We assessed the severity of itching and the early inhibitory effects of antiallergic drugs on itching in 16 hospitalized patients with asteatotic dermatitis using the Visual Analogue Scale (VAS). During the observation period, data was inputted in the VAS by the patients themselves at breakfast and supper times enabling nocturnal itching (itching from evening to night) as well as daytime itching (itching from morning to evening) to be determined. A crossover examination of oxatomide and epinastine hydrochloride was performed to compare their early inhibitory effects on itching in the patients. Nocturnal itching was higher than daytime itching during the observation period. Oxatomide significantly reduced daytime and nocturnal itching compared to those before administration. On the other hand, daytime itching was also significantly suppressed by epinastine hydrochloride. However, there was no significant difference in nocturnal itching before and after having administered epinastine hydrochloride. These findings suggested that oxatomide is expected to produce early inhibitory effects on itching in patients with asteatoic dermatitis.

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Fragrance materials used for foods are called food flavors and spices. Reports on allergic contact dermatitis from spices are relatively few, except for cinammon oil, clove, peppermint oil and menthol.
We have applied 13 kinds of spices as patch test allergens. The test allergens were menthol, camphor oil, peppermint oil, clove, red pepper, caraway, coriander, ginger, thyme, Japanese pepper, nutmeg, white pepper and laurel. Cinnamic aldehyde and cinnamic alcohol, main ingredients of cinnamon oil are patch tested as standard fragrance materials.
Three cases of allergic contact dermatitis from spices were reported.
Case 1 showed positive reactions to menthol, camphor oil, peppermint oil, red pepper, caraway, coriander and shiitake mushroom. Case 2 showed positive reactions to ginger and thyme. Case 3 showed positive reactions only to clove. Clinical findings were contact cheilitis in the all three patients. It should be noticed that contact cheilitis has no itching even in allergic reaction, and is induced with various allergens.

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Here we report severely burned two cases with alcoholic liver disease. Their transaminases were remarkably elevated with suppressed choline esterase levels. Because of the widely distributed third degree burn, we have to perform debridement followed by thin split skin grafts for several times. It happened bleeding at the first operation in both cases. Coagulatory insufficiency developed because of the consumption of factor VII and XIII by burn with poor supply of them by severe alcoholic liver dysfunction. Then, we pretreated them with fresh frozen plasma and vitamin K, and surgically treated them after returning the clotting factor within normal level. Since the alcoholism patients are the high risk group for the severe burn, we should be careful to keep coagulatory function within normal levels for these patients.

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On March 25, 2002, a 63-year-old male with a medical history of hepatocellular carcinoma developed on liver cirrhosis by hepatitis C, and partial hepatectomy (S8 region, performed 3years ago) followed by repeated transcatheter arterial chemotherapy for intrahepatic recurrence of the tumor, was injected with a mixture of lipiodol, mitomycin and farmorubicin through the 10th intercostal artery that fed the hepatic tumor. He experienced pain in the right dorsolateral area of the back the next day, and developed strongly infiltrative and indurative erythema at the painful site 3 days after the treatment. Pathology showed partial necrosis of keratinocytes and appendages, embolization of small vessels, perivascular edema, infiltration of neutrophils around the vessels, and extravasation of erythrocytes. There was no degeneration or necrosis of collagen fiber. Acrinol packing was performed for dermatitis and inflammation gradually disappeared 3 weeks after transcatheter arterial chemotherapy, leaving pigmentation, sclerosis and an intractable ulcer. Injury of the epidermis and vessels was considered due to the cytotoxic effect of the anti-cancer drug and the ischemic effect of lipiodol.

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A 74-year-old woman developed arthralgia and deformation of the fingers and the toes, reddish-purple discoloration of the face, Raynaud′s phenomenon, and positive antinuclear antibodies (ANA). She had been followed up in another clinic suspecting of connective tissue diseases (CTDs). She visited our hospital, desiring further examinations. Examination of the skin showed pernio-like plaques on the face and the hands. Skin biopsy specimens were taken from the plaques of the face and the hand. Hematoxylin-eosin staining specimens from both lesions showed non-caseating granulomas in the dermis. The chest roentgenogram and the computer tomography revealed a bilateral hilar and mediastinal lymphadenopathy. An ophthalmological examination disclosed a nodular lesion in the chamber angle. The tuberculin test was negative. The patient was diagnosed as lupus pernio. Serological examination revealed positive ANA with positive anticentromere antibodies suggesting the subclinical existence of CTDs, especially limited Systemic Sclerosis (lSSc). However, our case does not satisfy the criteria for lSSc.

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A 37 year old woman was consulted to our hospital for the evaluation of many brown or black flat tumors on the trunk on October 1st, 1997. According to the patient, some of them had became flared with mild tenderness and their color changed to reddish black. Since the first visit , tumors began to become smaller and changed to small prominent nodules, and then gradually fell off in eight months. Histology of the nodule without inflammation was consisted with seborrheic keratosis. The histology of inflamed tumors exhibited that both edges of the horny layer invaded into the epidermis. The small prominent nodules that just began to fall off showed the papillomatous change of the epidermis accompanying hematoma in the horny layer and infiltration of plasma cells, eosinophiles and lymphocytes.
According to Berman, spontaneous regression of seborrheic keratosis includes three types, 1) papillomatous changes of the picked epidermis, 2) pseudo-horny cyst going through the epidermis and 3) infiltration of inflammatory mononuclear cells in the upper dermis. Taken together of our findings, the regression pattern of seborrheic keratosis in our case is consisted with the type of the papillomatous changes of the picked epidermis in the classification by Berman.

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We report a case of various kinds of apocrine tumors arising in nevus sebaceus. The patient was a 44-year-old man, who first had a nevus sebaceus on his left temporal region. A reddish tumor arose in it one year ago and gradually developed in size. The tumor measured 3×2×1.5cm. The tumor had some histopathological features ; those of syringocystadenoma papilliferum, tubular apocrine adenoma, apocrine hidrocystoma, and syringomatous tumor. Immunohistochemically, GCDFP-15 was positive in every portion of the tumor.

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We here describe two cases of non-pigmented basal cell epitheliomas. Case 1, the patient was a 57-year-old woman. She noticed a flesh colored nodule on her dorsum nasi for 5 years ago. In April 2000, she visited to our department because of examining this tumor. The histopathological examiniation revealed a solid type basal cell epithelioma. Case 2, the patient was a 36-year-old man. He noticed a flesh colored nodule on his saddle nose for 15 years ago.
In Novmber 1999, he visited to our department because of examining this tumor. The histopathological examiniation revealed a basal cell epithelioma which was composed of solid lesions and morphea-like lesions. The immunohistochemical studies of our cases showed basal cell epithelioma patterns using antibodies to human membrane epithelioma antigen(EMA), human cytokeratin 20, NSE, human bcl-2 oncoprotein and CD34 ; The human bcl-2 oncoproteins are positive of our cases, but other antigens are negative.
We analized 12 cases of non-pigmented basal cell epitheliomas that have been reported for 10 years ago in Japan. And we concluded that non-pigmented basal cell epitheliomas in the Japanese patients can be classified intofive clinical types.

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Cholesterotic fibrous histiocytoma is a rare variant of common fibrous histiocytoma. Due to the replacement by cholesterotic deposits with the tumor and to the association with hyperlipidemia, this type of fibrous histiocytoma is regarded to be the histiocytic response to cholesterotic substances derived from circulating blood. We present an unusual case of cholesterotic fibrous histiocytoma not associating with hyperlipidemia. Hence, this case report may add a newer paradigm of the members of fibrous histiocytoma.

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We herein report a case of solitary genital leiomyoma, in a 70-year-old man with a lesion of the right side of scrotum. Microscopic examination revealed the tumor tissue to be circumscribed within the dermis and adjacent to the dartos muscle. The tumor consisted of interlacing bundles of smooth muscle cells and contained centrally located, uniform, long and blunt-edged,‘eel-like’nuclei. The smooth muscle bundles showed slight vacuolization, especially in cross sections. No mitotic figures were seen.
The dartos muscle and tumor cells were positive for actin and desmin .
We discerned this tumor as a solitary genital leiomyoma from above results.

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A fifty-eight year-old male first came to our hospital on November, 2001. Red-brown papules and nodules had appeared on his face since 1991, and then, on his chest and back since 1999. Indurated red-brown maculae and nodules had scattered mainly on his face, chest and back. Lymph nodes were palpable on his neck, axillae and inguinal area. Laboratory test showed anemia, hyperproteinemia, and polyclonal hypergammmaglobulinemia. Pathological examination of the skin revealed dense perivascular infiltration of mature plasma cells in the dermis, and there were similar findings in lymph node from neck and bone marrow. We diagnosed this patient as systemic plasmacytosis, and started oral prednisolone (40mg/day) therapy because of progressive worsening of anemia and serum total protein level. While the skin lesion was slightly improved, marked improvement of anemia and hyperproteinemia were achieved. We also discussed about the treatment of systemic plasmacytosis quoting recent reports.

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We developed a new fabric, Bemceric^® that as compared to cotton fabric, has a smoother surface and a smaller amount of residual washing detergents. Short-term (3 days) and long-term (2 weeks) trials of Bemceric^® underclothes were performed in 114 adult patients with atopic dermatitis who had been wearing cotton underclothes. The short-term trial of Bemceric^® underclothes brought about a decrease in itch on the trunk in approximately half of the patients examined. A slight increase in itch occurred in a few patients. Similar results were obtained from the long-term trial. Thus, it appears that Bemceric^® underclothes are more beneficial to patients with atopic dermatitis than cotton underclothes.

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