The Nishinihon Journal of Dermatology
Online ISSN : 1880-4047
Print ISSN : 0386-9784
ISSN-L : 0386-9784
Volume 81, Issue 2
Displaying 1-12 of 12 articles from this issue
Index
Color Atlas
Mini Reviews
Clinical Case Reports
  • Hitomi MARUSHIMA, Yuka MIYOSHI, Akemi TAKEMOTO, Junji NAKANO
    Article type: case-report
    2019 Volume 81 Issue 2 Pages 103-105
    Published: April 01, 2019
    Released on J-STAGE: May 20, 2019
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    A 2-day-old Japanese male infant visited our hospital due to having scaly erythematous skin over the whole body. He had presented striking and generalized glistening, taut, and yellowish film stretched over the skin at birth. After shedding of the collodion membrane, generalized scaly erythroderma was apparent. The entire body surface showed hyperkeratosis with fissures. In addition, the eyelids and the lips were tethered and everted, i.e., ectropion and eclabion. These clinical features were consistent with collodion baby. Histological examination of a skin biopsy specimen revealed compact hyperkeratosis without either parakeratosis or acanthosis. The dilatation of small vessels was seen in the upper dermis. Taken together, the diagnosis of nonbullous congenital ichthyosiform erythroderma was made. Genetic examination demonstrated that the patient carried compound heterozygous missense mutations in TGM1 : aG→A change in exon 4 and a C→T change in exon 6, which were inherited from his parents. Both mutations have previously been identified in other families with the disease. The patient was treated with a topical preparation containing 20% urea. Although his skin condition has gradually been improving, continuous careful treatment will be needed, because there is no clear correlation between the mutations and the disease severity or prognosis.

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  • Midori TSUTSUMI, Misa NAKAMURA, Sotaro KAWAZU, Takamichi ITO, Masutaka ...
    Article type: case-report
    2019 Volume 81 Issue 2 Pages 106-109
    Published: April 01, 2019
    Released on J-STAGE: May 20, 2019
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    Here we report a case of an 88-year-old woman with secondary hemochromatosis. Because of severe anemia, she had received blood transfusions many times in the past three years. She had a history of surgical treatments for uterine cervical cancer and rectal cancer. Her entire skin showed a progressive greyish-blue hue. Histopathologically, Berlin blue staining-positive granules were found in the dermis and the subcutaneous tissue. Ultrasound sonography, CT, and MRI revealed the deposition of iron in the liver, pancreas, and spleen, leading to the diagnosis of hemochromatosis. The concentration of interleukin-6 in serum was elevated. We speculate that the elevated serum interleukin-6 was associated with the etiology of the severe anemia and hemochromatosis in this patient.

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  • Noriko KITAGAWA, Chikage MITOMA, Maiko WADA, Hiroshi UCHI, Masutaka FU ...
    Article type: case-report
    2019 Volume 81 Issue 2 Pages 110-114
    Published: April 01, 2019
    Released on J-STAGE: May 20, 2019
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    Sebaceoma is a benign sebaceous tumor that is commonly seen on the face of middle aged and older women. This tumor exhibits various histological growth patterns. "Rippled-pattern" is one of the growth patterns that shows tumor cells regularly arranged in palisading pattern. A 77-year-old man noticed a nodule on the parietal scalp two years prior to his presentation. He presented to our department due to the recurrence of the lesion after surgical treatment was performed at a previous hospital. On his initial visit to our department, a 12×11 mm skin-colored nodule was present on his parietal scalp. Histologically, the resected nodule showed a proliferation of basaloid tumor cells in the dermis, while rippled patterns were seen in parts of the tumor nests. However, sebaceous gland duct structures were not evident. Immunohistochemical staining revealed that the tumor cells were negative for Ber-EP4. Almost all the nuclei in the tumor cells stained positively for p63. In the rippled-pattern areas, adipophilin and perilipin stained positively in the cytoplasm of the tumor cells. Therefore, we diagnosed this case as rippled-pattern sebaceoma. Rippled-pattern sebaceoma arises predominantly in males and most frequently on the scalp, whereas conventional sebaceoma occurs more frequently in females and on the face. We present a typical case of rippled-pattern sebaceoma and discuss its characteristics.

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  • Kyoko FUKAI, Kotaro KOMATSU, Yuji MATSUO, Kentaro HAYASHI, Yoshiyuki K ...
    Article type: case-report
    2019 Volume 81 Issue 2 Pages 115-119
    Published: April 01, 2019
    Released on J-STAGE: May 20, 2019
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    Case 1 : An 87-year-old man was diagnosed as having L-type Hansen's disease at 18 years of age. He presented with a skin ulcer on the dorsal side of his left foot five years ago, which had gradually enlarged and developed a tumorous nodule. At his first visit to our hospital, he presented with a dome-shaped tumor on the dorsal side of his left foot. He was diagnosed with squamous cell carcinoma(SCC), and his left leg was amputated from below the knee. Case 2 : A 54-year-old man was diagnosed as having L-type Hansen's disease at 20 years of ago. He presented with a skin ulcer on his first toe when he was 43 years old. He was diagnosed with SCC at 47 years of age, and his right leg was amputated from below the knee. He had developed a callus on his left sole decades before, and a skin ulcer appeared on this callus when he was 52 years old. The skin ulcer expanded when he was 54 years old, and he was diagnosed with SCC. His left first, second, and third toes were then amputated. Three months after the operation, the tumor recurred from the postoperative wound and metastasized to the lung, and he died of the illness. Chronic refractory skin ulcers due to Hansen's disease can play a role in scar carcinogenesis. Considering the relatively poor prognosis of scar cancer, refractory ulcer due to peripheral neuropathy after Hansen's disease should be monitored carefully.

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  • Mai KAWAKAMI, Hiroki SHIMIZU, Yumiko KUBOTA
    Article type: case-report
    2019 Volume 81 Issue 2 Pages 120-124
    Published: April 01, 2019
    Released on J-STAGE: May 20, 2019
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    A 50-year-old woman visited our department with a 1-month history of a painful nodule with ulcer formation on her left lower leg that arose after she scratched an insect bite wound. Her leg ulcer produced some exudates and the ulcer did not improve upon the application of Iodocoat® ointment. Laboratory findings revealed hyperchloremia(156 mEq/l, normal range 98-108 mEq/l). Four years ago, she had treated chronic constipation with internal medicine and was found to have hyperchloremia, but closer inspection was not performed at that time. Through a detailed interview, we discovered that she had taken a commercial antipyretic analgesic(Naron® Karyu) for 10 years. On this basis, we suspected that she had pseudohyperchloremia owing to an excessive intake of bromide. Histopathologically, we found hyperkeratosis and pseudocarcinomatous hyperplasia in the epidermis in addition to a thick infiltration of neutrophils and abscess formation in the dermis. Therefore, we diagnosed the case as bromoderma because of the clinical and histopathological findings, the prolonged administration of a bromide-containing drug, and an elevated blood bromide level(500 mg/l, less than 5 mg/l). After the discontinuation of oral bromide, her ulcer reepithelialized immediately and the hyperchloremia normalized. In conclusion, the assessment of a history of exposure to a bromide-containing drug and the detection of hyperchloremia are helpful for the diagnosis of bromoderma mimicking pyoderma gangrenosum.

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Clinical and Investigative Report
  • Yusei NAKAGAWA, Yuko CHINUKI, Susumu MURATA, Hiroyuki NIIHARA, Reiko T ...
    Article type: research-article
    2019 Volume 81 Issue 2 Pages 125-127
    Published: April 01, 2019
    Released on J-STAGE: May 20, 2019
    JOURNAL RESTRICTED ACCESS

    Recent studies have revealed that sensitization to galactose-α-1, 3-galactose (α-gal), which is a major IgE-binding epitope in red meat allergy, is caused by tick bites. In this study, we examined the relationship between tick bites and sensitization to beef allergens by measuring the serum concentration of beef-specific IgE chronologically in nine patients with tick bite. Consequently, serum beef-specific IgE was detected in three of the nine patients at their first visit to our hospital. The serum concentration of beef-specific IgE had increased at 2 weeks after the first measurement in two of the nine patients. Furthermore, serum-specific IgE for α-gal was detected in five of the nine patients at their first visit. However, none of the nine patients clinically developed beef allergy. We herein report the relationship between tick bites and the possibility of sensitization to beef.

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Dermatological Researchers in the World
  • Dong-Youn Lee
    Article type: letter
    2019 Volume 81 Issue 2 Pages 131-132
    Published: April 01, 2019
    Released on J-STAGE: May 20, 2019
    JOURNAL RESTRICTED ACCESS

    Dr. Dong-Youn Lee is a professor and chair of the Department of Dermatology at Samsung Medical Center, Sungkyunkwan University, Seoul, Korea. He is a director for education program in Korean Dermatological Association. Dr. Lee graduated from Seoul National University (M.D., Ph.D.) and completed his dermatology residency and fellowship at the Seoul National University Hospital. On the weekends of his residency period, he participated in treating poor people free of charge. In 2004, he received International Board of Dermatopathology. He studied about innate immunity in sebocytes as a research fellow under the guidance of Professor Richard Gallo in the Department of Dermatology, University of California, San Diego from 2006 to 2008.

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