The Nishinihon Journal of Dermatology
Online ISSN : 1880-4047
Print ISSN : 0386-9784
ISSN-L : 0386-9784
Search
Advanced search
OR
Browse
Search
Volume 72, Issue 5
Displaying 1-19 of 19 articles from this issue
Show all abstracts
    • |<
    • <
    • 1
    • >
    • >|
Color Atlas
Clinical Case Reports
  • Psoriatic Arthritis Significantly Improved by Methotrexate
    Yumiko KUBOTA, Juichiro NAKAYAMA, Hiroshi JOJIMA, Hitoshi NAKASHIMA
    2010 Volume 72 Issue 5 Pages 447-451
    Published: September 15, 2010
    Released on J-STAGE: November 19, 2010
    DOIhttps://doi.org/10.2336/nishinihonhifu.72.447
    JOURNAL RESTRICTED ACCESS
    Show abstractHide abstract
    A 36-year-old male Japanese factory worker had developed erythema with scales on the scalp, and pain and swelling of the distal interphalangeal joint (DIP) of his third finger since 1999. In 2007, both of his thumbs and his right third finger became swollen with pain. In 2008, swelling of both fourth toes, difficulty of flexion of his right fingers, and subungual pustules appeared. He visited our hospital for pain and deformities of the nails and IP joints. Laboratory examination revealed the following : WBC 8600/mm3 (Seg 65.7%) ; UA 7.2 mg/dl ; MMP-3 200 ng/ml (normal 36.9-121.0) ; rheumatic factor, negative ; anti-CCP antibody, negative ; ASO 25 IU/ml ; bacterial culture from tonsil, negative ; right grip 15 kg, left grip 46 kg. HLA typing was positive for A24, B39, B54, DR4, and DR8. The patient was negative for HLA B27. Roentgenographic examination of the right third finger showed the pencil-in-cup deformity. 99mTc bone scintigraph showed abnormal uptake in the left sarco-ilial region in addition to the phalangeal joints. He had scales only on the scalp and there were infiltrates of neutrophils in the corneal layer histopathologically. We diagnosed this case as psoriatic arthritis. Two weeks after oral administration of methotrexate 6 mg per week, every 12 hours, the pain in the fingers improved remarkably, and 5 weeks after administration, his right fingers were flexible and his right grip increased to 40 kg. Five months later, methotrexate was discontinued because of liver dysfunction, and the right finger pain reappeared. Although methotrexate was decreased in doses of 4 mg weekly, his finger pain became again improved.
    View full abstract
    Download PDF (1161K)
  • Umbilical Endometriosis
    — A Case Report —
    Maki MORIYA, Hidefumi WADA, Kou KENZEN, Zenro IKEZAWA, Shinobu MOHRI
    2010 Volume 72 Issue 5 Pages 452-456
    Published: September 15, 2010
    Released on J-STAGE: November 19, 2010
    DOIhttps://doi.org/10.2336/nishinihonhifu.72.452
    JOURNAL RESTRICTED ACCESS
    Show abstractHide abstract
    A 37-year-old Japanese woman presented with a tender tumor in her navel in March 2009. She had noticed the tumor in October 2008, which gradually enlarged and was sometimes tender, though she thought that the occasional tenderness coincided with her period. On examination, a hard intradermal tumor, about 1 cm in diameter, was palpable on the right wall of the navel. The overlying skin showed brownish pigmentation. The tumor was excised under local anesthesia. Histological examination revealed endometrial glands and stroma in the dermis with focal siderophages. Review of the literature showed that endometriosis commonly occurrs in the ovaries, pouch of Douglas, uterine ligament, pelvic peritoneum, and other pelvic spaces, but rarely in the skin or subcutaneous tissue. However, it occurs in 40% of female navel tumors.
    View full abstract
    Download PDF (1630K)
  • A Case of Adult Mastocytosis Accompanied with Anaphylaxis
    Mito TOYODA, Hisashi KOKUBA, Hiromaro KIRYU, Masutaka FURUE
    2010 Volume 72 Issue 5 Pages 457-461
    Published: September 15, 2010
    Released on J-STAGE: November 19, 2010
    DOIhttps://doi.org/10.2336/nishinihonhifu.72.457
    JOURNAL RESTRICTED ACCESS
    Show abstractHide abstract
    In August 2007, a 43-year-old male had a fracture in his left arm. Surgical intervention which comprised the use of metal plates was necessary. In September 2007, during the convalescent period at home following the operation, after the subject had dinner, which included the ingestion of alcohol, he was performing rehabilitation exercises when he suddenly developed acute head itching, vomiting, and finally, loss of consciousness. He was rushed to the emergency room and treated with steroids and inotropic agents. The patch tests for the material contained in the metal plates, Titan-Vanadium-Aluminum alloy and Titan, were both positive. A sample of tissue, harvested from around the plates, showed the presence of inflammatory cells with eosinophilic cells, foreign bodies and macrophages engulfing them in the connective tissue. The subject presented with brown macules on the upper trunk and the neck which both turned red every time he ingested alcohol. He consulted our department in March 2009. The Darier sign was positive on the lesion. A biopsy sample showed infiltration of mast cells in the dermis. Toluidine-blue and tryptase stains were positive. Consequently, his condition was diagnosed as mastocytosis accompanied by anaphylaxis. Additionally, it was inferred that alcohol was the anaphylaxis-precipitating agent. Furthermore, due to the pathology findings and the fact that the subject did not develop any trace of anaphylaxis once the plates were removed, it was considered that the metal allergy may have been related to the anaphylaxis.
    View full abstract
    Download PDF (1391K)
  • A Case of Folliculotropic Mycosis Fungoides
    Manami ISHIKAWA, Mikiko TOHYAMA, Shinji MURAKAMI, Koji HASHIMOTO, Hiro ...
    2010 Volume 72 Issue 5 Pages 462-466
    Published: September 15, 2010
    Released on J-STAGE: November 19, 2010
    DOIhttps://doi.org/10.2336/nishinihonhifu.72.462
    JOURNAL RESTRICTED ACCESS
    Show abstractHide abstract
    We report a case of a 66-year-old Japanese female. In 1995, an itchy erythematous plaque developed on her forehead. The plaque was recalcitrant to several kinds of topical ointments and new follicular papules developed on her neck. She was then referred to us in July 1997. Physical examination revealed a 3 × 2 cm slightly elevated erythematous plaque on her forehead and small red papules on her neck and back. A biopsy specimen from her forehead showed heavy lymphocytic infiltration in the hair follicles and the dermis without the involvement of the epidermis. Hair follicles were edematous and marked accumulation of mucin was observed. The diagnosis of follicular mucinosis was made, and the plaque disappeared after topical clobetasol propionate ointment treatment. In October 2007, she was admitted to our hospital on suspicion of autoimmune hepatitis. She was then referred to our department to diagnose dark red purple tumors on her cheek and lower jaw and neck. A biopsy specimen from the tumor of the lower jaw showed diffuse lymphocytic infiltration throughout the dermis and destruction of the follicles, and sheet-like growth of large atypical cells with cerebriform nuclei. A diagnosis of folliculotropic mycosis fungoides was finally made, which included her forehead plaque on her first visit.
    View full abstract
    Download PDF (1188K)
  • Five Cases of Primary Cutaneous Epithelial Tumors Which Could Be Histopathologically Differentiated from Porocarcinoma
    Ryoko TAKAYAMA, Shin-ichi ANSAI, Yayoi NIIMI, Takashi UENO, Ayako FUTA ...
    2010 Volume 72 Issue 5 Pages 467-472
    Published: September 15, 2010
    Released on J-STAGE: November 19, 2010
    DOIhttps://doi.org/10.2336/nishinihonhifu.72.467
    JOURNAL RESTRICTED ACCESS
    Show abstractHide abstract
    We report five cases of primary cutaneous epithelial tumors which could be histopathologically differentiated from porocarcinoma. Two cases were finally diagnosed as basal cell carcinoma, and three cases as squamous cell carcinoma. The lesions, which consist of both basaloid cells and squamoid cells, and/or which contain clefts, which are necessary to be distinguished from sweat duct, and/or from tumor cells that extend into the epithelial cells of sweat glands, are easy to be histopathologically misdiagnosed as porocarcinoma.
    View full abstract
    Download PDF (1363K)
  • Tumor Formation on the Lower Eye Lid and Self-healing Papules on the Face in a Patient with Mycosis Fungoides
    Ai KAJITA, Osamu YAMASAKI, Shoji ASAKURA, Ichiro YAMADORI, Koichi ICHI ...
    2010 Volume 72 Issue 5 Pages 473-477
    Published: September 15, 2010
    Released on J-STAGE: November 19, 2010
    DOIhttps://doi.org/10.2336/nishinihonhifu.72.473
    JOURNAL RESTRICTED ACCESS
    Show abstractHide abstract
    A 59-year-old man presented with a few year history of multiple erythematous and depigmented patches over the entire body, and was treated with topical steroids. Subsequently, he developed a tumor on his lower eyelid and visited our department. Histopathology of a biopsy specimen from the tumor revealed medium to large lymphoid cells throughout the dermis and lymphoid epidermotropism. The patient was diagnosed as stage II B mycosis fungoides. The tumor was diminished by local radiation therapy and the patches were treated with PUVA therapy. The papules on his face evolved and involuted spontaneously. The development of a tumor and concomitant lymphomatoid papulosis in early stage mycosis fungoides were characteristic. As the large cells of the tumor on the eyelid and papules on the face were positive for CD30, we interpreted the changes of CD30-positive lymphoproliferative disorder as associated with mycosis fungoides.
    View full abstract
    Download PDF (1141K)
  • A Case of Cryoglobulinemia Associated with Chronic Hepatitis C
    Noriko TANAKA, Akihiro UEDA, Fumitake ONO, Shinichiro YASUMOTO, Takash ...
    2010 Volume 72 Issue 5 Pages 478-481
    Published: September 15, 2010
    Released on J-STAGE: November 19, 2010
    DOIhttps://doi.org/10.2336/nishinihonhifu.72.478
    JOURNAL RESTRICTED ACCESS
    Show abstractHide abstract
    A 66-year-old woman visited our outpatient clinic in September 2005 for purpura with infiltration on her legs. A pathological diagnosis of leuocytoclastic vasculitis was made from a skin biopsy. Serological tests indicated cryoglobulinemia and a high titer of RA factor, HCV-Ab positive, HCV-RNA 2700 IU/ml. A clinical diagnosis of cryoglobulinemia associated with chronic hepatitis C was made. With conservative treatment, the skin lesions regressed, but purpura recurred about 2 years and six month later, and membranoproliferative glomerulonephritis appeared at the same time. This prompt diagnosis and treatment of the underlying disease were important, and attention was necessary to detect the emergence of the renal disease.
    View full abstract
    Download PDF (1069K)
  • A Case of Cutaneous Malignant Lymphoma in a Limb with Elephantiasis
    Satoshi MORIOKE, Mikio KAWAI, Hajime SHINDOH, Michihiro HIDE
    2010 Volume 72 Issue 5 Pages 482-486
    Published: September 15, 2010
    Released on J-STAGE: November 19, 2010
    DOIhttps://doi.org/10.2336/nishinihonhifu.72.482
    JOURNAL RESTRICTED ACCESS
    Show abstractHide abstract
    We report a 67-year-old female patient who had cutaneous malignant lymphoma in her extremity with elephantiasis. About 30 years previously, she was affected with a gynecologic malignant tumor and treated by radiotherapy. Since then, her left lower limb had been affected with lymphedema. She visited our hospital about 18 years previously because of severe lymphedema with a widespread lichenoidal change and sclerosis in her left lower limb, and was diagnosed as severe lymphedema and elephantiasis. Since the diagnosis, she had been followed at our outpatient clinic. Because the diameter of her affected limb became three times larger than that of her normal limb and developed phlegmone, she was admitted into the hospital. During the treatment of the phlegmone, three erythematous papules appeared on her left thigh. They were not improved by steroid ointment, and a biopsy revealed cutaneous B cell malignant lymphoma. Since no other mass lesions were found by systematic examination, we diagnosed it as primary cutaneous diffuse large B cell lymphoma, leg type. In spite of chemotherapy, the papules rapidly enlarged and spread with tumor formation over her left lower limb. Moreover, her general condition promptly deteriorated, and she died 2 months after the diagnosis. It is known that patients with chronic lymphedema may be affected with malignant tumors, such as lymphangiosarcoma in their prolonged course. We should carefully follow chronic lymphedema, keeping in mind that it may develop not only lymphangiosarcoma, but also cutaneous malignant lymphoma.
    View full abstract
    Download PDF (1205K)
  • Two Cases of Clear Cell Hidradenoma
    Rinako KAWASAKI, Shingo SUZUKI, Chisato TANAHASHI
    2010 Volume 72 Issue 5 Pages 487-490
    Published: September 15, 2010
    Released on J-STAGE: November 19, 2010
    DOIhttps://doi.org/10.2336/nishinihonhifu.72.487
    JOURNAL RESTRICTED ACCESS
    Show abstractHide abstract
    We report two cases of clear cell hidradenoma (CCH). Case 1, a 59-year-old Japanese man presented with a subcutaneous tumor on the left side of the head. Case 2, a 27-year-old Japanese man presented with a red peduncular tumor on the scrotum. Based on histological findings, which included clear cells and epidermoid cells without atypia, and the presence of several sizes of lumina, we diagnosed them as CCH. Case 2 was a rare case because it occurred in a young man, with a peduncular tumor located on the scrotum.
    View full abstract
    Download PDF (1129K)
  • A Case of Follicular Lymphoma Associated with Neurofibromatosis Type 1
    Miki MATSUO, Kotaro ITOH, Shinichi IMAFUKU, Juichiro NAKAYAMA
    2010 Volume 72 Issue 5 Pages 491-493
    Published: September 15, 2010
    Released on J-STAGE: November 19, 2010
    DOIhttps://doi.org/10.2336/nishinihonhifu.72.491
    JOURNAL RESTRICTED ACCESS
    Show abstractHide abstract
    A 62-year-old man presented with a complaint of a mass on the occipital area. He had been diagnosed as having neurofibromatosis 1 (NF1). The subcutaneous mass appeared one year before his visit and had been increasing in size. Histopathological examination showed the dense infiltration of the atypical lymphoid cells of the medium to large size that presented plural germinal center-like structure. The tumor cells were positive for CD20, CD10, Bcl-2 and Bcl-6, but were negative for CD3 and MUM-1 immunohistochemically. A diagnosis of folliclar lymphoma Grade3a (a classification of WHO) was made. Systematic investigation revealed the tumor cell infiltration in the spleen. He was treated with 8 courses of systemic chemotherapy (R-CHOP). Subsequently, the occipital mass disappeared and the tumor in the spleen was reduced in size. Association of B cell lymphoma in NF1 patients is rare and only a few cases has been reported.
    View full abstract
    Download PDF (1047K)
Clinical and Investigative Report
  • Psoriasis Patients Have Abnormal Ceramide Profile in Stratum Corneum
    Satomi KOYANO, Atsushi HATAMOCHI, Soji YAMAZAKI, Junko ISHIKAWA, Takas ...
    2010 Volume 72 Issue 5 Pages 494-499
    Published: September 15, 2010
    Released on J-STAGE: November 19, 2010
    DOIhttps://doi.org/10.2336/nishinihonhifu.72.494
    JOURNAL RESTRICTED ACCESS
    Show abstractHide abstract
    Ceramides, major lipids of the stratum corneum (SC), are known to play critical roles in various epidermal functions. It is also known that patients with atopic dermatitis (AD) or psoriasis commonly possess reduced ceramide contents. Previously, we established a method to quantify SC ceramides and identified several parameters that reflect epidermal barrier impairment in AD patients. In the present study, we applied the method to psoriasis patients. In the involved and uninvolved skin sites of psoriasis patients, we evaluated the levels of ceramides in total, classes and species. As compared to healthy subjects, psoriasis patients showed a significantly lower ceramide level in total, and in eight classes (NDS, NH, NP, AH, AP, EOS, EOH and EOP), and a significantly higher level in two classes (NS and AS). The larger species tended to be expressed at lower levels, while smaller species tended to be expressed at higher levels in psoriasis patients than in healthy subjects. These results of psoriasis patients bear a resemblance to those of AD patients. The difference from healthy subjects was found in the uninvolved sites of psoriasis patients, thereby proving a systemic deficiency of ceramide metabolism in psoriasis patients. Our findings support the potential of ceramide profiling for early diagnosis of psoriasis.
    View full abstract
    Download PDF (1312K)
Review
Therapy
  • A Study of the Effectiveness of t-Flavanone on Alopecia Areata
    Sachie ITO, Hiroshi OKITA, Shujiro HAYASHI, Hiroshi OKITA, Yoichiro HA ...
    2010 Volume 72 Issue 5 Pages 507-513
    Published: September 15, 2010
    Released on J-STAGE: November 19, 2010
    DOIhttps://doi.org/10.2336/nishinihonhifu.72.507
    JOURNAL RESTRICTED ACCESS
    Show abstractHide abstract
    The most common therapy for alopecia areata is topical steroids. Topical immunotherapy with squaric acid dibutylester (SADBE) has been reported to be effective, but can be performed only in a few institutions. This study evaluated the efficacy of topical t-flavanone together with oral glycyrrhizin and cepharantine in alopecia areata (simplex or multiplex) patients with three bald patches or less. Their scalps were treated with a lotion containing 0.1% t-flavanone or with a placebo containing all components of the test lotion except t-flavanone for three months. All patients were instructed to take one cepharantine tablet and one glycyrrhizin tablet three times a day (morning, mid-day and night) during the study. At the conclusion of the study, the efficacy of t-flavanone was evaluated by considering comprehensive improvement, and objective and concomitant symptoms. As a result, 85% of the t-flavanone group and 27% of the placebo group were evaluated as effective or better, showing a statistically significant difference (p<0.05). The difference was more evident when the results were compared among patients who had no new hair in their bald patches at the beginning of the test, which showed that 100% of the t-flavanone group and 29% of the placebo group were evaluated as effective or better. These results indicate that topical t-flavanone can be an effective therapy for treating alopecia areata patients.
    View full abstract
    Download PDF (1092K)
  • Effects of Hochu-ekki-to Extract Fine Granules in Treatment of Atopic Dermatitis Patients with Delicate Constitation
    Motoi TAKENAKA, Shinichi SATO
    2010 Volume 72 Issue 5 Pages 514-519
    Published: September 15, 2010
    Released on J-STAGE: November 19, 2010
    DOIhttps://doi.org/10.2336/nishinihonhifu.72.514
    JOURNAL RESTRICTED ACCESS
    Show abstractHide abstract
    Hochu-ekki-to mediates the balance between type 1 (Th1) and type 2 (Th2) helper cells, and many patients with atopic dermatitis who showed improvement after treatment with this drug have been reported. We used Hochu-ekki-to in addition to standard treatment in adult patients with atopic dermatitis, and evaluated its effects. Hochu-ekki-to was orally administered for 12 weeks. To evaluate its clinical effects, Th1 and Th2 in peripheral blood mononuclear cells were compared between before and after the oral administration. The measurement of Th1 and Th2 was outsourced to SRL Co. The subjects consisted of 7 patients showing a disease duration of 7-50 years. As clinical effects, slight aggravation was observed in 3 patients, no change in 1, and improvement in 3. Before treatment, the mean Th1 value was 17.8% ± 5.0% (13.7%-25.5%), and the mean Th2 value was 2.3% ± 1.0% (1.3%-3.9%). After treatment, the mean Th1 value was 17.7% ± 7.1% (11.6%-30.1%), and the mean Th2 value was 2.6% ± 1.2% (1.5%-4.6%). The mean Th1/Th2 ratio was 9.4 ± 3.8 (4.1-16.2) before treatment but significantly decreased (p<0.05) to 7.7 ± 3.7 (4.0-15.9) after treatment ; the ratio decreased in all patients excluding 1 showing almost no change. These results suggest that Hochu-ekki-to has actions other than its known inhibitory effects on a Th2-predominant state. Treatment with Hochu-ekki-to is a method may be effective in the treatment of chronic atopic dermatitis.
    View full abstract
    Download PDF (1045K)
  • Safety Study of Low-irritancy Skin Care Products in Patients with Acne Vulgaris
    Osamu NEMOTO, Kenji SAGA, Kuniko KAWAMURA, Hiroyuki ASANUMA, Takashi O ...
    2010 Volume 72 Issue 5 Pages 520-530
    Published: September 15, 2010
    Released on J-STAGE: November 19, 2010
    DOIhttps://doi.org/10.2336/nishinihonhifu.72.520
    JOURNAL RESTRICTED ACCESS
    Show abstractHide abstract
    We carried out a six-week study in acne vulgaris patients under treatment with Aadapalen gel, which contains a topical retinoid-like agent, in order to assess the safety of low-irritancy skin care products. These products consisted of a facial cleanser, a skin lotion, a milky lotion and a cream in the “NAVISION®” series developed by Shiseido Co., Ltd.. A total of 48 subjects completed the study. We observed adverse skin reactions, including slightly dry skin, slightly irritating sensation and slightly itchy sensation, in 28 of the subjects. Among them, 21 adverse skin reactions were caused by the Aadapalen gel used in the treatment of acne vulgaris. The other seven were caused by the low-irritancy skin care products. After completion of application of the low-irritancy skin care products, the average number of acne eruptions at 6 weeks was significantly decreased compared with baseline. Use of the low-irritancy skin care products did not adversely affect the treatment of acne vulgaris. It was concluded that these low-irritancy skin care products can be used safely by patients under treatment for acne vulgaris.
    View full abstract
    Download PDF (1505K)
  • A Study of Early Effectiveness and Severity-based Effectiveness of Lanoconazole Cream (Astat®) for Tinea Pedis
    Mariko HATTORI, Akiko OHTSUKI, Maho YASUI, Hiroko SADAMASA, Masataro H ...
    2010 Volume 72 Issue 5 Pages 531-536
    Published: September 15, 2010
    Released on J-STAGE: November 19, 2010
    DOIhttps://doi.org/10.2336/nishinihonhifu.72.531
    JOURNAL RESTRICTED ACCESS
    Show abstractHide abstract
    We evaluated early effectiveness, severity-based effectiveness, and compliance using a diary for external application of lanoconazole cream for tinea pedis. The safety population of the study was 63 patients with tinea pedis. The drug was applied to affected areas once daily, and skin symptoms were observed and mycologically examined at the start of the test, as well as 1, 2, and 4 weeks later. Rates of improvement of skin findings (“improvement” or better) were high : 77.8% at week 1 and 96.8% at week 4. Negative conversion rates of fungi were 35.6% at week 1 and 83.9% at week 4. The efficacy rates of the drug by severity were 90.3% in the grade 1-3 group and 77.4% in the grade 4-6 group, and even the higher-severity group exhibited sufficient drug efficacy. The relationship between the actual number of days of external application of the drug based on the diary and overall clinical efficacy was evaluated. The efficacy rates of the drug in the group with daily external application were 36.4% at week 1 and 87.5% at week 4, and superior to those in the group without daily external application (16.7% at week 1 and 78.9% at week 4). Regarding the safety of this drug, contact dermatitis was observed in 1 patient. In conclusion, lanoconazole cream was highly efficacious against tinea pedis even early in treatment, and results were also satisfactory in higher-severity patients. In addition, daily external application of the drug tended to result in earlier efficacy.
    View full abstract
    Download PDF (1455K)
Dermatologists around the World
    • |<
    • <
    • 1
    • >
    • >|
feedback
 Top