bluuebunny/crossref_metadata_2025 huggingface dataset:
Successful Treatment of Adult T‐cell Leukemia/Lymphoma with MACOP‐B, M‐FEPA and VEPP‐B Combination Chemotherapy
Authors: Nagatani Tetsuo , Miyazawa Megumi , Matsuzaki Toshiko , Iemoto Gaijiro , Kim Shu‐taku , Baba Naoko , Miyakawa Kanata , Miyamoto Hideaki , Nakajima Hiroshi , Hirai Yoshio
Published: April 2015

A 45‐year‐old man was referred to our department in March of 1989. Physical examination showed erythroderma, palmo‐plantar hyperkeratosis, generalized lymphadenopathy, hepatosplenomegaly, and leukemic manifestation. The lymphocyte count in the peripheral blood before treatment was 1.7 × 104 cells/mm3. Atypical lymphocytes such as flower cells and lobulated cells were seen in the peripheral blood. A sample excised from a lymph node showed immunoblastic, pleomorphic T cells by a modified classification scheme of the Working Formulation. A high level of serum LDH was detected (2.1 times the upper normal limit). Anti HTLV‐1 antibody was also detected in the serum. The atypical lymphocytes were positive for CD3, CD4, CD5, CD7 and HLA‐DR, and negative for CD8. Thus, the clinical, pathologic and immunologic features were those of typical acute‐type ATL.

The patient was treated with VEPA‐M for three months starting in March of 1989. Because of poor response, the patient was then treated with MACOP‐B, M‐FEPA, and VEPP‐B for about one year from June of 1989 and has been free of disease up to the time of writing, March of 1993.
A Combination of Speckled Lentiginous Nevus with Patch‐type Blue Nevus
Authors: Misago Noriyuki , Narisawa Yutaka , Kohda Hiromu
Published: April 2015

A peculiar case of “nevus on nevus” was reported. A 67‐year‐old man had had a pigmented lesion in the left hypochondrial area since birth. The clinicopathologic findings of the pigmented lesion revealed a combination of speckled lentiginous nevus and patch‐type blue nevus. This case of “nevus on nevus” is not described under the term of combined nevus as is current in the literature; it was considered to be a subtype of the type II atypical blue nevus described by Kawamura.
Joint Pains with Psoriasis and Long‐term Systemic Etretinate Therapy: A Case Report and Summary of 12 Cases
Authors: Ishida Yoshitsugu , Ozawa Akira , Ohkido Muneo , Imai Nozomu
Published: April 2015

We report a case of psoriasis with joint pain related to long‐term etretinate therapy. In addition, our experiences with twelve additional patients with psoriasis who also received etretinate therapy are discussed.
Increased Incidence of Antismooth Muscle Antibody in Korean Vitiligo Patients
Authors: Hann Seung Kyung , Im Sungbin , Kim Hyung Il , Kim Hyon‐Suk , Lee Yung Jae , Park Yoon‐Kee
Published: April 2015

To evaluate the incidence of autoimmune disorders and organ‐specific autoantibodies in Korean vitiligo patients, antibodies to nuclear, mitochondrial, smooth muscle, gastric parietal cell, thyroglobulin, and microsomal antigens were screened in 226 vitiligo patients and 120 controls. Of the 226 vitiligo patients, three (1.3%) had thyrotoxicosis and two (0.8%) had diabetes mellitus. The vitiligo patients had an increased incidence of antinuclear (12.4%), antimicrosomal (7.1%), and antismooth muscle antibodies (25.7%). The increased incidence of antismooth muscle antibody was correlated with early onset (less than 15 years), a positive family history of vitiligo, and long duration of vitiligo. These results support an autoimmune origin of vitiligo and suggest that the high incidence of antismooth muscle antibody is a distinctive feature of laboratory findings in Korean vitiligo patients.
A Case of a Giant Schwannoma on the Extremities
Authors: Hagiwara Keisuke , Higa Tadashi , Miyazato Hajime , Nonaka Shigeo
Published: April 2015

A 52‐year‐old Japanese female with a human head sized lump on the medial femoral region of her right thigh is described. The histopathological diagnosis after the excision of the tumor was an ordinary type of schwannoma composed of two types of tissue, Antoni types A and B. The tumor was 20 × 15 × 12 cm in size and 2250 g in weight; this is probably the biggest of all the reported cases of schwannoma on the extremities in Japan.
Dermatomyositis, Carcinoma of Colon and Meningioma in the Same Patient
Authors: Glück Zahava , Kutsherowsky Michael , Abraham Zeev , Galper Izequiel
Published: April 2015

Dermatomyositis and carcinoma of colon were diagnosed in a 66‐year‐old woman. Meticulous physical examination excluded further systemic or cutaneous involvement. The musculocutaneous disorders responded well to daily oral corticosteroid, and the malignant tumor was totally removed surgically. After a seven‐year follow‐up of actual dermatomyositis controlled by maintenance doses of prednisone ranging from 5 to 15 mg daily, the patient developed a meningioma. Current concepts and data regarding various aspects of the combination between dermatomyositis and tumors are discussed. To our knowledge, this is the first reported case of meningioma associated with dermatomyositis.
Psoriasis in China
Authors: Lin Xi‐Ran
Published: April 2015

This paper presents a review of the epidemiology, the frequency of HLA antigen, the special clinical forms, the associations, and the treatment of psoriasis in China. Special attention is paid to the practice of treating psoriasis with traditional Chinese medicine and combinations of traditional Chinese and Western medicine.
Alterations in Pressure under Elastic Bandages: Experimental and Clinical Evaluation
Authors: Sawada Yukimasa
Published: April 2015

Clinical and experimental studies of pressure under elastic bandages are performed in order to assess their effectiveness in compressing wounds to prevent edema in burn wounds. In experimental studies, pressure decreased slowly over a day when applied with a tension of 250 grams to a limb model without a pad. However, pressure decreased a little more rapidly when applied using a pad, especially when the pad became wet. In clinical studies among patients, the pressure under the elastic bandage decreased more rapidly over time than it did in the experimental studies.

From those findings, although harmful side effects such as circulatory disturbances will not occur when an elastic bandage is applied on the limb with a tension of 250 grams, it is very difficult to maintain the initial level of pressure correctly and control the pressure for even the duration of a single day clinically.
Human Papillomavirus Type 6 Associated Buschke‐Loewenstein Tumor (Giant Condyloma Acuminatum)
Authors: Kato Naoko , Ueno Hiroo , Tanaka Hideo , Nishikawa Takeshi
Published: April 2015

The term “Buschke‐Loewenstein tumor” has been used for tumors with exophytic, wart‐like excrescences in the anogenital region. This broadly includes giant condyloma acuminatum and verrucous carcinoma. We report a 44‐year‐old Japanese man with a giant condyloma acuminatum Buschke‐Loewenstein tumor on the right femoinguinal area. The lesion was a huge grape‐like nodule composed of multiple small nodules, reaching 135 × 65 × 40 mm in size.

Histologically, it showed a regularly acanthotic papilloma with numerous koilocytes in the upper squamous and granular layers. Ultrastructural findings included gradual differentiation from basal cell layers to uppermost corneocytes without disorganized relationships in the epithelial‐stromal junction or cellular atypia. Human papillomavirus type 6 DNA was detected in the tumor tissues by polymerase chain reaction and restriction enzyme analysis, although immunohistochemical staining for papillomavirus common antigen was negative.
Ringworm‐like Cutaneous Candidiasis: Report of a Case of Localized Type
Authors: Dekio Satoshi , Jidoi Joji
Published: April 2015

A 52‐year‐old Japanese female patient with ringworm‐like cutaneous candidiasis on the right axillary area is described. It appeared to have developed in relationship to previous local steroid therapy in this area for a long time.
Autoantibodies in Scleroderma
Authors: Fritzler Marvin J.
Published: April 2015

Autoantibodies directed against nuclear, nucleolar, and a number of cytoplasmic components are described in the sera of scleroderma patients. Early studies of autoantibodies that relied on cryopreserved sections of rodent organ substrates showed that approximately 50% of scleroderma patients had anti‐nuclear antibodies (ANA). More recent studies that have used tissue culture cell substrates have shown that up to 98% of scleroderma patients have a positive ANA. In all of these studies, the presence of different patterns of staining have suggested that scleroderma sera reacted with a variety of intracellular antigens. The use of molecular and immunochemical techniques has now shown that over 20 intracellular autoantigens are targets of autoantibodies in scleroderma sera. Clinical studies have shown that these autoantibodies are important diagnostic and prognostic markers in scleroderma. In the future, autoantibody testing may be used to monitor the patient's response to immunological therapies.
A Case of Necrobiosis Lipoidica Treated with Systemic Corticosteroid
Authors: Taniguchi Yoshiki , Sakamoto Takayoshi , Shimizu Masayuki
Published: April 2015

A 43‐year‐old woman had asymptomatic eruptions on the anterior sides of both legs for 5 years. Biopsy specimens revealed the typical findings of necrobiosis lipoidica. An immunofluorescence study demonstrated no deposits of immunoglobulins, complement, or fibrinogen in vessel walls. Immunohistochemical staining revealed CD4 positive lymphocytes dominating in the lesion and strong expression of ICAM‐l on the endothelial cells, giant cells, lymphocytes and dermal fibroblasts in the lesion. The eruptions resolved remarkably with oral corticosteroid therapy.
Papillary Tubular Adenoma of the Skin
Authors: Makunura Catherine N.
Published: April 2015

A case of papillary tubular adenoma of the skin in a 31‐year‐old black man is reported. This lesion is also termed papillary eccrine adenoma, and it commonly occurs in the extremities.
Analyses of Serum Copper and Zinc Levels and Copper/Zinc Ratios in Skin Diseases
Authors: Tasaki Michiko , Hanada Katsumi , Hashimoto Isao
Published: April 2015

With the objective of comprehending abnormal metabolisms of the essential metals of zinc (Zn) and copper (Cu) in three groups of skin diseases, skin cancer, inflammatory diseases, and non‐inflammatory disease, we measured serum levels of Zn and Cu in 151 cases of various cutaneous manifestations and estimated the significance of the ratios between the two metals (Cu/Zn). The serum level of Zn was significantly decreased in cases of bullous pemphigoid, decubitus ulcer, and alopecia areata. The serum level of Cu was elevated in cases of psoriasis, decubitus ulcer, and skin cancer. We observed no elevation of serum Zn level or abnormally depressed serum Cu level. The Cu/Zn ratio showed significantly different values among these three groups of the diseases, suggesting the utility of measuring Cu/Zn ratios for differential diagnosis over that of determining the serum level of Zn or Cu alone. It was also demonstrated that, in each skin disease, the Cu/Zn ratio clearly reflects the severity of the progress.
Electron‐microscopic Observation of a Human Epidermal Langerhans Cell in Mitosis
Authors: Kanitakis Jean , Hoyo Eduardo , Perrin Claude , Schmitt Daniel
Published: April 2015

Langerhans cells are dendritic cells of the epidermis originating from bone marrow precursors which may exceptionally undergo mitosis within the skin. We report herein an electron‐microscopic observation of a dividing LC within a seemingly hyperproliferative human epidermis. This observation further underlines the self‐reproducing capacity of LC in situ and suggests that LC may respond to the same mitogenic stimuli as keratinocytes.
A Case of Cutaneous B‐cell Lymphoma Treated Successfully with MACOP‐B
Authors: Nagatani Tetsuo , Miyazawa Megumi , Matsuzaki Toshiko , Hayakawa Hiroki , Iemoto Gaijiro , Kim Shu‐Taku , Baba Naoko , Sugiyama Asami , Aihara Michiko , Miyamoto Hideaki , Nakajima Hiroshi , Katakura Hitoshi
Published: April 2015

A case of cutaneous B‐cell lymphoma successfully treated by MACOP‐B therapy is described. The patient was a 43‐year‐old man with reddish tumors measuring 3 to 7 cm in diameter on the right cheek and the post‐auricles. Histopathologically, massive infiltrations of medium‐sized atypical lymphoid cells were found in the reticular dermis and subcutis. A clear zone beneath the epidermis was also detected. The atypical lymphoid cells were positive for CD19, CD20, CD22 and HLA‐DR but negative for CD3, CD4, CD5, CD10, CD43, CD45RO and CDw75. The patient was treated successfully with the MACOP‐B protocol from March of 1990 to May of 1990. Since April of 1990, he has been free of disease.
Dyskeratosis Congenita: A Case Report
Authors: Sehgal Virendra N. , Thappa Devinder M. , Sharma Ravi C. , Jain Sanjiv , Bhattacharya Sambit N.
Published: April 2015

Dyskeratosis congenita, an uncommon situation in females, is described in a 30‐year‐old woman. The expression of the disease was partial and was characterized by mottled pigmentation, nail dystrophy, palmoplantar keratoderma, and hyperhidrosis.
A Case of Pretibial Dystrophic Epidermolysis Bullosa: Decreased Expression of the Non‐helical Domain of Type VII Collagen Molecule
Authors: Horiguchi Yuji , Leigh Irene M. , Oguchi Motoi , Tanaka Toshihiro , Imamura Sadao
Published: April 2015

A 27‐year‐old man with an ataxic gait due to infantile cerebral paralysis exhibited recurrent blistering caused by mechanical stimuli on the pretibial areas of both legs from the age of 20. His parents were not consanguineous, and he had no relatives who suffered from blistering. The histology showed a subepidermal bulla due to dermolytic epidermal‐dermal separation. The anchoring fibrils were sparse and rudimentary in the predilection area. An LH 7:2 monoclonal antibody against the non‐helical domain of the type VII collagen molecule stained the basement membrane zone of the patient's skin at a weaker intensity than the staining of normal human skin, but at a distinctively stronger intensity than the staining of skin from a patient with recessive dystrophic epidermolysis bullosa. Immunoelectron microscopy revealed that LH 7:2‐immuno‐reactants were distributed irregularly within the lamina densa and sparsely in the sublamina densa region. The patient was diagnosed with pretibial dystrophic epidermolysis bullosa.
Secondary Syphilis Mimicking Borderline (BL) Leprosy
Authors: Sehgal Virendra N. , Lal Sardari , Jain Sanjiv , Bhattacharya Sambit N. , Thappa Devender M. , Logani Kulbhusham B.
Published: April 2015

A young woman with syphilids resembling borderline lepromatous (BL) leprosy is being described. This is yet another addition to its already well‐documented manifestations. The high prevalence of leprosy and syphilis augments the epidemiological significance of the case.
Introduction of a Fluorescence‐microscopic Technique for the Detection of Eggs, Egg Shells, and Mites in Scabies
Authors: Bhutto Abdul Manan , Honda Minoru , Kubo Yorjiro , Nonaka Shigeo , Yoshida Hikotaro
Published: April 2015

A technique using the fluorescence microscope can prove helpful in the laboratory diagnosis of scabies. Specimens from fifteen patients with scabies were used in this study. All of the specimens were embedded with glycerine instead of potassium hydroxide (KOH) solution. The specimens were examined at 0 min, 30 min, 1 hr, 6 hrs, 24 hrs, and one week after mounting under light and fluorescence microscopes. Specimens embedded with non‐fluorescent glycerine were not clear immediately after mounting but became so after about 1 hr. Eggs and egg shells were easily counted in the specimens under the fluorescence microscope but were very hard to identify under the light microscope. Mites were absent in half of the specimens; only eggs and egg shells were present in those specimens found by the fluorescence microscope. The above findings suggest that the detection of egg shells by the use of fluorescence microscope may be helpful for the diagnosis of scabies, in particular with mite negative specimens. Slides prepared with non‐fluorescent glycerine were more stable and could be preserved for a long time. However, this method is time‐consuming and requires expensive equipment.
Reactivity and Persistence of Local Immunological Memory on Murine Contact Hypersensitivity
Authors: Natsuaki Masaru , Yamashita Noriko , Sagami Seiichiro
Published: April 2015

In a rechallenge system examining murine contact hypersensitivity to DNFB in BALB/c mice, the reactivity to the specific antigen at the previously responded site and the persistence of an immunological memory were investigated. Flare‐up reactions were induced 4 weeks after the first challenge only at the previously responded site by local or systemic administrations of minute quantities of a specific antigen. The intensity of ear swelling was dependent on the quantity of applied antigen at the time of the rechallenge. The local hypersensitivity to the specific antigen observed in the previously responded site and the regional lymph node persisted for at least 1 year.

These results suggest that the sensitivity to a specific antigen at the previously responded site is intensified and the immunological memory persists for a long time. This may explain the mechanisms by which chronic contact dermatitis recurs readily at the limited site by exposure to minute quantities of causative antigens.
Intercellular Adhesion Molecule‐1 on Cultured Human Melanoma Cells: Influence of Cytokines
Authors: Yoneda Kazufumi , Mori Shunji , Takemura Masao , Noma Akio , Yamamoto Akifumi
Published: April 2015

Adhesion molecules such as intercellular adhesion molecule‐1 (ICAM‐1) and its counter‐receptor, lymphocyte function associated antigen‐1 (LFA‐1), play very important roles in immune responses. In this study, the effects of cytokines on cultured human melanoma cells (MMG2) were examined, especially focussing on the expression of ICAM‐1 on MMG2 and lymphocyte adhesion to MMG2. Both the expression of ICAM‐1 and HLA‐DR on MMG2 increased after treatment with IFN‐gamma. ICAM‐1 expression began to increase earlier than HLA‐DR expression. TNF‐alpha and IL‐1 beta also increased the expression of ICAM‐1 on MMG2. However, these cytokines did not increase the expression of HLA‐DR. IFN‐gamma had a dose dependent effect on lymphocyte adhesion to MMG2. Pretreatment of IFN‐gamma treated MMG2 with 84H10 (anti‐ICAM‐1 antibody) or pretreatment of lymphocytes with either SPV‐L7 (anti‐LFA‐1 alpha antibody) or IOT10 (anti‐LFA‐1 beta antibody) inhibited the lymphocyte adhesion to MMG2. These results suggest that ICAM‐1 molecules induced on melanoma cells by IFN‐gamma can interact with LFA‐1 molecules on lymphocytes.
Giant‐cell (Temporal) Arteritis Following a Bypass Operation for Cerebral Infarction
Authors: Tsuji Takuo , Sawabe Motokazu
Published: April 2015

A 61‐year‐old man was referred to us with linear and indurated erythemas and severe tenderness on the scalp, neck, tongue, and scrotum which had gradually spread over the previous six months. He had a history of an intracranial bypass operation for cerebral infarction. Histologic and ultrastructural examinations revealed giant‐cell arteries in the skin as well as inflammatory cells infiltrating into nerves. Carotid angiograms indicated stenosis of cranial arteries.

It is suggested that the bypass operation may be related to the occurrence of the giant‐cell arteritis and that the inflammatory cell infiltrate into nerves may have caused the severe tenderness of this disease.
Adenoid Cystic Carcinoma of the Skin
Authors: Matsumura Tetsuri , Kumakiri Masanobu , Ohkawara Akira , Yoshida Tetsunori
Published: April 2015

Adenoid cystic carcinoma of the skin was studied. Histologically, tumor cells were arranged in a tubular and a cribriform pattern, mainly in the reticular dermis. Immunohistochemically, epithelial membrane antigen was reactive with the tumor cells, but S‐100 protein, vimentin, and carcino‐embryonic antigen were not. On electron microscopy, we confirmed the findings of previous reports; tumor cells were arranged to form luminal structures; most of them were pseudolumina containing fine mucin granules, basal laminae, and collagen fibers, but some were true lumina with numerous microvilli and junctional complexes. New findings of this study were bizarre‐shaped, electron‐dense, net‐like structures within the true lumina which were considered to be a type of mucin.
Childhood Lichen Planus (LP)
Authors: Kumar Vijay , Garg Bhagat R. , Baruah Manik C. , Vasireddi Srinivas S.
Published: April 2015

In adults, lichen planus (LP) is relatively more common than in children. Among 222 cases of LP, there were 25 (11.2%) children in our study. The majority of the cases were females in the age group of 8–14; the youngest child was 3 years old. Papular and linear types of LP were common in children. There was no familial history of LP in any of the cases. The patients with classic LP lesions responded well to dapsone therapy. This study supports the suggestion of Ramsay and Hurley that childhood LP is more common in the tropics.
The Incidence of Isolation of Methicillin‐resistant Staphylococcus aureus (MRSA) Strains from Skin Infections during the Past Three Years (1989–1991)
Authors: Nishijima Setsuko , Namura Shoko , Mitsuya Kaoru , Asada Yasuo
Published: April 2015

We did a statistical study of 294 strains of Staphylococcus aureus (S. aureus) isolated from skin infections during the period from January of 1989 to December of 1991 in the Department of Dermatology, Kansai Medical University Hospital. We especially examined methicillin‐resistant S. aureus (MRSA) from the point of view of incidence, variety of skin infections with MRSA, coagulase type, phase type, and resistance against antimicrobial agents. The frequency of isolation of MRSA has been increasing. In 1991, the proportion of MRSA isolates among all S. aureus strains isolated from skin infections was 41.5%. MRSA was isolated most often from infectious decubitus. Coagulase type II and phage group NT (not typable) MRSA were most frequently isolated. The resistance of MRSA to OFLX and IMP/CS had remarkably increased. Notably, the resistance to MINO was low before 1991.
Nuclear DNA Content and Distribution of Ki‐67 Positive Cells in Nodular Fasciitis
Authors: Ooe Mariko , Ishiguro Naoko , Kawashima Makoto
Published: April 2015

Nodular fasciitis (NF) is regarded as a disease of reactive growth of fibroblasts, although it frequently shows clinically rapid growth and sometimes has to be histologically discriminated from fibrosarcoma. In order to confirm the position of NF as a benign tumor, we studied 5 cases of NF by a quantitative analysis of the nuclear DNA content using flow cytometry in paraffin‐embedded specimens. In 3 of the 5 cases, an immunohistochemical study using Ki‐67 monoclonal antibody was also conducted in frozen sections. In the analysis of nuclear DNA content, DNA histograms showed a diploid pattern in all cases, and G1, S and G2 + M periods were calculated as 96.7%, 2.5% and 0.8% (on the average), respectively. Although the labeling index of Ki‐67 antibody (positive cells/tumor cells; %) was as scattered as 1.3–7.8 (5.6 on the average), the mean value was higher than that in already reported dermatofibroma and dermatofibrosarcoma protuberans and lower than that in malignant fibrous histiocytoma. These results endorse the hypothesis that NF is a reactive benign disease and reflect the biological behavior of this disease, which may frequently show rapid growth.
Generalized Skin Reaction Following Tinea Pedis (Dermatophytids)
Authors: Iglesias M. Eugemia , España Agustin , Idoate Miguel A. , Quintanilla Emilio
Published: April 2015

An 11‐year‐old boy presented with inflamed tinea pedis followed by a generalized id type skin eruption, with disappearance of the rash after treatment of the mycotic foot lesions. The pathogenesis of this process is not precisely known. Fungal infection was not detected from the generalized skin lesions. Various clinical forms of dermatophytid reaction are discussed.
Immunohistochemical Study of Elevated Expression of Squamous Cell Carcinoma (SCC)‐Related Antigens in Erythrodermic Epidermis
Authors: Horiuchi Yasuhiro , Tsukahara Tetsuya , Otoyama Kazunobu
Published: April 2015

Using immunohistochemical staining with the monoclonal antibodies (mAb) of squamous cell carcinoma‐related antigens (SCC‐RAg), the expression of SCC‐RAg in erythrodermic epidermis, which included senile erythroderma following eczema, atopic erythroderma, psoriatic erythroderma, and Sézary syndrome was examined. In senile erythroderma and atopic dermatitis, the most intense staining with SCC‐RAg mAb was evident in the upper epidermis. The cytoplasm of epidermal cells showed particularly strong staining. Although serum SCC‐RAg in the Sézary syndrome was not as high as in other erythroderma patients, staining with SCC‐RAg mAb was relatively strong in the upper epidermis. However, in psoriatic erythroderma cases with severe skin conditions, staining was weakly positive and diffuse throughout the entire epidermis. Following treatment, SCC‐RAg decreased significantly with remission. Elevated SCC‐RAg release may be attributed to epidermal cells, and SCC‐RAg should prove useful as a clinical marker of erythroderma.
Acute Urticaria: History and Natural Course of 50 Cases
Authors: Aoki Toshiyuki , Kojima Masuko , Horiko Tamio
Published: April 2015

Fifty patients with acute urticaria who visited within a week after the onset were interviewed and the history around the onset of urticaria was carefully taken. It was known that the majority of the patients had experienced some symptoms suggestive of infection. The patients were followed up for a year to determine the last efflorescence. It was disclosed that 43 cases were cured within two weeks and 5 other cases were cured between 2 weeks and 3 months. The remaining 2 cases persisted over a year.

These results seem to suggest that urticaria is an immunologically erroneous reaction to foreign body innoculation, a large majority of which is acute infection.
A Statistical Study on In vivo Sorption and Desorption of Water in Ichthyosis Vulgaris
Authors: Mukherjee Soma , Gupta Amulya Bhusan
Published: April 2015

Experiments on the variation of electrical conductance on sorption and desorption of water were performed on the skin of 34 subjects: 17 ichthyosis vulgaris patients and 17 normal subjects, matched for age and gender, under different ambient conditions. An exponential model of the form ft=θoeθt, where ft denotes fractional conductance at time t, describes the process of desorption with high accuracy. The parameter θ, identifiable as the rate of desorption, is significantly different between the ichthyotic and normal populations. The study discusses the impaired barrier function of the ichthyotic skin.
Histopathological Features of Recalcitrant Erythema of the Face in Adult Patients with Atopic Dermatitis
Authors: Omoto Mitsuyoshi , Sugiura Hisashi , Uehara Masami
Published: April 2015

Recalcitrant erythema on the face of 21 adult patients with atopic dermatitis was histologically examined. All patients had been applying topical corticosteroids to the facial erythema for three years or more.

The histopathology of the recalcitrant facial erythema was not homogeneous. Thus, the facial erythema was roughly classified into three categories: 1) erythema which mainly showed eczematous changes, 2) erythema which mainly showed steroid‐induced rosacea‐like changes, and 3) erythema which showed both eczematous changes and steroid‐induced rosacea‐like changes. The majority (75%) of recalcitrant facial erythema belonged to the third category.
Psoriasis Verrucosa Showing Peculiar Histologic Features
Authors: Nakamura Sawako , Mihara Motoyuki , Hagari Yoshitaka , Shimao Shuhei
Published: April 2015

A 60‐year‐old man had a 10‐year history of linearly arranged verrucous papules on his left fingers in addition to psoriatic erythematosquamous papules and plaques on his trunk and extremities. The verrucous papules were clinically classified into two types: dome‐shaped papules with a keratotic plug and crater‐shaped papules with a central depression. Histopathologically, the former showed cup‐shaped acanthosis with a parakeratotic column containing Munro's microabscesses, while the latter showed a cup‐shaped epidermal invagination with Kogoj's spongiform pustule‐like changes. Both types of papules were clinically diagnosed as psoriasis verrucosa, but their histologic features differed from those reported previously.
An Unusual Form of Skin Tuberculosis Following B.C.G. Vaccination
Authors: Lee Seung Min , Hann Seung Kyung , Chun Soo II , Lee Seung Hung , Park Yoon‐Kee
Published: April 2015

A 25‐year‐old female has had brown to erythematous telangiectatic patches and grouped papules on her face, neck, arm, and trunk since childhood following B.C.G. vaccination. Histopathologically, the lesions consisted of hyperkeratosis, slight acanthosis, tuberculoid granulomas with some Langerhans type giant cells in the mid‐dermis.

Although various forms of cutaneous tuberculosis after B.C.G. vaccination have been reported, it was difficult for us to assign the patient's skin lesion to any specific disease entity. Remission of her cutaneous lesions occurred clinically and histopathologically after treatment with isoniazid and rifampin.
Skin Diseases First Described in Japan
Authors: Teraki Yuichi , Nishikawa Takeji
Published: April 2015

Over the 90 year history of dermatology in Japan, about 30 skin diseases have been first described by our colleagues. Although some of them have become well known internationally, many of them are less well known outside of Japan. In this article, we introduce those conditions first described in Japan which are lesser known but have international significance.
Focal Gaps in the Basement Membrane of Involved and Uninvolved Skin of Vitiligo: Are They Normal?
Authors: Bose Sumit Kumar , Ortonne Jean‐Paul
Published: April 2015

It has been suggested that, in vitiligo, the structural abnormalities may not be restricted to melanocytes alone, but also to keratinocytes of involved and uninvolved skin. Focal gaps in the vitiligo epidermal basement membrane have been furthermore interpreted as evidence of extramelanocyte alterations. To understand the occurrence of the gaps we undertook a study to establish which cells are related to them. Immunofluorescence and immunoperoxidase techniques were used to visualize, in involved, uninvolved, and control skin, the basement membrane, melanocytes, and Merkel cells. Double staining was performed with fluorescein‐coupled anti‐collagen IV antibodies and rhodamin‐coupled antibodies against Nicein (GB3), a hemidesmosome component Propidium iodide staining was used to detect infiltrating lymphocytes.

The basement membrane structure was always found to be intact and unaltered. Absence of staining in areas of uninvolved skin was related to the presence of Merkel cells, melanocytes, and infiltrating lymphocytes. Gaps in the epidermal basement membrane are thus due to lack of staining caused by the presence of immigrant cells.
A Case of Mammary Paget's Disease without an Underlying Carcinoma: Microscopic Analysis of the DNA Content in Paget Cells
Authors: Mori Osamu , Hachisuka Hiroshi , Nakano Shunji , Maeyama Yasuhiko , Sasai Yoichiro
Published: April 2015

A 72‐year‐old woman had a 7‐year history of a scaly red area on the right breast which had enlarged asymptomatically. A biopsy of the nipple was taken, and, following the finding of Paget's disease, a modified radical mastectomy was carried out. On histological examination of the entire breast specimen by serial sections, no evidence of an intraductal adenocarcinoma was found.

Fractionation of Paget cells was performed from the epidermis. Stripped skin was treated with EDTA and trypsin, and epidermal cell suspensions were obtained. They were layered onto discontinuous Percoll gradients and centrifuged. Paget cells fell into three fractions with densities of 1.041, 1.058, and 1.078. Electronmicroscopically, the purity of fractionated cells obtained by this method ranged from 55 to 74% with viabilities of from 70 to 90%. Microscopic analysis of the DNA content in these cells was performed. The DNA histogram was close to the normal ploidy. This may explain why the mammary Paget's disease lesions in this case enlarged rather slowly.
The Antibiotic Susceptibility of Propionibacterium acnes and Staphylococcus epidermidis Isolated from Acne
Authors: Nishijima Setsuko , Akamatsu Hirohiko , Akamatsu Maki , Kurokawa Ichiro , Asada Yasuo
Published: April 2015

We studied the susceptibility of antimicrobial agents to Propionibacterium acnes (P. acnes) and Staphylococcus epidermidis (S. epidermidis) isolated from acne patients.

We measured the minimum inhibitory concentrations (MICs) of the following five drugs: roxithromycin (RXM), erythromycin (EM), clindamycin (CLDM), minocycline (MINO) and ofloxacin (OFLX), which are frequently Used to treat acne and skin infections. We found many resistant strains of S. epidermidis and some resistant strains of P. acnes. There was a correlation between the resistance of S. epidermidis and the former therapy for acne, but no distinct correlation between the resistance of P. acnes and the former therapy for acne.
Induction of Intercellular Adhesion Molecule‐1 and Adherence of HTLV‐1‐Infected T‐cells to Cultured Keratinocytes
Authors: Fenxiang Jin , Iwatsuki Keiji , Takigawa Masahiro , Yamada Mizuho
Published: April 2015

Cutaneous lesions of T‐cell proliferative disorders are characterized by epidermotropic infiltration of the neoplastic cells and expression of intercellular adhesion molecule‐1 (ICAM‐1) and HLA‐DR by lesional keratinocytes. Using cloned HTLV‐1‐infected T‐cells obtained from patients with adult T‐cell leukemia (ATL), we have studied immunobiological activities of cytokines released from the T‐cell lines and their ability to adhere to cultured keratinocytes. Three out of the five CD‐4‐positive, HTLV‐1‐infected T‐cell clones secreted both IFN‐γ and IL‐4, similar to murine Th0 clones. The other two clones did not produce such cytokines. ICAM‐1 and HLA‐DR molecules were induced on cultured normal human keratinocytes and organ‐cultured skin specimens by co‐cultivation with IFN‐γ‐producing T‐cell clones or their culture supernatants. Induction of both molecules was markedly inhibited by pretreatment of the supernatants with excess amounts of anti‐IFN‐γ monoclonal antibody. The number of cells adherent to the normal cultured keratinocytes was greater in the IFN‐γ‐producing clones than in the non‐producing ones. These data suggest that some HTLV‐1‐infected clones produce cytokines, including IFN‐γ, which in turn induce ICAM‐1 on keratinocytes, thereby enhancing the ability of the T‐cell clones to adhere to the keratinocytes.
Cutaneous Arterial Fibromuscular Dysplasia: A Case Report and Electron‐microscopic Study
Authors: Setoyama Mitsuru , Shimada Tokihiko , Kanzaki Tamotsu , Moriya Kazuhiro , Okahara Kazunori , Asakura Tetsuhiko
Published: April 2015

A case of a 39‐year‐old female with fibromuscular dysplasia (FMD) manifesting subcutaneous pulsatile nodules on the right side of her forehead and on her right wrist is reported here. These nodules proved to be FMD aneurysms of the frontal ramus of the right superficial temporal artery and the right radial artery. The patient had also suffered a stroke with subarachnoidal bleeding as a result of this disease.

Angiographic examination showed aneurysms in the union and the bilateral vertebral arteries, a branch of the right renal artery, and one the right lumbar artery. A biopsy specimen taken from the frontal branch of the right superficial artery revealed segmental intimal thickening consistent with intimal fibroplasia type FMD upon histological examination. Electron‐microscopic findings were also discussed in connection with the histogenesis of the disease.

This appears to be the second case of FMD involving arteries in the skin to be reported in the dermatological literature.
A Case of Nail Picking
Authors: Kinoshita Tadashi , Johno Masayoshi , Ono Tomomichi , Kikuchi Ichiro
Published: April 2015

A case of nail picking seen in an eleven‐year‐old Japanese girl and confirmed by its favorable response to management is reported.
Pemphigus Developed on Preexisting Dermatoses
Authors: Lee Chang Woo , Ro Young Suck
Published: April 2015

A case of pemphigus foliaceus which initially developed at sites of preexisting psoriasis and a case of pemphigus erythematosus that developed on the lesions of photosensitive erythemas are described.

Inflammatory dermatoses can be considered to be local factors which facilitate the autoimmune response of pemphigus, which in turn may induce blistering cutaneous lesions in subclinical patients with autoantibodies.
Sensitivity of Staphylococcus aureus and Streptococcus pyogenes Isolated from Skin Infections in 1992 to Antimicrobial Agents
Authors: Nishijima Setsuko , Namura Shoko , Kawai Shuzou , Akamatsu Hirohiko , Asada Yasuo , Kawabata Sigekatsu
Published: April 2015

We studied the efficacy of antimicrobial agents against Staphylococcus aureus (S. aureus) and Streptococcus pyogenes (S. pyogenes) isolated from skin infections in 1992.

For S. aureus, we measured the minimum inhibitory concentrations (MICs) of the following 10 drugs: methicillin (DMPPC), cefaclor (CCL), gentamicin (GM), erythromycin (EM), clindamycin (CLDM), minocycline (MINO), vancomycin (VAN), fusidic acid (FA), ofloxacin (OFLX) and nadifloxacin (NDFX); for S. pyogenes, we determined the MICs of the following 9 drugs: ampicillin (ABPC), amoxicillin (AMPC), cefpodoxime proxetil (CPDX‐PR), erythromycin (EM), clindamycin (CLDM), minocycline (MINO), norfloxacin (NFLX), ofloxacin (OFLX) and nadifloxacin (NDFX). These drugs are frequently used to treat skin infections, either systemically or topically. NDFX is a new synthetic fluoroquinolone, recently developed for use as a topical acne medication in Japan. It is used NDFX for acne, but not for skin infections.

There were no strains of S. aureus resistant to NDFX, VAN or FA. The resistance (≧12.5 µg/ml) of S. aureus was highest to GM and lowest to OFLX. Four strains of methicillin‐resistant (≧12.5 µg/ml) S. aureus (MRSA) were found.

In contrast, no resistant strains of S. pyogenes were found except to MINO. Only two strains of S. pyogenes were susceptible to MINO. The sensitivity of S. pyogenes to ABPC, AMPC, CPDX‐PR, EM and CLDM was very good. All the strains were susceptible at a MIC below ≧0.05 µg/ml. However, the S. pyogenes strains were not very sensitive to the new quinolones, especially NFLX.

We concluded that penicillins, cephalosporins and macrolides are still effective against streptococcal infections. In contrast, we found S. aureus to be resistant to several kinds of antimicrobial agents. Accordingly, we need to check the sensitivity of S. aureus, before using antimicrobial agents for staphylococcal infections.

Roughly speaking, the drugs that are strongly effective against S. aureus are not effective against S. pyogenes. For example, the efficacy of MINO against S. aureus was very good, but almost all S. pyogenes strains were resistant to it. The pattern is much the same for the new quinolones.
Natural Cellular Cytotoxicity in Behçet's Disease
Authors: Önder Meltem , Bozkurt Meral , Gürer Mehmet Ali , Gülekon Ayla , Sezgin Pervin , İmir Turgut
Published: April 2015

This study evaluated the cytotoxic activity of natural killer cells in the active and inactive stages of Behçet's disease (BD) and attempted to develop a new explanation for its immuno‐pathogenesis. Blood samples were taken from 16 BD patients and compared with 11 healthy individuals. The lymphocyte fraction was separated and diluated in RPMI‐1640. Candida as a target cell (T) was mixed with lymphocytes (E) (effector cells) in ratios of T:E 1/5 and T:E 1/25. After the numbers of colonies were counted with controls, the anticandidal index (natural cytotoxicity) was calculated. Natural cytotoxicity relatively decreased in the active stage and increased in the inactive stage of BD. Although the difference between the mean value of natural cytotoxicity in the active stage and in the inactive stage was significant, the difference between the averages of active stage and the control group was insignificant. However, the difference between inactive stage and the control group was remarkable. The increase of the natural cytotoxic activity in the inactive period of the disease may play a role together with other immune mechanisms in the aetiopathogenesis of BD.
A Case of Chronic GVHD Following Bone Marrow Transplantation from a Phenotypically HLA‐Matched Unrelated Donor
Authors: Sano Yoshimi , Tanaka Keiko , Shimao Shuhei
Published: April 2015

A 45‐year‐old male with chronic myelocytic leukemia who received a bone marrow transplantation from a phenotypically HLA‐matched unrelated donor developed chronic GVHD on day 100 post transplantation. He developed a slight fever, malaise, hepatic dysfunction and extensive itchy erythema with scaling over his entire body. The inflammatory skin lesion developed into erythroderma in about two weeks. H&E staining of a skin biopsy revealed eosinophilic bodies and a lymphocytic infiltration in the dermis and epidermis, which were compatible with the early phases of chronic GVHD. Immunohistochemistry revealed that keratinocytes expressed dense HLA‐DR and ICAM‐1 epitopes. Langerhans cells (CD1a+ cells) had disappeared from the epidermis. Many T cells (CD3+ cells) had migrated into the epidermis as well as into the reticular dermis. The majority of the T cells in the epidermis were CD8+ cells, while almost all the T cells in the dermis were CD4+ cells. These immunohistochemical features were similar to those previously reported for acute cutaneous GVHD. Despite the corticosteroid therapy, the eruptions did not disappear. The patient was then treated with whole body bath‐methoxsalen (Oxsoralen®) plus ultraviolet A (UVA). The bath‐psoralen plus UVA therapy was effective in this patient.
A Case of Superficial Epithelioma with Sebaceous Differentiation
Authors: Akasaka Toshihide , Imamura Yuko , Tomichi Nobukazu , Kon Saiichi
Published: April 2015

Superficial epithelioma with sebaceous differentiation developed on the left cheek of a 58‐year‐old man over a three‐year period. Biopsy of the lesion demonstrated plate‐like lobules of basophilic basaloid cells with broad attachments to the overlying epidermis. Clusters of or solitary sebaceous cells were present within the lobules. Three tumor types were considered; a subtype of sebaceoma growing in the epidermis, an acanthotic seborrheic keratosis subtype with sebaceous differentiation, or a tumor of the follicular infundibulum with sebaceous differentiation.
A Case of Generalized Lichen Nitidus with Koebner's Phenomenon
Authors: Maeda Manabu
Published: April 2015

A 12‐year‐old boy was seen in our department with a three year history of eruptions on his back consisting of normal colored or slightly reddish, pinhead‐sized papules, which had gradually spread to his trunk within the previous year. Four days before the first visit, May 13, 1992, the eruption involved his entire extremities. On the back side of his lumbar region, Koebner's phenomenon was observed. He had received several medications for more than two years to treat this eruption in several hospitals, but none were effective. He was in good general health. Mantoux reaction was negative two months after BCG injection. Histopathologic features of the papules included focal epidermal hyperplasia and elongation of the rete ridges in a narrow area and a well demarcated dense lymphohistiocytic infiltrate on the papillar layer. Biscoclaurine alkaloids (20 mg/day) and Jumi‐haidoku‐to (TJ‐6; 7.5 g/day) were administered to the patient after the biopsy. No topical ointments were applied. Two weeks after of these treatments, he reported moderate pruritus on the back. The eruption diminished rapidly within 2 weeks after the therapy began. Almost all the eruptions were cured within one year. Mantoux reaction developed 8 times 8 mm erythema two and half months after the treatment began, and it was significantly positive (23 times 30 mm) 6 months later.
Accessory Tragi: A Case Report
Authors: Sehgal Virendra N. , Chander Ram , Garg Vijay K. , Jain Sanjiv , Logani Kulbhushan
Published: April 2015

Accessory tragi, a fascinating supernumerary embryonic accessory in a 3‐year‐old child, is described, emphasizing the cardinal clinical features and histopathological characteristics.
A Case of Fibrous Histiocytoma Associated with Xanthogranulomatous Alteration
Authors: Maruyama Michiyo , Sato Shinichi , Tsuchida Tetsuya , Toda Kiyoshi
Published: April 2015

We report here an unusual case of fibrous histiocytoma in which an area of xanthogranuloma was observed histologically. Our case suggests that adult xanthogranuloma is a variant of fibrous histiocytoma.
In situ Expression of Interleukin‐6 in Psoriatic Epidermis during Treatment
Authors: Ohta Yukinori , Nishiyama Shigeo , Nishioka Kiyoshi
Published: April 2015

Interleukin‐6 (IL‐6) is a multipotential cytokine which may act as a growth factor for keratinocytes. The epidermal hyperplasia of psoriasis may be explained in part by an overproduction of this cytokine. We have previously shown by in situ hybridization that IL‐6 mRNA is most strongly expressed in the peripheral lesion of an advancing psoriatic plaque. In the present study, we investigated whether there were differences between the expression of IL‐6 in untreated psoriatic epidermis and the lesion during the course of clinical improvement. In the untreated psoriatic lesion, the weak expression of IL‐6 mRNA was localized in the lower epidermis. However, IL‐6 mRNA was not detected in the clearly improved lesion. In the improving lesion, with clinically less scaling, less induration, and histologically thinner epidermis, IL‐6 mRNA‐expressing keratinocytes were detectable in a greater proportion of the total epidermal components than in the untreated, fully developed lesion. These results showed that IL‐6 mRNA was strongly expressed in lesions with moderate epidermal hyperproliferation, indicating that this cytokine may play a role in the transitional phase during the course of improvement as well as in the lesion's formation.
Bone Mineral Density of the Lumbar Spine in Psoriatic Patients with Long Term Etretinate Therapy
Authors: Okada Natsuko , Nomura Masao , Morimoto Shigeto , Ogihara Toshio , Yoshikawa Kunihiko
Published: April 2015

Etretinate has been known to produce a variety of skeletal manifestations when administered for prolonged periods. To study whether osteoporotic changes occurred during the treatment, bone mineral density (BMD) was measured by dual energy X‐ray absorptiometry in 13 psoriatic patients who received long term etretinate therapy (average 3.7 yrs). The values of BMD of the lumbar spine in these patients were decreased from those of age‐matched controls (92.3 ± 9.7%, p<0.01), while those in psoriatic patients who received topical corticosteroid applications alone showed no significant decrease. Our findings suggest that long term etretinate intake induces an increased risk of osteoporotic changes.
Hair Fibrous Protein Compositions in Some Hereditary Hair Abnormalities Determined by Two‐Dimensional Polyacrylamide Gel Electrophoresis
Authors: Koike Shun'ichi , Dekio Satoshi , Jidoi Joji , Yoshimura Yasuro , Ishii Masamitsu , Hamada Toshio , Saito Ryuzo
Published: April 2015

S‐carboxymethylated (SCM) fibrous proteins (FPs) from the scalp hairs of the three different hereditary hair abnormalities (trichorrhexis invaginata in Netherton's syndrome, pili trianguli et canaliculi in uncombable hair syndrome, and fine hair in anhidrotic ectodermal dysplasia) were analyzed by two‐dimensional polyacrylamide gel electrophoresis. Comparison of the SCM FP compositions of the three hair abnormalities with that of the normal revealed that the SCM FP compositions of these three abnormal hairs were all electrophoretically different from each other and that of the normal.