All issues
Volume 77 (2015)
- Issue 6 Pages 533-
- Issue 5 Pages 443-
- Issue 4 Pages 333-
- Issue 3 Pages 201-
- Issue 2 Pages 109-
- Issue 1 Pages 1-
Volume 77, Issue 2
Displaying 1-14 of 14 articles from this issue
- |<
- <
- 1
- >
- >|
Color Atlas
-
Haruna HIROSE, Shuei SATO, Toshihiro SATO2015 Volume 77 Issue 2 Pages 109-110
Published: April 01, 2015
Released on J-STAGE: July 28, 2015
JOURNAL RESTRICTED ACCESSDownload PDF (1035K)
Mini Review
-
― Comparison of Environment between Japan and TibetYasuyuki SUMIKAWA2015 Volume 77 Issue 2 Pages 111-114
Published: April 01, 2015
Released on J-STAGE: July 28, 2015
JOURNAL RESTRICTED ACCESSDownload PDF (1003K)
Clinical Case Reports
-
A Case of Eosinophilic Granulomatosis with Polyangiitis Initially Presenting with Edematous ErythemaMai HONDA, Yutaka KUWATSUKA, Kosuke YOSHIMI , Saori TOMIMURA, Makoto H ...2015 Volume 77 Issue 2 Pages 115-118
Published: April 01, 2015
Released on J-STAGE: July 28, 2015
JOURNAL RESTRICTED ACCESSA 51-year-old man who was diagnosed with Crohn's disease at 27 years old had been treated by subcutaneous injection of adalimumab since he was 50 years old. From one month prior to the first visit, edematous erythema with itch frequently appeared at various locations throughout his body. The erythema was diagnosed as urticaria at a nearby hospital, and antiallergic agents were prescribed to be taken together with oral prednisolone for three days. However, the erythema returned after the discontinuation of oral prednisolone. He was referred to our department and admitted to our hospital. While the erythema on the limbs and trunk disappeared after bed rest and continuation of the antiallergic agent, his serum eosinophils count gradually increased to 64%. Moreover, joint pain in the extremities appeared and worsened. On the 20th day of antiallergic agents administration, multiple purpura appeared on his lower legs and hands. Histological examination of skin biopsies obtained from the purpura showed infiltration of eosinophils and neutrophils around the small blood vessels and fibrinoid necrotizing vasculitis in the superficial dermis. Based on these findings, eosinophilic granulomatosis with polyangiitis (EGPA) was diagnosed. Treatment with oral prednisolone (30 mg/day) improved the clinical symptoms. The symptoms have not relapsed for nine months from the start of treatment through tapering of oral prednisolone to 15 mg/day. As the cutaneous manifestations of EGPA are varied, this case took some time to reach the correct diagnosis.View full abstractDownload PDF (1144K) -
Yusuke KURATA, Takahiro YAMADA, Miwa HIROSHIGE, Makoto KUBO, Michiya Y ...2015 Volume 77 Issue 2 Pages 119-123
Published: April 01, 2015
Released on J-STAGE: July 28, 2015
JOURNAL RESTRICTED ACCESSA 24-year-old Japanese woman visited our hospital complaining of arthralgia and a facial eruption. She had been diagnosed with systemic lupus erythematosus (SLE) at the age of 15 and treated with oral prednisolone, but she had discontinued the treatment 4 years previously. Physical examination revealed a butterfly rash, photosensitivity, and swelling of the knees, ankles, and fingers bilaterally. We made a diagnosis of acute exacerbation of SLE and reinstituted oral prednisolone at 40 mg/day. The treatment was effective and reduced her symptoms, but she suddenly developed right-sided hemiparesis on the 21st day of the treatment. Laboratory investigations revealed that she was positive for lupus anticoagulant, and magnetic resonance imaging (MRI) revealed cerebral venous thrombosis (CVT). These findings suggested that her condition was caused by antiphospholipid syndrome accompanied by SLE. Anticoagulant therapy (heparin sodium and warfarin) and intravenous methylprednisolone (1000 mg/day) improved the hemiparesis. MRI after these treatments showed recanalization of CVT, and recurrence was not observed. CVT might occur in patients with exacerbation of SLE ; therefore, we should be vigilant for CVT in this setting.View full abstractDownload PDF (1230K) -
Honoka IHARA, Monji KOGA, Kaori KOGA, Motokimi SHIRAISHI, Shinichi IMA ...2015 Volume 77 Issue 2 Pages 124-127
Published: April 01, 2015
Released on J-STAGE: July 28, 2015
JOURNAL RESTRICTED ACCESSA 27-year-old man presented to a nearby hospital with headache and a high fever. He was referred to our internists and diagnosed with tuberculous pyothorax by imaging examination and QuantiFERONR® test. Soon after, he was started on antituberculosis agents (isoniazid, rifampicin, and ethambutol) and gradually improved. No relapse has been observed since treatment began. However, brownish macules appeared gradually on his legs 1 year ago, and have increased in number. Specimens taken from the lesions showed epithelioid cell granuloma surrounding the homogenized substance in the dermis. These findings were not sufficient for definitive diagnosis, therefore, we referred to the findings of immunochemical staining with anti-Propionibacterium acnes antibody (PAB antibody) and Ziehl-Neelsen stain. These results together with a high level of angiotensin-converting enzyme in the peripheral blood test and a negative result for the tuberculin test led to a definitive diagnosis of sarcoidosis. Recently, positivity for PAB antibody staining has been the crucial finding for differential diagnosis of tuberculosis and sarcoidosis. However, to the best of our knowledge, no study on tuberculin with PAB antibody has been published. Although the present case did not show any involvement of the tubercle bacillus in sarcoidosis, tuberculin-like clinical manifestations were of particular significance in considering the pathogenesis.View full abstractDownload PDF (1123K) -
Toshikazu OMODAKA, Koichi HAYASHI, Fuminao KAMIJO, Atsuko OHASHI, Tom ...2015 Volume 77 Issue 2 Pages 128-130
Published: April 01, 2015
Released on J-STAGE: July 28, 2015
JOURNAL RESTRICTED ACCESSA 26-year-old Japanese female presented with a two-week history of a gradually growing erythematous swelling on her left lumbar region, 10 cm in diameter with pain and oozing pus. Physical examination showed no fever and no abdominal signs. Contrast-enhanced computed tomography and magnetic resonance imaging revealed that the subcutaneous swelling was connected with an enterocutaneous fistula. Bacterial cultivation identified Escherichia coli and Streptococcus anginosus from the pus. We performed drainage together with administration of antibiotics immediately. A barium enema showed stenosis of the descending colon and enterocutaneous fistula. Colonoscopy showed a cobblestone appearance of the colonic mucosae as well as colonic stenosis. She was diagnosed with an enterocutaneous fistula associated with Crohn's disease, and was treated with anti-TNF-α therapy. Although subcutaneous abscess is common, enterocutaneous fistula caused by Crohn's disease is uncommon. Physicians should consider the possibility of enterocutaneous fistula in cases presenting with a subcutaneous abscess on the trunk.View full abstractDownload PDF (1043K) -
Mika MIZOTE, Chikage MITOMA, Masutaka FURUE2015 Volume 77 Issue 2 Pages 131-133
Published: April 01, 2015
Released on J-STAGE: July 28, 2015
JOURNAL RESTRICTED ACCESSWe report a unique case of protuberant type of pilomatricoma on the preauricular region in an aged woman. A 67-year-old woman noticed a tumor on her preauricular region about 3 months previously. On her first visit to our hospital, a black-brown soft tumor measuring 6 × 3 mm was recognized on her preauricular region. Histologically, the tumor showed the typical features of pilomatricoma, consisting of basophilic cells and shadow cells. Dermoscopic features showed irregular white structures, white streaks, and reddish homogeneous area with irregular vessels. Pilomatricoma is commonly observed as a subcutaneous nodule on the face and neck in young patients ; however, it can develop in elderly people with a variety of clinical manifestations. Our case suggested that dermoscopy is useful for the diagnosis of pilomaticoma to a certain degree. Also, pilomatricoma should be included in the differential diagnosis of protuberant tumors of face and neck, even in aged individuals.View full abstractDownload PDF (1098K) -
Akiko NAKAMURA, Yoshitaka NAKAMURA, Kishiko MATSUMOTO, Yusuke KURATA, ...2015 Volume 77 Issue 2 Pages 134-137
Published: April 01, 2015
Released on J-STAGE: July 28, 2015
JOURNAL RESTRICTED ACCESSA 54-year-old Japanese woman presented with purpuric eruptions on both legs, associated with arthralgia and swelling of wrist, knees, and ankles bilaterally. The patient's temperature was 38.3 ℃ and laboratory investigations identified a raised erythrocyte sedimentation rate and a C-reactive protein level of 2.53 mg/dl, an increased serum rheumatoid factor (RF) level of 632.9 U/ml, and a decreased CH50 level of 25.3 U/ml. Histopathological examination of a skin biopsy from the purpuric lesion of the right lower leg revealed a perivascular neutrophil dominant inflammatory cell infiltration with leukocytoclasis, red blood cell extravasation, and fibrinoid degeneration of the small vessel walls in the upper and middle dermis, consistent with leukocytoclastic vasculitis. Rheumatoid arthritis (RA) was initially suspected, but we diagnosed our patient as human parvovirus B19 (HPaV-B19) infection from the result of a positive serum HPaV-B19 IgM antibodies level of 8.84. The symptoms of pyrexia, arthralgia, and skin lesions were resolved in 12 days with supportive measures. Recurrence was not observed thereafter, although her raised serum RF level has remained positive. HPaV-B19 infection should be kept in mind as a differential diagnosis in an adult case presenting with RA-like symptoms and atypical eruptions.View full abstractDownload PDF (1191K) -
Reika FUKUCHI, Kaori NISHIMURA, Motoi TAKENAKA, Katsutaro NISHIMOTO2015 Volume 77 Issue 2 Pages 138-141
Published: April 01, 2015
Released on J-STAGE: July 28, 2015
JOURNAL RESTRICTED ACCESSCase 1 : An 8-month-old boy. One month before the first visit to hospital, a bean-size red nodule appeared on his right cheek. Oral antibiotics and topical antifungal ointments were not effective. There had been no episodes of injury to the affected site. Case 2 : A 73-year-old man sustained an injury to his left hand 11 months before the first visit to our hospital. Six months later, a red nodule 3 cm in diameter developed on the left hand dorsa, and after another 2 months, multiple similar red nodules appeared on the right arm, each 2 cm in diameter. Diagnosis of sporotrichosis was made based on histological findings and the isolation of Sporothrix schenckii. Both cases healed following treatment with oral itraconazole and hyperthermia. In contrast to adult cases, there have only been a few case reports of infatile sporotrichosis treated with itraconazole. For the treatment of infantile cases, oral itraconazole is required to be administered at 5 mg/kg/day for 2-3 months.View full abstractDownload PDF (1223K) -
Kenjiro TAKEI, Masakazu TAKAHARA, Konosuke NAGAE, Gaku TSUJI, Tetsuo M ...2015 Volume 77 Issue 2 Pages 142-145
Published: April 01, 2015
Released on J-STAGE: July 28, 2015
JOURNAL RESTRICTED ACCESSA 72-year-old man who had been treated for hypertension and diabetes mellitus accidentally punctured the skin of his forearm with a rose thorn 3 months before he visited our hospital. He presented with a crusted infiltrative erythema of 2 cm diameter on the left forearm and no other symptoms. Cultures of biopsied skin tissue with Sabouraud dextrose agar slants revealed white-orange colonies with a smooth surface and wrinkles. Gram staining of the cultured microorganism revealed branched bacilli. These results strongly suggested cutaneous nocardiosis. The isolated strain was finally identified as Nocardia brasiliensis by tests conducted at the Medical Mycology Research Center of Chiba University. On the basis of these findings, the patient was diagnosed with localized cutaneous nocardiosis caused by Nocardia brasiliensis. The patient was cured in 6 weeks by treatment with oral minocycline.View full abstractDownload PDF (1148K)
Review
-
― Benign Tumor, Carcinoma in situ ―Yoshiaki KUBO2015 Volume 77 Issue 2 Pages 146-152
Published: April 01, 2015
Released on J-STAGE: July 28, 2015
JOURNAL RESTRICTED ACCESSDownload PDF (1769K)
Therapy
-
Hiromi NARITA2015 Volume 77 Issue 2 Pages 153-158
Published: April 01, 2015
Released on J-STAGE: July 28, 2015
JOURNAL RESTRICTED ACCESSHere, a review is reported of 123 mucous cysts in 122 digits of 116 patients, who were treated by the author between October 2009 and February 2014. Epidemiological data was investigated about age, gender, finger or toe involved, and presence of a nail deformity and the Heberden's node. All the patients were treated by puncture and drainage of the cysts and subsequent compression of the affected digits with surgical tape. These treatments were repeated as needed. Treatment outcomes were also examined and the effectiveness of the method was evaluated. The average age of the patients was 62.0 years (range, 28-87 years). Forty-eight patients (40%) were men and 71 (60%) were women. One hundred and three fingers and 20 toes were affected. The most common digit affected was the middle finger (46 digits). None of the cases included in the review were affected on the fifth toe. Nail deformities manifesting as a longitudinal groove, which occurred secondary to the mucous cysts, were present in 27 of 60 digits (45%). Heberden's nodes were present in 23 of 58 fingers (40%). After a series of treatments, follow-up was carried out in 44 patients. Thirty-nine of 45 cysts (87%) disappeared completely after puncture treatment being performed 2.8 times on average (range, 0-19 times) and 4.4 months of continuous compression on average (range, one week-29 months). The combination of puncture, drainage, and compression by tape for the treatment of digital mucous cysts is a convenient and minimally invasive procedure that does not disturb the daily life of patients. Therefore, repetitive and long-term treatments may be accepted by some patients and may result in complete remission of the cysts. It should also be emphasized that longitudinal grooving of nails was important as an aid in the diagnosis and digital mucous cysts and evaluation of their response to treatment.View full abstractDownload PDF (1365K) -
Hideo NAKAYAMA, Ko-Ron CHEN , Kazuhiro IGA, Hiroyuki JINNAI2015 Volume 77 Issue 2 Pages 159-165
Published: April 01, 2015
Released on J-STAGE: July 28, 2015
JOURNAL RESTRICTED ACCESSFor the purpose of treatment for hyperpigmentation, such as melasma, pigmented cosmetic dermatitis (PCD), dirty neck and other various postinflammatory pigmentation which did not easily disappear spontaneously were treated by the application of 0.4% kojic acid plus 0.05% liquiritin (0.45KL II cream) every day. The effect was followed up monthly, with the photographs taken from the same angle and distance using the same camera and color films. Results : melasma was improved at the rate of 94.4%, including 34 patients of complete cure and improvement when 0.45KL II cream used on average 10 months. PCD patients were patch tested using current cosmetic series patch test allergens, then they were requested to exclusively use the cosmetics and soaps which did not contain causative allergens to remove the crucial effect of various cosmetic allergens. Then they were requested to use 0.45KL II cream to speed up the improvement of hyperpigmentation. 16 out of 17 PCD patients were improved or cured at the rate of 94.1%. Only one Indonesian severe PCD patient who had multiple sensitization showed incompatibility to this whitening agent. 17 out of 19 postinflammatory hyperpigmentation including dirty neck showed improvement at the rate of 89.5%. 0.45KL II cream was concluded as to be very effective to the above mentioned hyperpigmentation with excellent adaptability. Production of leukoderma has never been recorded during 30 years of various formula of kojic acid.View full abstractDownload PDF (573K)
Dermatologists around the World
-
Yoshinori UMEZAWA2015 Volume 77 Issue 2 Pages 169-170
Published: April 01, 2015
Released on J-STAGE: July 28, 2015
JOURNAL RESTRICTED ACCESSDownload PDF (1004K)
- |<
- <
- 1
- >
- >|