The Nishinihon Journal of Dermatology
Online ISSN : 1880-4047
Print ISSN : 0386-9784
ISSN-L : 0386-9784
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Volume 76, Issue 5
Displaying 1-14 of 14 articles from this issue
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Color Atlas
Mini Review
Clinical Case Reports
  • Contact Dermatitis due to Disperse Dyes in the Pajamas
    Aya UKIDA, Osamu YAMASAKI, Osami NISHIHARA, Kazumi SASAKI
    2014 Volume 76 Issue 5 Pages 442-446
    Published: October 01, 2014
    Released on J-STAGE: February 03, 2015
    DOIhttps://doi.org/10.2336/nishinihonhifu.76.442
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    A 39-year-old man was admitted to the department of cardiovascular surgery for an operation of lower limbs varication. Four days after the admission, itchy erythematous edematous rash appeared on his face, neck and elbow, and became enlarged. Positive reactions to patch testing were induced by the pajamas. We analyzed the pajamas and obtained samples of textile dyes used for polyester. The patient reacted positively to Disperse Blue 106 and 124. We diagnosed his allergy as contact dermatitis induced by disperse dyes similar to Disperse Blue 106 and Disperse Blue 124. When a toxic rash occurs during hospitalization, we should be aware of a possible occurrence of contact dermatitis due to the patient's pajamas.
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  • A Case of Granuloma Annulare Successfully Treated with Narrow-band UVB
    Shingo MATSUKI, Kazuo MIZUMOTO, Youji KAWASAKI, Manabu YOSHIDA, Eishin ...
    2014 Volume 76 Issue 5 Pages 447-453
    Published: October 01, 2014
    Released on J-STAGE: February 03, 2015
    DOIhttps://doi.org/10.2336/nishinihonhifu.76.447
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    A 75-year-old man with a history of type 2 diabetes mellitus (DM) presented with erythematous papules on his back and the dorsum of the hand. Skin biopsy was performed for the papules on his back, and a pathological examination showed small non-caseating epithelioid granulomas. Because no other organ abnormalities were found on a computed tomography scan and other examinations, the patient was diagnosed with cutaneous sarcoidosis. Oral corticosteroid therapy was initiated when facial papules began to appear. With the corticosteroid therapy, the facial papules almost disappeared, but type 2 DM gradually worsened. Furthermore, new annular eruptions began to appear on his abdominal area. Skin biopsy was performed for the abdominal lesions, and a pathological examination showed epithelioid granulomas with unclear margins. Based on this pathological finding and the clinical history, we diagnosed these new eruptions as granuloma annulare (GA). The annular eruptions expanded to the whole body when we decreased the amount of oral corticosteroids in order to better control DM. Narrow-band UVB therapy was initiated twice a week. When the accumulating total UVB reached 20 J/cm2,the lesions almost disappeared. Here we report the effectiveness of narrow-band UVB irradiation therapy for disseminated GA, which we could use as an outpatient treatment. Furthermore, we discuss the mechanisms of narrow-band UVB for GA treatment and the relationship between DM ingravescence and worsening GA symptoms.
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  • Early Onset of Acute Compartment Syndrome Diagnosed by a Simple Needle Manometer Technique
    Shigetaka MATORI, Takuya MIYAGI, Hukuko HANASHIRO, Tetsu SONOSAKI, Ken ...
    2013 Volume 76 Issue 5 Pages 454-458
    Published: November 28, 2013
    Released on J-STAGE: February 03, 2015
    DOIhttps://doi.org/10.2336/nishinihonhifu.76.454
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    A 66-year-old woman was bitten by a Habu snake in the leg at home. One bite mark was observed on the dorsum pedis,and she complained of severe pain. Three hours after injury, a swollen erythema with a burning sensation spread toward the lower right thigh and the serum CPK (creatine phosphokinase) level increased. A severe elevation, 70 mmHg (normal values of 0-8 mmHg), of the intra-compartmental pressure in the lower leg muscles was recorded by a simple needle manometer technique, and she was diagnosed as acute compartment syndrome. The patient was treated with emergency incisional fasciotomy and recovered without any sequela or renal damage by a myonecrosis. The needle manometer technique is a simple but very useful method to detect the early onset of acute compartment syndrome of various causes, including snake poison.
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  • A Case of Alopecia Ophiasis Effectively Treated with 308 nm Excimer Lamp
    Maiko WADA, Akiko SATOMURA, Takamichi ITOU, Masakazu TAKAHARA , Masuta ...
    2014 Volume 76 Issue 5 Pages 459-464
    Published: October 01, 2014
    Released on J-STAGE: February 03, 2015
    DOIhttps://doi.org/10.2336/nishinihonhifu.76.459
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    A 14-year-old Japanese girl presented with a 2-year history of gradually developing hair loss in the hairline at the back and left side of the scalp. A diagnosis of alopecia ophiasis was made based on clinical features. Despite various treatments, including topical capronium chloride, topical corticosteroid, oral cepharanthin, oral grycyron and local immunotherapy with SADBE, the lesions showed gradual aggravation. We then started phototherapy with a 308 nm excimer lamp after obtaining informed consent. Three month after the initiation of the 308 nm excimer lamp therapy, more than 75% hair regrowth was observed. We suggest that the 308 nm excimer lamp therapy is effective in the treatment of alopecia areata of children.
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  • A Case of Fibrous Papule of the Nose with Abundant Hair Follicular Structures
    Kazuyo KITA, Shiori KATO, Makiko KIDO-NAKAHARA , Takeshi NAKAHARA , ...
    2014 Volume 76 Issue 5 Pages 465-468
    Published: October 01, 2014
    Released on J-STAGE: February 03, 2015
    DOIhttps://doi.org/10.2336/nishinihonhifu.76.465
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    A 68-year-old male presented with a 10-year history of a pedunculated nodule on his nose. Dermoscopy showed a white hair and a brownish pseudopigmented network-like structure. A histopathological analysis of the lesion revealed a proliferation of collagen fibers and dilatation and proliferation of capillaries associated with occasional satellite cells, which were immunohistochemically positive for factor ⅩⅢa and CD34, and negative for S-100 protein. Based upon these findings, a diagnosis of fibrous papule of the nose was suggested. However, there were areas of aggregation of mature and immature hair follicles with surrounding clefts dividing fibrofollicular units from one another in superficial parts of the upper dermis. We therefore diagnosed this case as a fibrous papule of the nose with abundant hair follicular structures. Our case would support the theory that fibrous papule of the nose probably represents a proliferative reactive process of a follicular unit affected by some external stimuli.
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  • A Case of Giant Subcutaneous Dermoid Cyst of the Right Shoulder
    Azusa KATANO, Daisuke UTSUMI, Aoi OHIRA, Yuriko KASUYA, Yoshiyuki KA ...
    2014 Volume 76 Issue 5 Pages 469-472
    Published: October 01, 2014
    Released on J-STAGE: February 03, 2015
    DOIhttps://doi.org/10.2336/nishinihonhifu.76.469
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    We describe a 16-year-old man suffering from a giant subcutaneous dermoid cyst. The patient presented a subcutaneous nodule on the right shoulder that he had had since birth, which gradually grew into a mass with the size of a chicken egg. The tumor could be removed easily from underling tissues and had fistula on the surface of the mass, from which several hair shafts projected. Contrast-enhanced computed tomography revealed a 86×44×67 mm well circumscribed low density unilocular cyst on the upper-dorsal aspect of the right scapula. The resected tumor displayed a fibrous connected tissue capsule that contained hair and atheromatous substance. A diagnosis of subcutaneous dermoid cyst was established based on the histopathological findings represented by a cyst lined by stratified squamous epithelium with hair follicles, sebaceous glands and smooth muscle. No recurrence had been observed for 20 months after the operation. Most subcutaneous dermoid cysts appear in the region of the head and neck, but rarely in other regions. Only 7 cases of subcutaneous dermoid cysts with diameters of more than 5 cm have been reported in Japan. Among these 7 cases, our case was the only one with the cyst observed in a region other than head and neck.
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  • Solitary Umbilical Paget's Disease : A Case Report
    Maki MAKINO, Eiichi MAKINO, Shunsuke SASAOKA, Daigo OKA, Wataru FUJIMO ...
    2014 Volume 76 Issue 5 Pages 473-477
    Published: October 01, 2014
    Released on J-STAGE: February 03, 2015
    DOIhttps://doi.org/10.2336/nishinihonhifu.76.473
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    An 86-year-old Japanese man noticed erythema on his abdomen more than 5 years before his first visit to our department. Two years earlier, he was diagnosed with prostate cancer, and had received anti-androgen therapy. On his first visit, he presented with a large, well-demarcated erythema, about 20×22 mm in size in the center of the abdomen. Blurred, mottled light brown patches were observed in the area surrounding the erythema, but no obvious infiltration on palpation, or other abnormalities were observed in the genitalia, axilla, and perianal regions. Abdominal computed tomography revealed thickened skin lesions that led to the umbilicus in the subcutaneous tissues. A skin biopsy confirmed the diagnosis of extramammary Paget's disease. No signs of regional lymph node involvement or distant metastasis were observed, and the patient underwent surgery. Neither recurrence nor metastasis has been observed for 3 years after surgery. Umbilical Paget's disease is a rare condition, and only 5 such cases have been reported in Japan. Among them, 4 cases showed multiple lesions in other parts of the body in addition to the umbilicus. To the best of our knowledge, this is the first detailed report of solitary umbilical Paget's disease in a patient who previously had received anti-androgen therapy for prostate cancer.
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  • [title in Japanese]
    Aki HASHIMOTO, Machiko HISATOMI, Shinichi KOBA, Tsuyoshi OOKAWA, Nor ...
    2014 Volume 76 Issue 5 Pages 478-481
    Published: October 01, 2014
    Released on J-STAGE: February 03, 2015
    DOIhttps://doi.org/10.2336/nishinihonhifu.76.478
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    [in Japanese]
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Review
Statistics
  • A Comparative Study of Adult-onset Anaphylactoid Purpura Associated with Malignancy and without Malignancy
    Akimasa SAITO, Yasuhiro FUJISAWA, Yoshiyuki NAKAMURA, Junichi FURUTA , ...
    2014 Volume 76 Issue 5 Pages 487-492
    Published: October 01, 2014
    Released on J-STAGE: February 03, 2015
    DOIhttps://doi.org/10.2336/nishinihonhifu.76.487
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    Adult-onset anaphylactoid purpura (AP) is known to be associated with malignancy. However, few reports have described the clinical differences between adult-onset AP with malignancy and that without malignancy. We retrospectively reviewed data from 19 adult-onset cases of AP between 2004 and 2012 in our department and categorized them into two groups to compare their clinical features and managements : a malignancy group (group A : 6 cases) and a non-malignancy group (group B : 13 cases). In group A, all the patients had solid tumors and 3 cases (50%) were diagnosed as AP at the time of or prior to the discovery of malignancy. There were no significant differences between the two groups in the incident of precursory infections, arthralgia, gastrointestinal symptoms, or widespread purpura ranging beyond the lower limbs. The incident of renal dysfunction was significantly higher in group A than in group B (P＜0.05). There were no significant differences between the two groups in the level of serum IgA and ASO. In group A, systemic steroid therapy mainly applied to renal dysfunction. We should be aware of the possibility of underlying malignancy when we encounter adult-onset AP. Because of the high rate of renal dysfunction, careful observation is recommend for adult-onset AP patients with malignancy.
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Therapy
  • Clinical Efficacy and Irritability of Protopic® Ointment 0.1%
    ― Effects of Dual Application of Hirudoid® Lotion 0.3% ―
    Takeshi NAKAHARA, Makiko NAKAHARA , Kazuyo KITA, Eriko ITOH, Satoshi T ...
    2014 Volume 76 Issue 5 Pages 493-497
    Published: October 01, 2014
    Released on J-STAGE: February 03, 2015
    DOIhttps://doi.org/10.2336/nishinihonhifu.76.493
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    Topical emollients and anti-inflammatory drugs are key remedies for atopic dermatitis (AD). We examined the effects of heparinoid moisturizer (Hirudoid® lotion 0.3%) on the clinical effectiveness and irritability of topical tacrolimus. Half side comparative application study was conducted on two affected area, namely face and trunk/extremities, in seventeen patients with AD (15 moderate cases, 2 severe cases) ; right side was applied once a day with Protopic® ointment 0.1% only (Tacro group), and left side with Hirudoid® lotion 0.3% + Protopic® ointment 0.1% (Hirud + Tacro group) for 2 weeks. Skin severity was evaluated by 5-grade scores ; 0 : none, 1 : mild, 2 : moderate, 3 : severe, 4 very severe. Irritability of topical tacrolimus was evaluated by 5-grade scores ; 1 : very strong irritation, 2 : strong irritation, 3 : mild irritation, 4 : almost no irritation, 5 :no irritation. Significant improvement was observed in skin severity after 2 weeks treatment both in Tacro group and Hirud + Tacro group, and the clinical efficacy of Tacro group was similar to Hirud + Tacro group. As for the tacrolimus-associated irritation after 1-week application, 5 patients reported their irritation as Hirud + Tacro < Tacro, 12 as Hirud + Tacro = Tacro,and 0 as Hirud + Tacro > Tacro. These results prove that topical application of Hirudoid® lotion 0.3% does not weaken the clinical efficacy of Protopic® ointment 0.1%. Moreover, Hirudoid® lotion 0.3% may be feasible to reduce the tacrolimusassociated skin irritation in a part of AD patients.
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