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Volume 75 (2013)
- Issue 6 Pages 489-
- Issue 5 Pages 397-
- Issue 4 Pages 293-
- Issue 3 Pages 195-
- Issue 2 Pages 117-
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Volume 75, Issue 2
Displaying 1-12 of 12 articles from this issue
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Color Atlas
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Teppei SAKAI, Noriko SATO, Shinichi IMAFUKU, Kaori KOGA, Hirohshi IWAS ...2013 Volume 75 Issue 2 Pages 117-118
Published: April 01, 2013
Released on J-STAGE: June 24, 2013
JOURNAL RESTRICTED ACCESSDownload PDF (1117K)
Clinical Case Reports
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Sayuri SATO, Hiroyuki TAKAHASHI, Noriko MIZUKAKI, Makiko KAGAYA, Hiroy ...2013 Volume 75 Issue 2 Pages 119-122
Published: April 01, 2013
Released on J-STAGE: June 24, 2013
JOURNAL RESTRICTED ACCESSA 73-year-old man visited our clinic because of various cutaneous complications on the extremities consistingof purpura, blisters, hemorrhagic bullae and thick crust, resulting in development of necrotic ulcers. Histopathologically, there were infiltration of leukocytes, nuclear dusts, and fibrinoid degeneration of blood vessels, which were findings that were compatible with those of leukocytoclastic vasculitis. Urinalysis revealed microscopic hematuria and proteinuria. Furthermore, endoscopic examination displayed a tubular adenocarcinoma in the sigmoid colon in addition to gastric ulcer. Based on these findings, we diagnosed this case as Henoch-Schonlein purpura, and prednisolone was orally administered, which was followed by a rapid improvement of skin lesions as well as gastric complications. Henoch-Schonlein purpura in the elderly may demonstrate unusual cutaneous complications, includingblisters, hemorrhagic bullae, and skin ulcers. Moreover, Henoch-Schönlein purpura in the elderly may be associated with solid-organ malignancies. It is therefore suggested that examination for internal malignancies should be considered in connection with the management of Henoch-Schönlein purpura, especially in elderly patients.View full abstractDownload PDF (1242K) -
Atsuko MATSUO, Aki OGATA, Michiko KUGIMIYA, Taizou SHIMOMURA, Masayosh ...2013 Volume 75 Issue 2 Pages 123-128
Published: April 01, 2013
Released on J-STAGE: June 24, 2013
JOURNAL RESTRICTED ACCESSThis is a report on malignant lymphoma (diffuse large B-cell lymphoma) discovered during diagnosis and treatment of dermatomyositis usingPET and lymph node biopsy in two male patients, 80 and 71 years old. The patients were successfully treated with rituximab in combination with chemotherapy, and they are in complete remission for 6 and 5.5 years, respectively. CHOP or THP-COP chemotherapy plus rituximab has improved dramatically the prognosis of B-cell lymphoma in current practice. In our cases, the common features in the two patients were : Strongskin symptoms, but with no itching ; mild interstitial pneumonia ; and negative results for anti-155/140 antibody. We conclude that in older male patients with dermatomyositis, PET scan can be valuable to detect undiagnosed malignant lymphoma.View full abstractDownload PDF (1261K) -
Miki KOHNO, Masakazu TAKAHARA, Masayoshi NAKAO, Ayako KAMEDA, Tomoko S ...2013 Volume 75 Issue 2 Pages 129-133
Published: April 01, 2013
Released on J-STAGE: June 24, 2013
JOURNAL RESTRICTED ACCESSWe report two cases of pemphigoid nodularis with anti-BP180 antibody and prurigo-like nodules preceding the development of blisters. Case 1 : A 62-year-old woman with a 2-year history of pruritic nodules on her trunk, extremities, and head, which had been treated as prurigo nodularis, developed blisters on her thighs. She was diagnosed as having pemphigoid nodularis, based on results that included increased titer of serum anti-BP180 antibody (ELISA), histopathology, and direct and indirect immunofluorescence. The blisters cleared after treatment with oral prednisolone (5 mg/day) and minocycline (150 mg/day) but recurred duringthe taperingof the dose of minocycline. After the prednisolone dose was raised to 15 mg/day, the nodules quickly improved. Case 2 : In March 2007, a 55-year-old woman had pruritic nodules on the upper extremities, which gradually extended to the entire body. She had been resistant to treatment with topical steroids and narrow band UVB under the initial diagnosis of prurigo nodularis, while blisters appeared on the extremities in June 2007. After the diagnosis of pemphigoid nodularis was made, treatment with oral prednisolone (25 mg/day) and minocycline (100 mg/day) was initiated, which resulted in clearance of the blisters. When the blisters recurred in April 2010, oral prednisolone (50 mg/day) cleared the blisters. However, because severe pruritus and nodules remained, prednisolone was exchanged for betamethasone, leadingto a partial resolution. Consideringthe previous reports, pruritic nodules appear first and blisters develop later in many cases. When clinical manifestations consist only of pruritic nodules, anti-BP180 antibody (ELISA) and immunofluorescence are valuable tools to diagnose pemphigoid nodularis.View full abstractDownload PDF (1229K) -
Yasutaka MITAMURA, Takamichi ITO, Kayo HARADA, Kazunori URABE, Takanor ...2013 Volume 75 Issue 2 Pages 134-137
Published: April 01, 2013
Released on J-STAGE: June 24, 2013
JOURNAL RESTRICTED ACCESSA 49-year-old man visited our hospital with high fever (up to 39°C), tender erythematous nodules, and bilateral infiltration of cutaneous scars on the patellae. Histopathological examination revealed that both the eruptions had noncaseating epithelioid granulomas with foreign bodies in the middle. Angiotensin-converting enzyme (ACE) and serum calcium levels were normal. Successful regression was achieved using oral steroids, but the patient had to be admitted to the hospital because of febrile neutropenia. Bone-marrow biopsy confirmed the diagnosis of acute myeloid leukemia (AML) and sarcoid reaction preceding AML. The patient had been previously diagnosed with thrombocytopenia, which indicated the possibility of progression to AML from myelodysplastic syndrome (MDS). The patient was treated with chemotherapy, and no recurrence of eruptions was noted. We reviewed cases of sarcoidosis or sarcoid reaction preceding AML in the literature. To date, only 2 cases of sarcoid reaction preceding AML have been reported.View full abstractDownload PDF (1116K) -
Ai FUJIOKA, Maki YOKOGAWA, Kimiko NAKAJIMA, Masahito TARUTANI, Shigeto ...2013 Volume 75 Issue 2 Pages 138-140
Published: April 01, 2013
Released on J-STAGE: June 24, 2013
JOURNAL RESTRICTED ACCESSA 70-year-old man visited our hospital because of gradually enlarging erythema on the abdomen, which appeared 8 years ago without subjective symptoms. At the first visit, there was annular, confluent erythematous plaque over the lower abdomen. Also, there was an erythematous nodule on the scalp that had appeared 1 year ago at a site where he had experienced a traumatic injury 30 years ago. A histopathological examination revealed that both lesions had epithelioid cell granulomas and were diagnosed as cutaneous sarcoid. Interestingly, examination under polarized light microscopy revealed silica-like materials at the center of the granulomas in the scalp lesion, suggestive of scar sarcoidosis due to a post-traumatic scar. Therefore, we suggest that the patient's scalp lesion was preceded by the plaque-type cutaneous sarcoid in the abdomen. Sarcoidosis with multiple skin lesions may be complicated by the internal disease. A periodic whole body examination includingonset of new skin eruptions is necessary.View full abstractDownload PDF (1218K) -
Asuka YOKOYAMA, Shinichi KOBA, Machiko HISATOMI, Miho MASUOKA, Noriyuk ...2013 Volume 75 Issue 2 Pages 141-144
Published: April 01, 2013
Released on J-STAGE: June 24, 2013
JOURNAL RESTRICTED ACCESSA 64-year-old female presented with comedo-like lesions from the right shoulder to the cervix that had been present since early childhood. These lesions showed a linear and Z-like arrangement and were characterized by multiple scars and comedones of various sizes. She underwent excision three times, and the lesions were diagnosed clinically as nevus comedonicus. Microscopic examination revealed irregular funnel-, spindle-, and glove-shaped recesses in the epidermis and also showed epidermal cyst-like structures filled with stratified keratin. In addition, in a part of the cystic structures the microscopic characteristic findings in the present case were as follows: 1) the cystic wall accompanied mature sebaceous glands, 2) vellus hairs were present, 3) by immunohistochemistry, almost all cystic walls were positive for cytokeratin (CK) 1, which generally indicates positivity for epidermal infundibular hair follicle, whereas a part of the cystic walls presenting at dermis was positive for CK17, which usually expresses the differentiation between the hair follicle infundibulum and the hair bulb. The present case was diagnosed as nevus comedonicus, which might be hamartoma with differentiation of folliculosebaceous glands. Although the histogenesis of nevus comedonicus is unclear, the present case may be a key that can contribute to elucidatingthe histogenesis of this disease.View full abstractDownload PDF (1161K) -
Shiho KANEMARU, Tomohiro INOUE, Eiji MUROI, Kousuke MOCHIDA, Yukiyo NA ...2013 Volume 75 Issue 2 Pages 145-148
Published: April 01, 2013
Released on J-STAGE: June 24, 2013
JOURNAL RESTRICTED ACCESSA 77-year-old Japanese female was referred to our hospital with an erythematous nodular lesion on her left cheek. Approximately one month previously she had first noticed a nodule with a diameter of approximately 1.0 cm. She suffered from rheumatoid arthritis, which had been treated with etanercept for 3 years followed by injections of adalimumab duringthe last 2 years. The histological diagnosis was Merkel cell carcinoma. The tumor was excised. The patient underwent subsequent conventional fractionated radiation therapy. On the latest follow-up 3 months later, the patient was doingwell with no recurrence of disease. The immunosuppression associated with long-term use of biologics may have induced the development of Merkel cell carcinoma.View full abstractDownload PDF (1153K) -
Masako INOUE, Koichi IZUMIKAWA, Yasutaka SUZAKI2013 Volume 75 Issue 2 Pages 149-153
Published: April 01, 2013
Released on J-STAGE: June 24, 2013
JOURNAL RESTRICTED ACCESSA 67-year-old woman with ulcerative colitis since 2009 was treated with infliximab (5 mg/kg), but her symptoms of ulcerative colitis were aggravated, so the amount of infliximab was increased (10 mg/kg). She then developed erythematous, edematous plaque and pustules from her left wrist to the dorsum of her hand with high-fever. Antibiotics were administered, but her symptoms became aggravated. Necrotic fasciitis was suspected from CT and MRI, and surgical debridement was done. A submitted bacterial culture, acid fast bacterial culture, and a fungal culture of the pus all came back as negative. A histological examination of a skin biopsy of necrotic tissue demonstrated neutrophilic infiltrate with leukocytoclasia and dermolysis in all of the dermis. Based on these results, we diagnosed pyoderma gangrenosum, and her symptoms have improved after we stopped the treatment with infliximab and started treatment with prednisolone. It is possible that infliximab could not suppress the development of pyoderma gangrenosum, but we should take into consideration that it might be possible that an abnormal reaction to infliximab could have occurred.View full abstractDownload PDF (1542K)
Review
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Hiroshi Uezato2013 Volume 75 Issue 2 Pages 154-163
Published: April 01, 2013
Released on J-STAGE: June 24, 2013
JOURNAL RESTRICTED ACCESSDownload PDF (2012K)
Therapy
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Single and Combined Therapies Using 0.05 % Betamethasone Butyrate Propionate Lotion and 2 % Ketoconazol LotionMami SAITO, Masashi YAMAZAKI, Ryoji TSUBOI2013 Volume 75 Issue 2 Pages 164-168
Published: April 01, 2013
Released on J-STAGE: June 24, 2013
JOURNAL RESTRICTED ACCESSMalassezia spp. play a major etiological role in seborrheic dermatitis. Antimycotics are occasionally prescribed for this disease as are topical steroid ointments. In the present study, we designed two groups and compared their response to different treatments for seborrheic dermatitis : application of 0.05% betamethasone butyrate propionate (BBP) lotion alone for the first two weeks followed by the combined application of BBP lotion and 2% ketoconazole (KC) lotion for the next two weeks (BBP group) ; the application of KC lotion alone for the first two weeks followed by the combined application of BBP lotion and KC lotion for the next two weeks (KC group). As a result, total skin scores for both groups had significantly (p<0.01) improved at two weeks. However, the score for the BBP group was significantly (p<0.05) lower than that of the KC group at two weeks. After the last two weeks of combination therapy, the total skin scores for both groups had improved significantly (p<0.01) and showed no significant difference. The BBP group demonstrated a significantly (p<0.01) lower score for erythema compared with the KC group, whereas the scores for scalingand itchingshowed no significant difference between the two groups. No adverse effects were reported in this trial. These results indicate that therapy combining topical steroid lotions and antimycotics, startingwith the application of the topical steroid alone and followed by the combination with antimycotics, is effective treatment of seborrheic dermatitis.View full abstractDownload PDF (1297K)
Dermatologists around the World
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Tadashi KARASHIMA2013 Volume 75 Issue 2 Pages 171-172
Published: April 01, 2013
Released on J-STAGE: June 24, 2013
JOURNAL RESTRICTED ACCESSDownload PDF (1074K)
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