Hifu no kagaku
Online ISSN : 1883-9614
Print ISSN : 1347-1813
ISSN-L : 1347-1813
Volume 6, Issue 6
Displaying 1-21 of 21 articles from this issue
COLOR LIBRARY
CLINICAL INVESTIGATION
  • Akiko Miyake, Tatsuya Okumura, Tohru Okamoto
    2007 Volume 6 Issue 6 Pages 560-566
    Published: 2007
    Released on J-STAGE: December 06, 2010
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    It is well known that tranexamic acid (TA) is used as an oral medicine for chloasma. Recently it attracts notice that the external use of TA can also be effective against chloasma and dry-skin. In this study, iontophoresis, which can enhance the efficacy of TA through the facilitation of the transepidermal permeation of the compound, was evaluated. Since TA is an amphoteric substance and becomes various kinds of dissociation status, it is expected that TA shows a complex permeation behavior to the skin. The transepidermal permeation of TA was found to depend on the pH of formulation and the polarity of electrodes. For maximizing the TA concentration in the skin, it was found that (1) the pH of formula should be slightly acidic (around pH 5) and (2) TA should be used on anode upon iontophoresis.
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CASE REPORT
  • Yoshihito Sasaki, Atsuko Adachi, Shinichi Shimoura, Akihisa Yao, Takaf ...
    2007 Volume 6 Issue 6 Pages 567-571
    Published: 2007
    Released on J-STAGE: December 06, 2010
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    A twenty four-old man, who suffered from acute epididymitis for two weeks, came to the dermatology department of our hospital on November, 2005, because of his oral ulceration and painful erythema of bilateral lower legs. The histopathological finding of biopsy specimen from the erythematous lesion showed septal panniculitis and vasculitis, which is compatible with Behçet’s disease. At first, treatment with potassium iodide and colchicines relieved him from acute epididymitis and erythema nodosum, but he suffered from diarrohea two weeks after. Endoscopic findings of the terminal ileum showed multiple deep ulcers, indicating that he developed intestinal Behçet’s disease. He had recovered completely by the treatment with oral predonisolone 30mg/day since then.
    We think that acute epididymitis is a rare initial symptom of Behçet’s disease as well as the sign which should suggest the severe form of Behçet’s disease. Since intestinal Behçet’s disease often recurs, the patients is now under the intensive observation.
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  • Yuika Uno, Yukiko Endo, Shinichi Moriwaki, Kimihiro Kiyokane, Eijiro M ...
    2007 Volume 6 Issue 6 Pages 572-576
    Published: 2007
    Released on J-STAGE: December 06, 2010
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    We report a case of Henoch-Schönlein purpura (HSP) with severe abdominal symptoms and purpura, resistant to systemic steroid therapy. A 17-year-old woman who had noticed purpura on her foot with no precedent episode, and the skin lesions exacerbated gradually. She came to our hospital because of abdominal pain and arthralgia. A diagnosis of HSP was made based on the clinical symptoms as well as histopathological examination showing leukocytoclastic vasculitis. The patient’s serum level of factor XIII activity dropped to 32% of normal value. Systemic prednisolone treatment was commenced, however, there was no improvement of abdominal pain, proteinuria and purpura. Additional treatment with intravenous factor XIII and steroid pulse therapy were effective to these symptoms.
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  • Yuki Yoshida, Naoki Maekawa, Kazuhoshi Yamanaka, Shuichi Kuniyuki
    2007 Volume 6 Issue 6 Pages 577-581
    Published: 2007
    Released on J-STAGE: December 06, 2010
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    We describe two cases that were successfully treated by this method. One is skin ulcers with pocket-formation, and the other is fixation of skin graft dressings for exudative skin ulcers. This method has the advantage of providing a good dranaige and keeping wound bed preparation for skin ulcers. In addition, it provides a good fixative and well-balanced pressure dressing on the skin grafts.
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  • Yuki Shimizu, Shigefumi Morimoto, Hiroshi Kosaka
    2007 Volume 6 Issue 6 Pages 582-586
    Published: 2007
    Released on J-STAGE: December 06, 2010
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    Oxaliplatin has become a pivotal drug as a part of FOLFOX4 chemotherapy against the colon cancer. Here we show two cases of colon-cancer-bearing females, both stricken by hypersensitive reaction just in a few-minute infusion of oxaliplatin. Case 1 : a 52 year-old female, having been attacked by dyspnea and itchiness in the hands at the seventh term of FOLFOX4, was proven clearly positive to oxaliplatin in intracutaneous test. Although a combination of dexamethasone, cetirizine and hydroxyzine were previously taken before the next term to prevent hypersensitivity, the crucial reaction was hardly circumvented. Case 2 : a 46-year old female, having been suffered from general urticaria at the ninth term, showed weakly but significantly positive in intracutaneous test. Rechallenge to her was canceled based on the experience of the previous case.
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  • Mayuko Yamamoto, Kimiko Nakajima, Hajime Kodama, Shigetoshi Sano
    2007 Volume 6 Issue 6 Pages 587-589
    Published: 2007
    Released on J-STAGE: December 06, 2010
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    A 82-year-old male presented with violaceous papules on the trunk and extremities that had appeared 4 months after the oral administration with methyldigoxin for angina and arhythmia. A biopsy specimen obtained from a papule revealed vacuolar alteration of the basal layer of the epidermis, the presence of colloid bodies, and dense band-like infiltration of lymphocytes in the superficial dermis, all of which are characteristic of lichen planus. The lesions disappeared after discontinuation of the medication. Oral provocation test with methyldigoxin showed positive reaction.
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  • Yui Hirata, Yukiko Endo, Shinichi Moriwaki, Kenzo Takahashi, Kimihiro ...
    2007 Volume 6 Issue 6 Pages 590-594
    Published: 2007
    Released on J-STAGE: December 06, 2010
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    A 42-year-old woman noticed a 6 months history of asymptomatic erythema on the back of head. The patient had been diagnosed as impetigo contaginosa, and had been treated by oral and topical antibiotic without effectiveness. The patient consulted our hospital complaining of the refractory, partially crusted erythema on the head and newly-appeared multiple erythema on the back. Histological examination of erythema on the head revealed acantholytic cells in the suprabasal cleft. Direct immunofluorescence result was negative. We diagnosed this patient as having transient acantholytic dermatosis (pemphigus vulgaris type, persistent type). Skin lesions were treated effectively by oral steroids.
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  • Tomoo Matsuo, Takeshi Horio, Yuuji Horiguchi
    2007 Volume 6 Issue 6 Pages 595-599
    Published: 2007
    Released on J-STAGE: December 06, 2010
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    A 67-year-old man had been suffering from pruritic eruption on the legs from May, 2001. Skin changes gradually worsened even though the patient had been treated with topical and systemic corticosteroids, and developed into erythroderma. Clinical findings were characterized by papules and plaques with cobblestone appearance on the body and limbs sparing large folds on the chest and abdominal regions. Broadband-UVB phototherapy was not effective and systemic corticosteroid had been continuously administered. Oral PUVA therapy was started with 30mg of 8 methoxypsoralen and 3~4J/cm2 of UVA. Pruritus was sufficiently decreased after 2~3 treatments, and the eruptions disappeared almost completely after 10 exposures, then systemic corticosteroid was discontinued. After 20 treatments, PUVA therapy was switched to narrowband-UVB phototherapy to prevent the reccurence with beneficial effects.
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  • Yoshiyuki Nakamura, Junichi Furuta, Shusaku Ito, Yasuhiro Kawachi, Fuj ...
    2007 Volume 6 Issue 6 Pages 600-604
    Published: 2007
    Released on J-STAGE: December 06, 2010
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    We report a 77-year-old female with pellagra. Two months before her initial visit, infiltrative erythema appeared on dorsum of her hands and feet. The erythema was well-demarcated, symmetric and asymptomatic. Topical corticosteroid was not effective. Dementia, appetite loss and numbness of her extremities were apparent. She was admitted to our hospital for further treatment. Routine biochemical and hematological studies revealed anemia and hypoproteinemia. Subsequent blood tests confirmed deficiencies in nicotinamide, tryptophan, several vitamins and minerals. Vitamin supplements and diet adjustment quickly controlled her symptoms. She was diagnosed with pellagra due to inadequate diet. Social isolation seemed to be the underlying cause of this case.
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  • Asuka Wakuda, Makiko Sasahashi, Soukou Sugi, Ken-Ichi Toda
    2007 Volume 6 Issue 6 Pages 605-609
    Published: 2007
    Released on J-STAGE: December 06, 2010
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    A case of the cutaneous ganulomatous lesions and refractory gastric ulcer was reported. A 63-year-old woman was suffering from uncurable gastric ulcers although she had been treated with various kinds of anti-gastric ulcer drugs for more than 9 years. The Helicobacter Pylori infection in the ulcer lesions was negative. The patient also noticed the skin lesions on the front side of her lower legs about 1 year before the ulcer treatment was initiated. The skin lesions showed marginally elevated asymptomatic annular erythemas on the legs with the sized of 5cm meter on her left leg and to 15cm diameters on the right. The histology of the biopsied skin specimen revealed noncaseous granuloma formation in the dermis with many Langhans type giant cells infiltrations and asteroid body existence inside the some giant cells. Both the clinical and histological findings strongly suggest necrobiosis lipoidica as the diagnosis of the skin lesions.
    Since topical steroid applications to the skin lesions were not successful and she did not have diabets, the systemic treatment with predonisolone was started and proved remarkably effective with a complete lesional remission. In addition, the gastric ulcers were also completely cured in conjunction with the improvement of the skin lesions, although the histology of the gastric ulcer specimens did not note the granuloma formation. From the standpoints of the remarkable steriod efficacy, it should be further disscused whether or not the systemic sarcoidosis would be a possible differential diagnosis for the both skin and gastric lesions.
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  • Hideyuki Iida, Nobuhiko Kobayashi, Satoshi Yurugi, Hideo Asada, Sachik ...
    2007 Volume 6 Issue 6 Pages 610-613
    Published: 2007
    Released on J-STAGE: December 06, 2010
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    A 74-year-old man was admitted to our hospital for the treatment of a tumor above his sternum. The tumor had been slowly enlarging for about 20 years and was a red-brown hyperkeratotic plaque, measuring 12×10cm at admission. By incisional biopsy, it was diagnosed as the clonal type of seborrheic keratosis. Later the tumor was excised and the defect was repaired with a split-thickness skin graft. Although cases of giant seborrheic keratoses larger than 3cm in diameter have rarely been reported, it should be noted that some authors have suggested the risk of malignant change.
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  • Masahiro Kira, Yoko Nishida, Chiho Matsumoto
    2007 Volume 6 Issue 6 Pages 614-617
    Published: 2007
    Released on J-STAGE: December 06, 2010
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    Cesarean section scar endometriosis is a rare condition.
    We report a case of ectopic endometriosis in surgical scar after cesarean section scar.
    A 42-year old woman complained of painful abdominal mass at the site of an old cesarean section scar. Physical examination revealed a slightly tender subcutaneous nodule at the left edge of the scar. The CT examination showed a high-density mass in the abdomen. Ultrasonographic imaging showed hypoechoic subcutaneous mass lesion. The subcutaneous mass was excised under local anesthesia. Histopathological examination of the specimen confirmed the diagnosis of ectopic endometriosis.
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  • Sonoko Miyamoto, Masaru Natsuaki, Yumi Nakayama, Shoichiro Minami, Nob ...
    2007 Volume 6 Issue 6 Pages 618-622
    Published: 2007
    Released on J-STAGE: December 06, 2010
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    A 10-year-old boy felt discomfort on the coccygeal region from his age of 6 and had noted a tumor on the region for one year. He saw us because the tumor was enlarging late. The subcutaneous tumor 4×2cm in size was not connected with spinal cord on computed tomography images and was totally resectable. Pseudorosettes were formed by tumor cells, which were strongly positive for glial fibrillary acidic protein (GFAP) and vimentin, and focally positive for S-100 protein. Myxopapillary ependymoma was diagnosed according to those features. No recurrence was evident one year after the resection.
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  • Atsuko Uchida, Aiko Watanabe, Tomoe Tsugawa, Toshiaki Doi, Naohisa Kaw ...
    2007 Volume 6 Issue 6 Pages 623-627
    Published: 2007
    Released on J-STAGE: December 06, 2010
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    We report on a 1-year-old boy who was referred to our hospital at the age of 3 months due to his proliferating firm nodules. A biopsy was performed and the diagnosis of IM was established by histological examination. CT scan revealed some nodules in his lung and kidney. As both the solitary and the multicentric variety without visceral involvement carry a good prognosis with spontaneous regression of the lesions, whereas patients with involvement of vital viscera have a high mortality, we took some treatment with chemotherapy into consideration. However, he had no clinical symptom and had a normal physical and laboratory examination, so we follow him without antitumour therapy.
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  • Hiroshi Hosokawa, Kayo Hosokawa
    2007 Volume 6 Issue 6 Pages 628-631
    Published: 2007
    Released on J-STAGE: December 06, 2010
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    A 65-year-old man presented with an asymptomatic, dark-red, firm plaque with well-defined borders in the right cheek. He stated that the lesion had been there more than 30 years and had enlarged very slowly. Histopathological examination of the lesion showed coalescing tuberculoid granulomas with a few Langhans-type giant cells just beneath the epidermis and in the papillary and mid-dermis. Caseation necrosis was absent. Culture of biopsied tissue on Ogawa egg medium was negative. A polymerase chain reaction(PCR) assay did not reveal the presence of mycobacteria in a lesional biopsy sample. Although the tuberculosis culture and PCR did not confirm tuberculosis, a diagnosis of lupus vulgaris was made considering the clinical and histopathological findings. After a 6-month antituberculous therapy, the lesion disappeared. We believe that a diagnosis of lupus vulgaris still depends more on clinical and histopathological findings than on tuberculosis culture or PCR.
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THE 9~10th CONFERENCE OF FUTURE DERMATOLOGY
  • Takeshi Kono
    2007 Volume 6 Issue 6 Pages 632-634
    Published: 2007
    Released on J-STAGE: December 06, 2010
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    In the aged society in Japan, geriatric medicine and home care are very important problems. Dermatological evidence for aged population was summarized. Prevalence of skin diseases was over 70% in users of the aged care centers or aged persons at home. Over 40% of the aged care facilities cooperated with dermatologists. By questionnaire survey, over 80% of visiting nurses required visits by dermatologists. As for the aged medicine and home care, needs and demands to dermatologists are thought to be high.
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  • Toru Onai
    2007 Volume 6 Issue 6 Pages 635-642
    Published: 2007
    Released on J-STAGE: December 06, 2010
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    The market of dietary supplements rapidly expanded in Japan during a decade. Japanese people anticipated the effectiveness of dietary supplements more than the fact because of their biased information through the mass media. Dietary supplements in Japan have several problems, such as no their standardization, lack of evidence, and adverse reactions. We need to inform the issues of dietary supplements to Japanese consumers.
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  • Hidekazu Yamada
    2007 Volume 6 Issue 6 Pages 643-648
    Published: 2007
    Released on J-STAGE: December 06, 2010
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    A countermeasure for medical examination and dermatology treatment in an aging society is proposed. Measurement methods and items measured during the anti-aging examination currently being performed at Kinki University School of Medicine, Nara Hospital were described. First, the antioxidation power and hormone value are gauged by blood vessel age, nervous system age, muscle age, bone age and skin age. Nutrition guidance and exercise guidance are given along with supplemental guidance for an individualized anti-aging program based on the overall aging pattern. It is necessary to study skin from the perspective of preventive medicine and evaluate skin aging along with other factors demonstrating the external and internal aging processes and to consider the role of dermatology in medical examination and treatment in the future.
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  • Nobuhiko Higashi
    2007 Volume 6 Issue 6 Pages 649-652
    Published: 2007
    Released on J-STAGE: December 06, 2010
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    The first study was designed to compare the effects on melasma between 5% tranexamic acid ceream and 0.5% tranexamic acid cream by means of double-blind inter-group comparison. The percentage of cases where treatment was rated as slightly useful or better was over 70% in both the 5% tranexamic acid cream group and the 0.5% tranexamic acid cream group. The second study was designed to evaluate the effects on melasma of 5% tranexamic acid cream in comparison to drug-free ream base by means of double blind inter-group comparison. The percentage of cases where treatment was rated as slightly useful of better did not differ markedly between the 5% tranexamic acid cream group(54%) and the drug-free cream group(48%). In stratified analylis(analysis by the severity of melasma), however, the percentage of cases with sever melasma showing alleviation in respose to treatment was 85.7% in the 5% tranexami acid cream group(n=7) and 30.0% in the drug-free cream base group(n=10), and this difference was statistically significant(U test).
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  • Osamu Nemoto
    2007 Volume 6 Issue 6 Pages 653-658
    Published: 2007
    Released on J-STAGE: December 06, 2010
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    Phototherapy is therapeutically beneficial in some skin diseases and nowadays PUVA, broadband UVB, narrowband UVB, UVA1 have been used. The number of patients in atopic dermatitis in Japan is increased and severe type of skin lesions is very difficult to treat by routine methods. Phototherapy is now available to severe case of atopic dermatitis. Narrowband UVB is used more often in atopic dermatitis but UVA1 therapy has high effectiveness to another atopic dermatitis skin lesions such as lichenification, prurigo and erythroderma. I achieved good results for treatment in severe atopic dermatitis for 8 years using narrowband UVB and UVA1 and no skin cancer have been occurred. I will show several cases in atopic patients treated with narrowband UVB and UVA.
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