Bronchogenic cysts are usually found in the mediastinum or lung parenchyma. Bronchogenic cysts located in the skin or subcutaneous tissue are rare. We report a case of a 47-year-old female with intracutaneous bronchogenic cyst. She visited us complaining of a gradually enlarging swelling in the right anterior neck, first noted at the age of 45. Physical examination revealed a nodule in the right anterior border of the sternocleidomastoido muscle,size of which was2×2cm. Clinical diagnosis was epidermal cyst. Operative excision was performed under local anesthesia. Histologically the tumor consisted of a large unilocular cystic space. The cyst wall was lined by tall columnar and ciliated epithelium. Smooth muscle, seromucous glands and cartilage weren′t present. The diagnosis determined intracutaneous bronchogenic cyst. As far as we know, 49 cases of subcutaneous bronchogenic cyst have been reported in the Japanese literature. The majority of reported cases are found in the pediatric population ; only 3 adult cases have been reported.

View full abstract

A 78-year-old man with renal failure developed erythema and tense bullous lesions on his limbs after he had taken furosemide. In the laboratory data, the titer of antibasement membrane antibody(IFA) showed 5,120. DLST for furosemide was negative. Biopsy specimen showed subepidermal bulla with numerous eosinophils and deposits of IgG and C3 in the dermoepidermal junction. In spite of prednisolon therapy, erythema and bulla exacerbated. Two months after patient′s first visit, the possibility of drug eruption by furosemide was suspected. About five months after furosemide therapy, furosemide was discontinueued. Two months later, erythema and bulla almost subsided in spite of a decrease in prednisolon. Because of the need for diuretic therapy, furosemide therapy was begun again. Ten days later, he developed fresh bulla and erythema. Fifteen days later, furosemide therapy was stopped. After furosemide therapy was discontinued, erythema and bulla disappeared. The diagnosis was confirmed as bullous pemphigoid due to furosemide.

View full abstract

Recently, many cases of drug-induced linear IgA bullous disease (drug-induced LABD) have been reported. Of the drugs reported, vancomycin is most frequently reported in association with drug-induced LABD. A 73-year-old man with a history of myxofibrosarcoma developed multiple blisters on his buttock,thigh,and groin. Bullous pemphigoid or paraneoplastic pemphigus was clinically suspected. Histopathological examination revealed a subepidermal blister with infiltration of neutrophils and eosinophils in the upper dermis. Direct immunofluorescence disclosed deposits of IgA and C3 at the cutaneous basement membrane zone. Besides these observations, he had been in the use of daily vancomycin hydrochrolide since 16 days before his onset. We diagnosed the case as vancomycin-induced LABD. Clinical knowledge concerning with drug-induced LABD may be required to make a precise diagnosis and carry out appropriate of treatment.

View full abstract

A 23-year-old woman noticed one year history of a giant nodule on her right upper arm gradually enlarging during pregnancy. Examination revealed a pedunculated, reddish, hard mass, measuring 63×61×33mm with crust partly. Histopathologically, the tumor showed the typical features of pilomatricoma including the presence of basophilic cells, transitional cells and shadow cells. We implied that the enlargement of pilomatricoma in our case may be related to the imbalance of sex steroid hormones due to pregnancy.

View full abstract

A 44-year-old Japanese woman was seen in August 2005 for pain and onycholysis of her right thumb of 5 months′ duration. The nail plate was removed under block anesthesia and the lesion was excised. Histological examination showed marked hyperkeratosis with acanthosis. Numerous eosinophilic dyskeratotic cells were scattered throughout the cell layers. There was no significant dysplasia. The patient recovered fully without recurrence.

View full abstract

A 74-years-old Japanese female had a small light brown macule on her upper back for long time. Recently, she noticed that the lesion had elevated gradually. Clinically, her back showed an 11×13mm sized, brown nodule with thick scale. It was surrounded by a 20×45mm sized plaque consisted of grouping 2~3mm sized brown papules. Histological diagnosis was seborrheic keratosis and Bowen’s disease at the peripheral and central areas, respectively. In the transitional zone the atypical cells of Bowen’s disease seemed to infilrate into the silhouette of seborrheic keratosis.

View full abstract

A 12-year-old Japanese girl noticed a subungal small nodule on the first right toe three months prior to her first visit to our hospital. She visited a near-by dermatologist as the nail of the first toe had detached. Since X-ray revealed an abnormalities of the toe bone, she was referred to our department. On examination, a small, bean-sized nodule with smooth surface was palpable below the nail of the first toe. The tip of the nail was lifted upward by the tumor, and a small amount of scale was attached to the surface of the skin. Some part of the tip of the nail was missing. X-ray and CT revealed an ax-like bone shadow protruding from the middle of the extensor aspect of the medial phalanx. With a diagnosis of exostosis, we performed an excision of the tumor opening the nail bed after removal of the nail under conduction anesthesia. Histopathological examination showed a osteochondroma type with a part changing into bone tissue with hyaline cartilage. No postoperative recurrence or nail deformation has been observed.

View full abstract

A 75-year old man had erythema and pain in a right buttocks in June 1, 2005. after 3 days, he had ischuria,motor paralysis of the lower right extremity. After 7 days, the patient came to our hospital and was admitted for the treatment, and was diagnosed as herpes zoster complicated with ischuria,motor paralysis of the lower right extremity. The colon carcinoma was detected while treating.
We must carefully treat a case of herpes zoster, we must not overlook a serious complication, and we will occasionally catch an opportunity of the detecting the internal malignant tumor.

View full abstract

Eighty-eight patients consulted Higashi Dermatology Clinic for management of onychogryphosis from April 2004 to March 2007. Eighty-two patients of the 88 patients were female. The largest number of patients were in the fourth decade of life(26 cases). Treatment was performed as follows. 1) grinding of the thickened nail plate with an electric grinder, 2) taping for mild cases, and 3) surgery.
The grinding method was performed for six patients, the QOL of whom was improved. The taping method was used for four patients, all of whom had good results. The surgical method consisted of two steps. The first step was avulsion of the nail plate. The second step, nailbed-plasty, was performed several months after the first step. After the operation, taping was applied to the affected toe until recovery. The rate of cure with the surgical method was 71.4 % (25/35). I wish to emphasize onychogryphosis is a curable disease.

View full abstract

We carried out a four-week study in patients with facial acne vulgaris in order to assess the safety of new acne treatment cosmetics (a cream and a lotion) containing sulfur and dipotassium glycyrrhizate. We found adverse skin reaction in 5.2% of the subjects who used the acne treatment cream, and in 6.1% of the subjects who used the acne treatment lotion. These adverse skin reactions were slight or moderate, and there was no severe reaction. The average number of acne eruptions at 4 weeks was significantly decreased after application, compared with baseline. The satisfaction index for skin condition, obtained by using a visual analog scale, was improved after the study. The results indicate that the acne treatment cream and lotion are safe and useful for patients with acne.

View full abstract