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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 6
Displaying 1-14 of 14 articles from this issue
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Color Atlas
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Yuko MACHIDA, Midori HIRUMA, Naoko FUNAKUSHI, Hiroko SADAMASA, Masatar ...2013 Volume 75 Issue 6 Pages 489-490
Published: December 01, 2013
Released on J-STAGE: March 12, 2014
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Clinical Case Reports
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Saho KAWAHARA, Ayako MIKUMO, Mito TOYODA, Makiko KIDO-NAKAHARA, Satoko ...2013 Volume 75 Issue 6 Pages 491-495
Published: December 01, 2013
Released on J-STAGE: March 12, 2014
JOURNAL RESTRICTED ACCESSA 34-year-old woman with atopic dermatitis was presented to our hospital with fever, visual field defect, purpura and hemorrhagic blisters on both palms and soles. We detected methicillin-sensitive Staphylococcus aureus (MSSA) by culturing blister fluid and circulating blood. Transthoracic echocardiography showed a growth on the mitral valve and mitral regurgitation, indicating a diagnosis of infective endocarditis. As she also suffered a cerebral infarction due to bacterial embolization, surgical intervention was undertaken to cure the infective endocarditis. Only 10 cases of atopic dermatitis with infective endocarditis have been reported in Japan. All of these patients had severe atopic dermatitis with Staphylococcus aureus infection. As Staphylococcus aureus is frequently found colonized on the skin surface of atopic dermatitis patients, it is likely that destruction of the skin barrier may cause sepsis leading to infective endocarditis. In order to avoid these serious complications, it is important to treat the atopic dermatitis appropriately according to standard therapeutic guideline.View full abstractDownload PDF (777K) -
Shingo MATSUKI, Yuko CHINUKI, Hiroyuki NIIHARA, Eishin MORITA2013 Volume 75 Issue 6 Pages 496-498
Published: December 01, 2013
Released on J-STAGE: March 12, 2014
JOURNAL RESTRICTED ACCESSA 64-year-old man, who had a history of pollinosis in the spring season, was referred to our clinic for evaluating the cause of anaphylaxis occurred after drinking soy-milk. His symptoms was ocular itching, cough, nasal congestion, and hives as well as the sensation of airway obstruction. The CAP-FEIA was negative for soybean, but positive for alder pollen and rGly m4. Skin prick test revealed positive reaction to soy and soy-milk, thus soy-milk allergy was diagnosed. Then we performed the basophil activation test based on CD203c with his consumed soy-milk. The CD203c on basophil surface was up-regulated in response to serially diluted soy-milk. From these results, soy-milk allergy was considered to be elicited by Gly m4 which was cross-reacted with alder pollen. This case suggests that the CD203c-based basophil activation test may be useful in the diagnosis of soy-milk allergy.View full abstractDownload PDF (1059K) -
Reiko SHIRAI, Noriyuki MISAGO, Takuya INOUE, Yutaka NARISAWA2013 Volume 75 Issue 6 Pages 499-503
Published: December 01, 2013
Released on J-STAGE: March 12, 2014
JOURNAL RESTRICTED ACCESSAn 85-year-old woman developed pigmentation and large subcutaneous indurations on her lower legs. Six months later she was diagnosed with pulmonary tuberculosis. With the administration of anti-tuberculosis drugs, the subcutaneous indurations on her legs did not change, and ulcers developed and enlarged gradually. A microscopic examination of the subcutaneous induration showed diffuse epithelioid cell granulomas in the dermis to the adipose tissue. The vessel walls of the deep dermis were occupied by the epithelioid cell granulomas. It was necessary to distinguish sarcoidosis from erythema induratum Bazin. However, the patient was diagnosed with sarcoidosis complicated by pulmonary tuberculosis because the bilateral hilar lymphadenopathy, uveitis, and elevated angiotensin-converting enzyme (ACE) activity indicated the diagnosis of sarcoidosis complicated by pulmonary tuberculosis. On the basis of these findings, we diagnosed the patient as having sarcoidosis with pulmonary tuberculosis. The patient was treated by oral prednisolone 0.5 mg/kg/day for leg ulcers, and about two and a half months later, they epithelialized. We suggest that ulcerative skin sarcoidosis is a rare but distinctive form of skin sarcoidosis with granulomatous vasculitis. Ulceration is a rare manifestation of sarcoidosis. We present a case of ulcerative sarcoidosis with granulomatous vasculitis that is an even rarer occurrence. We believe that the ulcers were caused by granulomatous vasculitis in this case.View full abstractDownload PDF (1200K) -
Reiko TSUTSUMI, Koji ADACHI, Yuichi YOSHIDA, Osamu YAMAMOTO2013 Volume 75 Issue 6 Pages 504-507
Published: December 01, 2013
Released on J-STAGE: March 12, 2014
JOURNAL RESTRICTED ACCESSWe describe a case of a 37-year-old woman with generalized pustular psoriasis (GPP) that worsened rapidly postpartum. A diagnosis of GPP was made when she was 3months old. She had been treated with topical corticosteroid and oral administration of cyclosporine. After the delivery of a second baby, she developed a severe rash and her general status worsened markedly. Although the dosage of cyclosporine was increased to 250 mg/day in addition to oral prednisolone (20 mg/day → 50 mg/day), the response was poor. Therefore, we started treatment with infliximab, resulting in an excellent response within 6 days. As far as we know, there has been no previous report of GPP worsening postpartum in Japan. With regard to the use of cyclosporine and infliximab during pregnancy or lactation, it is one of the options for the treatment of severe cases, according to the guidelines. However, the use of these drugs have to be considered carefully while comparing the risks and benefits.View full abstractDownload PDF (1247K) -
Misachi ASAI, Yuta KOIKE, Saori TOMIMURA, Motoi TAKENAKA, Atsushi UTAN ...2013 Volume 75 Issue 6 Pages 508-510
Published: December 01, 2013
Released on J-STAGE: March 12, 2014
JOURNAL RESTRICTED ACCESSXeroderma pigmentosum (XP) is associated with a deficient mechanism for repair of ultraviolet light-induced damage of DNA. The disease includes eight genetically different complementation groups comprising XP-A through-G and the XP variant (XP-V). We report on an 83-year-old man with XP group F (XP-F) disease. He had been sensitive to sunlight since childhood and had pigmentation changes in sun-exposed skin. He was diagnosed as XP-F at the age of 64 years. Despite avoiding sunlight exposure since the diagnosis by using sunscreen or wearing long-sleeved shirts, he developed two squamous cell carcinomas, one basal cell carcinoma and 14 actinic keratoses in the sun-exposed skin during almost 20 years of observation at our hospital. These observations suggest that early diagnosis of XP is important in order to prevent XP-F patients from developing skin cancers.View full abstractDownload PDF (1027K) -
Reiko NAITO, Aki FUJISAKI, Ryota TOKUMARU, Nobuta FUJISAKI, Kaori KOGA ...2013 Volume 75 Issue 6 Pages 511-513
Published: December 01, 2013
Released on J-STAGE: March 12, 2014
JOURNAL RESTRICTED ACCESSExtraskeletal chondroma is a benign cartilage nodule or mass independent of bone. It generally affects the soft tissue of the hands and feet, and those arising from the trunk are rare. We herein report a case of extraskeletal chondroma of the abdomen. A 36-year-old male patient presented with an asymptomatic nodular tumor on the right side of the abdomen. The patient had not noticed any growth since he first noticed the tumor 1 month earlier. Clinical examination revealed a 1-cmdiameter, hard, smooth, fixed tumor of the abdomen. He had no history of trauma. The lesion was surgically removed. The tumor was situated within the adipose tissue, and the bottom was partly adhered to the fasciae. Histopathologically, the tumor was encapsulated by a thin, fibrous connective tissue and comprised chondrocytic tumor cells. Lacy basophilic mineral deposits around the tumor cells were also seen. The matrix was Alcian blue-positive. Immunohistochemically, the tumor cells were positive for S-100 protein. A diagnosis of extraskeletal chondroma was established. To our knowledge, this is the ninth case of extraskeletal condroma located in the trunk in Japan. Extraskeletal chondroma occurred in the trunk may not be common in daily dermatological practice.View full abstractDownload PDF (1090K) -
Yuka NAKAMURA, Makoto ICHIMIYA, Kei NEMOTO, Yoshitaka NAKAMURA, Michiy ...2013 Volume 75 Issue 6 Pages 514-517
Published: December 01, 2013
Released on J-STAGE: March 12, 2014
JOURNAL RESTRICTED ACCESSA 44-year-old Japanese woman had noted a mass in the right breast about 10 years earlier. The mass gradually increased in size and developed overlying ulceration. By the time the patient presented at our hospital, the tumor had reached a diameter of 24 cm. Contrast-enhanced computed tomography revealed an irregular contrast effect in the tumor, but no metastases. Needle biopsy indicated a phyllodes tumor, and right mastectomy followed by skin grafting was performed. The 3-kg excised specimen was pathologically diagnosed as phyllodes tumor (borderline). Phyllodes tumors of the breast are comparatively rare, and rapidly growing to the large tumor. When rubefaction of the skin, necrosis or ulceration is caused by the tumor, the patient will consult dermatology. The biological properties of this tumor remain contentious. Diligent followup is required after tumor resection to ensure the absence of both local recurrence and distant metastases.View full abstractDownload PDF (1153K) -
Tamao OOTSU, Bunshiro AKIKUSA2013 Volume 75 Issue 6 Pages 518-522
Published: December 01, 2013
Released on J-STAGE: March 12, 2014
JOURNAL RESTRICTED ACCESSA 63-year-old man had developed Wegener granulomatosis (WG) in 2003 ; in January, 2012, he received intravenous cyclophosphamide, and the dose of prednisolone was increased due to recurrence of WG ; subsequently, the prednisolone dose was gradually decreased to 27.5 mg/day with improvement of the disease. In March, 2012, he was administered antibiotics intravenously through his left forearm for pneumonia. About two weeks after the start of therapy for pneumonia, several painful pustules appeared on his left forearm. About two days after the appearance of the pustules, he visited us. We prescribed antibiotics for infection by the bacteria that occur naturally on the skin, but the lesions did not disappear completely. In August, 2012, an incisional biopsy was taken from nodules on his left forearm, and Mycobacterium chelonae (M. chelonae) was identified with a mycobacteria-growing culture and DNA-DNA hybridization. Six weeks after initial administration of oral levofloxacin 500 mg/day and oral clarithromycin 400 mg/day, the lesions improved and did not recur for about five months with the same treatment. There are few case reports published on cutaneous M. chelonae infection with pustules. Although we could not prove that the pustules of this case were a manifestation of cutaneous M. chelonae infection, the eruptions or pain did not disappear during the period from the first medical dermatology examination to the time when we did a biopsy, and there had been pustules in almost the same areas as those from which the biopsy of the nodules was done, so we think that the pustules seen at the first visit might have been manifestations of cutaneous M. chelonae infection.View full abstractDownload PDF (1344K) -
Rieko NEMOTO, Nobuaki CHOSA, Katsumi OGATA, Mitsuru SETOYAMA2013 Volume 75 Issue 6 Pages 523-527
Published: December 01, 2013
Released on J-STAGE: March 12, 2014
JOURNAL RESTRICTED ACCESSA 17-year-old male judo club member presented with apparent kerion celsi. He displayed pustules in a follicular distribution, multiple small patches of alopecia with red nodules, and strong pain in the head area. Based on the results of a KOH direct microscopic examination and fungal culture of hair that easily fell out from the affected regions, kerion celsi caused by Trichophyton tonsurans was diagnosed. Treatment included oral itraconazole at 200 mg/day and removal of diseased hair, but even after completing the course of oral medication, subcutaneous abscesses continued to develop, indicating the refractory nature of the disease. Repetitive incision drainage was added to the treatment, and approximately 10 months after the beginning of treatment, the patient had nearly recovered. The present case suggests that while oral antifungal treatment is necessary for treating kerion celsi caused by T. tonsurans, concomitant removal of diseased hair is also helpful.View full abstractDownload PDF (1131K)
Review
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Pathomechanism and Treatment of Alopecia AreataShigeki INUI, Satoshi ITAMI2013 Volume 75 Issue 6 Pages 528-533
Published: December 01, 2013
Released on J-STAGE: March 12, 2014
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Therapy
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Comparison of Combination of Betamethasone Butyrate Propionate and Calcipotriol with Betamethasone Butyrate Propionate AloneTakeshi NAKAHARA, Satoshi TAKEUCHI, Hisashi KOKUBA, Akiko SATOMURA, Ch ...2013 Volume 75 Issue 6 Pages 534-539
Published: December 01, 2013
Released on J-STAGE: March 12, 2014
JOURNAL RESTRICTED ACCESSWe compared the clinical effects, patients' QOL, and adherence of psoriasis treatment with a) a combination of betamethasone butyrate propionate and calcipotriol, and b) betamethasone butyrate propionate alone. Although the clinical effects of both treatment showed equivalent efficacy, the usage of betamethasone butyrate propionate was a little smaller in combination treatment, and only the combination treatment improved patients' QOL. Surprisingly, the percentage of drug usage in the volume of prescription were very low. This study indicates that combination treatment of betamethasone butyrate propionate and calcipotriol is useful in terms of dose reduction of corticosteroid, and improvement of adherence in topical treatment might increase the clinical effects.View full abstractDownload PDF (1703K) -
Keiko NISHIMURA, Akiko YAGAMI, Akiyo SANO, Tsukane KOBAYASHI, Shigeki ...2013 Volume 75 Issue 6 Pages 540-544
Published: December 01, 2013
Released on J-STAGE: March 12, 2014
JOURNAL RESTRICTED ACCESSWe studied the use of “Nov®.Lip Care Cream UV” in 50 subjects with lip dryness for 4 weeks to assess humidity retention and shading of lips. The study subjects were selected from patients with atopic dermatitis, infantile dry dermatitis, and photoallergy, who visited Fujita Health University Hospital, Rikako's Clinic of Dermatology, and Kobe University Hospital between November 2010 and May 2011. At the start and end of the trial, we measured the moisture content in the horny layer and the volume of transepidermal water loss from the lip skin. Further, to evaluate skin physiological functions, we measured the number of nucleated cells and levels of tumor necrosis factor (TNF-α) and thymic stromal lymphopoietin (TSLP) in horny layer cells collected by tape stripping. Forty-seven patients out of 50 were evaluated, and 3patients discontinued the use of the cream because of individual preferences. In regards to adverse events, 1 patient observed mild scaling and sclerosis of the lip skin, but continued cream usage. After 4 weeks of cream usage, we observed that dryness, scale, cracking, erythema, and vertical wrinkles were improved significantly. Although no significant changes were observed in the horny layer moisture content and volume of transepidermal water loss, which was measured using conventional equipment, we observed a significant decrease in the number of nucleated cells and TNF-α, and TSLP levels in the horny layer cells. These results suggest that “Nov® Lip Care Cream UV” improves cutis symptoms in dry lips. Additionally, we confirmed that horny layer analysis using tape stripping is useful for the evaluation of skin physiological functions in lips, where accurate measurements of the moisture content and volume of water loss are difficult because of their irregular shape, elasticity, and their involvement in pulmonary respiration.View full abstractDownload PDF (1311K)
Dermatologists around the World
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Masutaka FURUE2013 Volume 75 Issue 6 Pages 545-546
Published: December 01, 2013
Released on J-STAGE: March 12, 2014
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