficacy and safety of pulse therapy with Itrizole® Capsule 50 for the treatment of onychomycosis.View full abstractDownload PDF (1755K)
Dermatologists around the World
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Katsumi HANADA2009 Volume 71 Issue 1 Pages 93-94
Published: February 01, 2009
Released on J-STAGE: April 21, 2009
JOURNAL RESTRICTED ACCESSDownload PDF (1080K)
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