Cepharanthine (CE) is a biscoclaurine alkaloid obtained from the plant, Stephania Cepharantha Hayata. CE has been known to have a vasodilatory effect and has been used for the treatment of alopecia areata in Japan. However, the exact mechanism of CE’s effect on hair growth has not been clarified.
In this study, we analyzed the effect of CE on hair growth stimulation in a C3H/HeN mouse system in vivo. We also analyzed the effects of CE on cell proliferation of dermal papilla cells (DPCs) and outer root sheath cells (ORSCs) in vitro preliminarily.
For quantitative evaluation of hair growth in mice, 0.002% CE solution or vehicle solution (75% alcohol) were applied to the dorsum of the 8 weeks old C3H/HeN mice once daily for three weeks, after clipping the dorsal resting hair. A significant stimulatory effect on hair growth of mice treated with CE was seen compared with the vehicle treated group (p<0.05, n=10). In addition, 0.1μg/ml CE stimulated cell proliferation of cultured DPCs (p<0.05), but not that of cultured ORSCs.
These results confirmed that CE has a stimulatory effect on hair growth in vivo. CE might have an effect on DPCs directly.

View full abstract

We experienced 219 cases of drug eruption which were confirmed by skin test or provocation test at the Department of Dermatology of Yodogawa Christian Hospital from July 1991 to December 2003. We analyzed the period from initiation of medication to development of symptoms. Most cases of urticaria type developed symptoms within 1 hour after taking medicine. No patients developed urticaria or anaphylaxis on the 6th and 7th day when the exanthema group (maculopapular, erythema multiforme and erythrodermic type), mediated by delayed-type hypersensitivity, frequently developed symptoms. We gave consideration to the pathogenesis, taking 3 clinical cases. In addition, our statistical analysis suggested evidence of a causative drug in each clinical type. We considered that the dosing period and the type of causative drug could help to diagnose adverse cutaneous reactions to drugs.

View full abstract

We report a case of contact dermatitis due to prednisolone valerate acetate. A 67-year-old female developed itchy erythema on her head. Although she was treated with topical corticosteroids such as Lidomex^® lotion by home doctor, the eruption was exacerbated. Patch testing showed positive reactions to Lidomex^® lotion and prednisolone valerate acetate, which was the major ingredient in Lidomex^®. Patch testing with other topical corticosteroids revealed negative reaction to Locoid^® (hydrocortisone propionate), positive cross reaction to Pandel^® (hydrocortisone butyrate propionate).

View full abstract

Thirty-two years old male visited our hospital suffering from severe systemic wheals occured every day more than one month before. He took anti histamine drug or steroid tablet but neither of them had satisfactory effect. The result of skin tests of autologous serum or acetylcholine were negative and aspirin intake test provoked no symptom. He had history of urticaria and angioedema after taking shrimp or crab on his childhood. So noting the relationship of tropomyosin, we checked tropomyosin-associated antigens which showed positive reactions especially on mite, cockroach, shrimp and crab by means of both specific IgE and skin prick test. Moreover tropomyosin specific IgE titer showed class 2 positive. So we diagnosed his symptom as chronic urticaria associated with tropomyosin allergy. As to therapy, additional administration of leukotriene antagonist Montelukast revealed conspicuous effect. His wheals disappeared just after starting this drug and now he keeps in good condition.

View full abstract

We report a case of 66-year-old woman with disseminated maculo-papular erythematous-type drug eruption due to tipepidine hibenzate. The next day after taking three kinds of drugs to treat sore throat and cough, she noticed disseminated maculo-papular erythema over her entire body with severe pruritus. In addition, she complained of vomiting and abdominal pain without fever. Histopathological findings from the leg showed perivascular lymphocyte infiltration with edema in the upper dermis. In this case, leucocytosis with neutrophilia, elevated lactate dehydrogenase and C-reactive protein, and mild disorder of renal function with elevated creatinine, blood urea nitrogen and hematuria were observed. Oral provocation test by taking 20mg of tipepidine hybenzate was performed, and tipepidine hibenzate was confirmed as the causative drug.

View full abstract

A 55-year-old woman presented with 6-year history of an eruption affecting her left leg. The eruption had periodically worsened in the summer and improved in the winter. There was no history of similar skin lesions in her family members. On physical examination she had brownishred keratotic papules following Blaschko’s lines on the left buttock and left leg. Histology of a keratotic papule obtained from the buttock showed hyperkeratosis, acantholysis, suprabasal clefting and dyskeratosis, and was typical of Darier’s disease. Although neither topical steroid ointment nor vitamin D₃ ointment was effective, the eruption cleared almost entirely 4 months after the initiation of treatment with systemic etretinate. As Blaschko’s lines are considered to link to the movement of distinct genetic clones of cells in the developing embryo, we speculate that the lesions of this case is induced by postzygotic mosaicism.

View full abstract

A 46-year-old male visited our department because of nasal papules that appeared about two years ago.
Firm red brown glossy papules were found partially merged in the left wing of nose and at the nasal apex at his first medical examination.
Skin biopsy revealed full thickness eosinophilic deposits in the dermis. The deposits were identified as ALκ amyloid. Systemic amyloidosis was ruled out by general examination, and diagnosis of nodular localized primary cutaneous amyloidosis was made.

View full abstract

A 42-year-old woman visited our out-patient clinic with a 10 year history of exanthema on the face and dorsal regions of the fingers. Skin biopsy of the left 3rd finger suggested dermatomyositis. Clinically, muscle weekness was not noticed, nor was there increase in serum myogenic enzymes. Taken together, a diagnosis of amyopathic dermatomyositis was made. There was no complication such as interstitial pneumonia or malignant visceral tumors. She had not visited our hospital thereafter. Exanthema aggravated for 2 months before her 2nd visit, and then the patient was referred to our department. Keratinizing papules were biopsied on the MP joint of the left 3rd finger. In addition to very mild hydropic degeneration of the basal cells and lymphocytic infiltration around blood vassels in the dermis, amyloid deposition was found in the stratum papillare. Immunohistochemical staining of the amyloid-diposited legion resulted in positive staining with 34βE12 and anti-CK5 antibody. indicaing that the amyloid was derived from CK5 of basal keratinocytes.

View full abstract

A 3-year-old boy was observed with elastic-hard white papules developed on his back one month before. They were flatly-protruding from the skin surface and of up to 5 mm in diameter, but they were not consistent with scars from varicella. During inquiries into the patient’s history, it became obvious that his mother (a 35 years old female) and siblings (a 7-year-old male and a 5-year-old female) were verified to have similar kinds of exanthems. Skin biopsies were performed on the 35-year-old female and on the 3 and 7-year-old boys. A diagnosis of connective tissue nevus was made as a result of histopathological findings and through the use of special staining procedures, because of the increase of poor collagen fibers and the relative decrease of elastic fibers. While a skin biopsy was not performed on the 5-year-old girl, it is thought that she also suffers from connective tissue nevus.

View full abstract

We present a case of poroid hidradenoma. The patient was a 31-year-old woman, with a reddish nodule on her face since her childhood. The nodule was 4mm in diameter. The nodule was excised. Histopathologically, the tumor with a cystic formation was present in the dermis. The epidermis was not involved. The cystic wall was composed of the tumor cells. Majority of the tumor cells were poroid cells. The clear cells were not seen. Based on these findings, we diagnosed this tumor as a poroid hidradenoma.

View full abstract

We herein described the case of a 72- year-old woman with two basal cell carcinomas (BCCs) on her face. One lesion had developed on her nose ten months ago and was followed by the second lesion on the right side of her upper lip two months later. Histologically, both nodules were diagnosed as solid type BCCs. She had no risk factor for BCC formation. Since multiple BCCs could sometimes develop in patients without any background or risk factors, we also studied the occurrence of multiple BCCs without risk factors reported in Japan.

View full abstract

Positron emission tomography (PET) using ¹⁸F-fluorodeoxyglucose(FDG) is now a widely accepted imaging approach in clinical oncology. However, there is some normal uptake and physiological distribution of FDG in many organs. Recently, detection and diagnosis of human malignant melanoma by PET using ¹⁸F-¹⁰B-fluoroboronophenylalanine (FBPA), an analog of a specific melanogenesis-seeking compound synthesized for use in boron neutron capture therapy (BNCT) for malignant melanoma, has been developed. FBPA-PET liver scan of a 35-year-old man with metastatic melanoma in liver showed a better imaging of a tumor mass compared to the computed tomography and FDG-PET scans. Our results indicate a novel, highly effective methodology for the selective imaging of metastatic malignant melanomas.

View full abstract

We report a 74-year old woman with mobile encapsulated lipoma. A subcutaneous nodule on the back of her left hand was smooth, palpated with elastic-hard consistency, and moved freely with pressure. Macroscopically, the surface was smooth and colored yellowish-white. Histopathological examination revealed mature fat cells, which was encapsulated by thin connective tissue.

View full abstract

Case report : The patient was a 3-year-old girl who was first examined at our clinic on April 12, 2004. Ten days before the first examination, red papules developed on her extremities, without subjective symptoms. Fever developed 5 days later. Her peripheral WBC was 73,000/mm³ with a blast count of 89.0%. Histopathologically, CD56-positive blast-like cell invasion was seen in the tissue immediately below the epidermis and around the blood vessels within the upper layer of the dermis. Invasion by these cells was also seen sporadically within the epidermis. The invading cells exhibited no chromatic response to myeloperoxidase staining and were cCD3-positive, sCD3-negative, CD33-positive and CD56-positive. On the basis of these findings, the girl was diagnosed with myeloid/NK cell precursor acute leukemia. She received chemotherapy and umbilical cord blood transplantation, and has remained in remission.

View full abstract

A 77-year-old Japanese woman came to us with a developed purplish red tumor on the left thigh. Histopathology of the tumor showed a dense infiltrate of markedly atypical lymphoid cells distributing whole dermis, and panniculus. These cells were identified as NK cells by immunohistochemistry. CT scan showed no metastases nor nasal lesions. She received two courses of biweekly CHOP, radiation therapy, and a course of carboplatin-etoposide salvage regimen. Three months later she readmitted to our hospital with unconscious state, because of intramedullary invasion of the tumors. Intraspinal chemotherapy brought temporal recovery of her consciousness. She died of wide spread metastases, DIC and pancytopenia.

View full abstract

We report a 55-years-old man with streptococcal toxic shock syndrome(STSS). He was admitted to our hospital because of high fever, malaise, and painful erythematous rush on his neck and extremities. In addition, pustule was seen on his right knee. Systolic blood pressure was 70mmHg and his body temperature was 35.7 degrees C. Laboratory findings revealed increased leukocytes, liver dysfunction and renal dysfunction. The culture from blood and pustule on his knee yielded the same bacteria, group A Streptococcus pyogenes. The diagnosis of STSS was made and surgical debridement was performed on emergency, that confirmed necrotizing fasciitis of both upper limbs and saved him from septic shock. Histopathological findings of pustule on his right knee involved intact epidermis and diffuse infiltrate of neutrophils from upper to mid-dermis. We consider the pustular eruption as septicemide. Septicemide can be an important clue to early diagnosis in cases of sepsis.

View full abstract

We herein report a case of Pasteurella multocida infection in a 50-year-old woman following a cat scratch. One day following a cat scratch, the patient experienced pain and swelling at the site of injury. Upon the culture of pus from abscess, Pasteurella multocida was identified as a causative agent. Following treatment with minocyline (200mg/day), the patient’s symptoms improved. Infection with Pasteurella multocida responds well to antibiotics and typically has a good prognosis. In immunocompromised patients, however, greater care must be taken in monitoring treatment and disease progression.

View full abstract

A 75-year-old man visited us with painful redness and swelling on his left popliteal fossa. Clinical examination revealed edematous erythema on his left popliteal fossa, redness with swelling on his lower limb and induration on his upper limb. After his admission, the treatment by antibiotics was started, but it was not effective. From the results of biopsy and tissue culture, we diagnosed the patient as Cryptococcus infection. Chest CT detected a cavity on his left lung. Then, the patient was successfully treated with Bolyconazole.

View full abstract

A one-day-old male infant that was presented with a large hard tumor on the left little finger at birth. The lesion was globose (25×25×25mm) with a thin pedicle 2mm in diameter, and 6mm in length. We treated it successfully with carbon dioxide laser. Histologically the tumor showed immature sweat grands, vessels, bone tissues and cartilageous tissues. We made the diagnosis of little finger polydactyly.

View full abstract

Recently, UVB therapy has been widely used for skin disorders, in particular psoriasis. BClear^™ is a novel therapeutic modality for UVB phototherapy with the principle of targeted photoclearing system. The purpose of this study was to investigate the efficacy of BClear^™ photothrapy for 13 patients with psoriasis vulgaris. In 13 patients, 9 patients showed excellent efficacy, 4 did effective. No patients demonstrated worsened. No intolerable adverse effects except UVB-induced erythema was found. Thus, our study revealed the efficacy, safety and well-tolerability of BClear^™ phtotherapy. Further studies, i.e. in larger scale trials and long-term observation to monitor photocarcinogenesis, are currently under the way.

View full abstract

Photodynamic therapy (PDT) is an established therapy for superficial skin cancers, however, laser apparatus used in previous reports in Japan were not affordable, not portable, not accessible and not flexible, and therefore, the method with laser apparatus is not ubiquitous. In our study, we adopted small, cheap and portable Light-Emitting Diode (LED) light source, with which we tried to treat 11 cases of non-melanoma skin cancers (NMSCs). All cases of actinic keratoses (AK) were well reactive to our method with LED light source. However, in two cases of extra-mammary Paget’s disease and one case of squamous cell carcinoma (SCC), they were reactive or seemed to be reactive at first, but soon tumour cells regrowth was histologically detected.
PDT using this apparatus has proved effective in the treatment of NMSCs, it appears to become one of the routine treatments of these skin cancers.

View full abstract

We carried out an application test of skin care cream “Neribas”, the base of the topical steroid “Nerisona”, in patients with atopic dermatitis and xerosis. 31 patients were enrolled, and 3 types of “Neribas” were applied (10 patients for ointment, 10 patients for water in oil type cream, and 11 patients for oil in water type cream). Clinical observations of skin appearance for 4 weeks revealed that all types of Neribas had improved the skin symptoms, including dryness, desquamation, erythema, and itch. Water content of the stratum corneum significantly increased in comparison to before application, and patients reported high level of satisfactory. No adverse effect was observed.
These results indicate that the application of “Neribas” on dry skin is very useful and safe.

View full abstract

We studied the clinical effect of a beverage containing fish oil rich in eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) on atopic dermatitis. The test beverage was taken by 21 patients with atopic dermatitis, in the volume of 200 ml (containing EPA 1,260 mg and DHA 540 mg) once per a day for 12 weeks. Except for 3 patients who dropped out, the skin symptoms of 18 patients tended to improve, and overall improvement showed the following scores: marked improvement 5.6% (1 patient); moderate improvement 38.9% (7 patients); slight improvement 27.8% (5 patients); unchanged 16.6% (3 patients); aggravation 11.1% (2 patients). These results suggest that the beverage containing EPA and DHA may be useful as an alimentary therapy for atopic dermatitis.

View full abstract