bluuebunny/crossref_metadata_2025 huggingface dataset:
Primary Cutaneous Ki‐1+ Anaplastic Large Cell Lymphoma: A Morphologic, Immunohistochemical and Genetic Study of an Indolent Case
Authors: Sato Noriko , Sato Kazunari , Yagi Eiichi , Tomita Yasushi
Published: April 2015

A 59‐year‐old woman with a large nodular ulcerative lesion on her neck was presented. She had a 3 year history of recurrent cutaneous nodules which spontaneously regressed before regional lymphadenopathies appeared. She has followed an indolent clinical course for seven years after the first overt lymphadenopathies appeared. Histological findings were compatible with anaplastic large cell lymphoma (ALCL). The tumor cells strongly expressed Ki‐1 (CD30), HLA‐DR, IL‐2 receptor (CD25) and leukocyte common antigen. These findings led to the diagnosis of primary cutaneous Ki‐1+ ALCL. Although the majority of the tumor cells did not express T‐cell related antigens, the detection of monoclonal TCR gene rearrangement clearly established the T‐cell lineage nature.
Coexistence of Subepidermal Calcified Nodule and Keratosis Punctata in a Patient with Hyperhidrosis
Authors: Yamamoto Toshiyuki , Katayama Ichiro , Nishioka Kiyoshi
Published: April 2015

A 47‐year‐old female with hyperhidrosis developed multiple subepidermal calcified nodules and keratosis punctata on her palms. Although calcification was not detected on eccrine sweat glands around the calcified mass by histologic examination, it was supposed that the eccrine sweat glands may have played a role in inducing these two lesions in our case.
Statistical Survey from 1982 to 1991 of 49 Patients with Malignant Melanocytic Tumors
Authors: Ueda Eiichiro , Kishimoto Saburo , Yasuno Hirokazu
Published: April 2015

We investigated the clinical characteristics and outcome of 49 patients with malignant melanoma: 17 with acral lentiginous melanoma, 14 with nodular melanoma, six with superficial spreading melanoma, one with lentigo maligna melanoma, eight with melanoma in situ, one with malignant blue nevus, and two with melanoma of unknown origin. Of the 41 patients without melanoma in situ, 34.1% were in stage I, 17.1% in stage II, and 48.8% in stage III. No patients had reached stage IV. All patients with stage I, II, and III melanoma were treated with wide resection, lymph node dissection including prophylactic dissection, and combination chemotherapy with dacarbazine, nimustine hydrochloride, and vincristine (DAV) with or without Interferon‐β. The statistical analysis revealed that tumor thickness and level of invasion were factors significantly associated with outcome. A gradual increase in the number of new cases of melanoma was seen each year of the registration period (1982–1991); there was an approximately 4‐fold increase during this decade over the previous decade. The majority of the primary lesions (80.5%) were located on the upper or lower extremities, the pT4 tumor thickness subgroup was the most frequent (39.0% of all melanomas), and invasion level IV was the most common (42.5%). About half (51.2%) of the melanoma patients were stage I or II; this group had a 5‐year survival rate of 100%. The stage III patients had a 5‐year survival rate of only 54.2% (p<0.05).
Clinico‐Epidemiological Profile of Ichthyosis in South Indian Patients
Authors: Baruah Manik C. , Oeducoumar P. , Garg Bhagat R. , Kumar Vijay
Published: April 2015

A high frequency rate of hereditary ichthyosis (141.89 per 1000) was detected in a 1029 member South Indian study population selected at random from the skin outpatients of a teaching hospital. An age and sex matched control population screened from the medical and pediatric outpatients of the same institute recorded the incidence of ichthyosis vulgaris as 150 per 1000 population which is even higher.
Striated Muscle Hamartoma of the Nostril
Authors: Nakanishi Hideki , Hashimoto Ichiro , Takiwaki Hirotsugu , Urano Yoshio , Arase Seiji
Published: April 2015

We observed two females, an 11‐month old and a 15‐year‐old, each with a round, soft mass in the nostril. Histologically, numerous bundles of striated muscle fibers were seen in the masses among normal dermal components. The lesions were excised without complications. Four patients with similar lesions confirmed clinically and histologically have been reported in the literature under various diagnostic names. These masses were diagnosed as striated muscle hamartomas in view of their characteristic features: congenital round, soft masses on the midline of the head or neck with multiple, mature striated muscles observed in the mass. Since these lesions may be associated with such anomalies as amniotic band syndrome and lipoma of the brain, a complete medical examination is required of such patients.
Scleroderma‐like Changes in a Patient with Insulin‐Dependent Diabetes Mellitus
Authors: Maekawa Yoshihiro , Nakamura Takehiko , Nogami Reiko
Published: April 2015

A 38‐year‐old Japanese woman with diabetes showed sclerosis of the hands, a short sublingual frenulum, and hypomotility of the esophagus. She had been on insulin therapy for insulin‐dependent diabetes mellitus since the age of 15. For the previous one year, the proximal interphalangeal joints had become painful and swollen with sclerosis of the hands. Although these findings are also seen in PSS, this case was assumed to be due to diabetes mellitus. The patient had a high serum level of HbAlc, which may reflect a poor control of diabetes and non‐enzymatic glycosylation of collagen fibers, resulting in an accumulation of collagen in the dermis.
Pyoderma Gangrenosum with Systemic Involvement
Authors: Urano Shoko , Kodama Hiroyuki , Kato Kazuaki , Nogura Kazuya
Published: April 2015

We report a case of a patient with pyoderma gangrenosum associated with multisystemic manifestations. The patient showed liver dysfunction, respiratory failure, and aseptic meningeal reaction. Corticosteroid therapy was efficient in treating both the skin lesions and the other systemic disorders.
Multiple Lentigines (Leopard) Syndrome with Chiara I Malformation
Authors: Agha Amr , Hashimoto Ken
Published: April 2015

This is a case report of multiple lentigines (Leopard Syndrome) with Chiari malformation, i.e. a herniation of the cerebellum into the foramen magnum. This male patient had generalized multiple lentigines since birth, and the lesions spread steadily, involving the scalp but sparing all mucous membranes. Organ system involvements included heart murmur, ocular hypertelorism, and retardation of growth.
Infrequent Expression of Protein p53 in Epidermotropic Variants of Cutaneous T‐Cell Lymphoma
Authors: de Misa Ricardo F. , Azaña José Manuel , Harto Antonio , Bellas Carmen , Ledo Antonio
Published: April 2015

Although diverse types of lymphomas have been examined for immunohistochemical detection of p53 protein, little information is available with regard to p53 protein expression in CTCL. We analyzed cutaneous biopsy specimens of 22 patients with the diagnoses of mycosis fungoides or Sézary syndrome with polyclonal rabbit anti‐p53 antiserum CM‐1. Staining of neoplastic cells was observed only in two patients with advanced disease. Overexpression of p53 protein does not seem to be a major feature of either mycosis fungoides or Sézary syndrome.
A Case of Lichen Myxedematosus with Clearly Exacerbated Skin Eruptions after UVB Irradiation
Authors: Yamazaki Soji , Fujisawa Takayuki , Yanatori Akihiko , Yamakage Akio
Published: April 2015

We report a 48‐year‐old male with typical lichen myxedematosus, liver dysfunction, and diabetes mellitus. His skin eruptions were clearly exacerbated after accidental over‐irradiation by UVB. These findings were clinically and histologically confirmed. The pathogenesis is still unknown, but we consider it to be due to Koebner phenomenon.
An Autopsy Case of Malignant Lymphoma with Lyell's Syndrome
Authors: Sadi Al Muktafi , Toda Takayoshi , Kiyuna Masaya , Tamamoto Tooru , Ohshiro Kazuiku , Shinzato Rimi
Published: April 2015

We present a case of fatal Lyell's syndrome which developed following a CT examination using omnipaque 3000 contrast medium. A 59‐year‐old man was suffering from malignant lymphoma. He was readmitted to this hospital due to relapse of fever and lymph node swelling. On the day of readmission, generalized erythema, purpura, and mucosal erosions developed after a CT examination. Steroids and chemotherapy were ineffective, and he expired approximately two weeks after admission. Drug‐induced dermatopathy or leukemic cell infiltration in the skin was clinically suspected. Histological findings disclosed toxic epidermal necrolysis.
Erythematous Papules in a Patient with Cardiac Myxoma: A Case Report and Review of the Literature
Authors: Misago Noriyuki , Tanaka Tatsurou , Hoshii Takashi , Suda Hisao , Itoh Tsuyoshi
Published: April 2015

A 35‐year‐old woman was followed up by a physician for one and a half years as a case of transient ischemic attack (TIA) due to thrombosis. She had a few erythematous papules on the dorsal side of her right forearm and on the right side of her neck. From the history of TIA and the transient erythematous papules, we suggested the possibility of cardiac myxoma. Echocardiogram demonstrated a large mass in her left atrium. An immediate operation was carried out, and the cardiac myxoma was excised surgically. Histological examination of the erythematous papule revealed myxoma emboli.
In vitro Comparative Study of the Antitumor Effects of Human Interferon‐α, β and γ on the Growth and Invasive Potential of Human Melanoma Cells
Authors: Horikoshi Takashi , Fukuzawa Kumiko , Hanada Nirou , Ezoe Kyori , Eguchi Hiroaki , Hamaoka Shuji , Tsujiya Hidenobu , Tsukamoto Taiji
Published: April 2015

We have studied the effects of interferon (IFN)‐α, β, and γ in vitro on the growth and invasive potential of human melanoma SK‐MEL‐118 cells.

The antiproliferative effects of IFNs were assessed by a quantitative regrowth assay in which cells were treated with IFNs at concentrations of 102, 103 or 104 IU/ml for 3 days (until day 4) and then further incubated without IFNs for 7 days (until day 11). The growth inhibitory effect of each IFN on melanoma cells was dose‐ and time‐dependent. Among these three types of IFNs, however, IFN‐β exerted the strongest inhibitory effect on cell growth.

To assess the anti‐invasive effect of each IFN on melanoma cells, we employed an in vitro assay system using matrigel‐coated Transwell chambers. When cells were treated with 102, 103, or 104 IU/ml of the three types of IFNs for 24 hours, the amount of tritiated thymidine incorporated into cells generally increased, indicating that cell growth was not inhibited by the pretreatment When melanoma cells were treated for 24 hours with 104 IU/ml of IFN‐β or γ prior to the assay, the number of cells that invaded the filter decreased by 40%; this decrease was only 10% with the same amount of IFN‐α. Simultaneous addition of IFNs during the invasion assay was not effective in any combination. Only when the cells were pretreated with IFNs, antiinvasive effects against melanoma cells were exerted. IFN‐a was less inhibitory than IFN‐β or γ on proliferation and not at all inhibitory on invasion. Considering both the antiproliferative and antiinvasive effects of IFNs, our results suggest that IFN‐β has the strongest antitumoral effect on human melanoma cells. IFN‐γ had a relatively strong inhibitory effect, especially on invasion.
Cytokine Profile of Tumor Cells in Mycosis Fungoides: Successful Treatment with Intra‐lesional Interferon‐γ Combined with Chemotherapy
Authors: Yamamoto Toshiyuki , Sasaki Go , Sato Takahiro , Katayama Ichiro , Nishioka Kiyoshi
Published: April 2015

Two cases of mycosis fungoides (MF) in the tumor stage were treated with intra‐lesional interferon‐γ (IFN‐γ) therapy. After systemic chemotherapy, intra‐lesional recombinant interferon‐γ was applied to the residual tumors. Intra‐lesional IFN‐γ was sufficiently effective in the treatment of MF tumors, especially small‐sized ones. Reverse transcriptase polymerase chain reaction (RT‐PCR) analysis of messenger RNA expression of cytokines commonly detected interleukin‐6 (IL‐6) and IFN‐γ in the tumor cells before intra‐lesional IFN‐γ. However, in our study, tumor cells in these cases did not exhibit the definitive cytokine patterns of Th1 or Th2.
Recurrent Dermatofibrosarcoma Protuberans with Myxoid and Fibrosarcomatous Changes Paralleled by Loss of CD34 Expression
Authors: Sato Noriko , Kimura Keisuke , Tomita Yasushi
Published: April 2015

A 38‐year‐old woman complained of recurrent nodules on her anterior chest wall. She noticed the first nodule at the age of 12 and has since undergone surgical removal a total of 31 times. Finally, wide resection of parts of the rib cartilage and sternum and chest wall reconstruction were required. Histopathological examination of a series of surgical specimens were reevaluated. Immunohistochemical staining of the tumors by anti‐CD34 antibody provided a definite diagnosis of dermatofibrosarcoma protuberans (DFSP). A noteworthy result was that her DFSP did not always express CD34; the recurrent tumors with myxoid and fibrosarcomatous changes lost their CD34 expression.
Necrotizing Fasciitis in Association with Hyperimmunoglobulin E Syndrome
Authors: Misago Noriyuki , Tanaka Tatsurou , Takeuchi Minora , Oka Shohki
Published: April 2015

A case of necrotizing fasciitis in association with hyperimmunoglobulin E (HIE) syndrome is reported. The patient was a 17‐year‐old Japanese boy with a clinical history of recurrent skin and pulmonary infections and eczematoid dermatitis, markedly elevated serum levels of IgE, and coarse facies. He had a gangrenous swelling on the lower abdominal wall, and his general condition was poor with high fever. The involved site was accompanied by subcutaneous gas; the culture of the pus of the lesion grew anaerobes without mixed growth of Staphylococcus aureus. Exhaustive debridment of necrotic fascia, which extended much farther than the gangrenous area, and administration of antibiotics had a curative effect on the gangrenous soft tissue infection. To the best of the authors' knowledge, this is the first published case of necrotizing fasciitis in association with HIE syndrome.
Nodular Melanoma in 62 Japanese Patients: Influence of Initial Surgical Treatment on Local Recurrence and Prognosis
Authors: Kato Taizo , Suetake Takaki , Kumasaka Naka , Tabata Nobuko , Sugiyama Yasuko , Tagami Hachiro
Published: April 2015

The incidence of malignant melanoma is much lower in Japanese than in Caucasians, and the commonest type of melanoma in Japanese is acral lentiginous melanoma (ALM). In contrast to the improved prognosis noted in ALM, it is now of increasing concern that there is a rise in both the frequency and mortality of nodular melanoma. During the 25 years from 1970 to 1994, we observed 190 patients with melanoma, including 62 nodular melanomas and 96 ALM, at the Department of Dermatology, Tohoku University Hospital, Sendai, Japan. We retrospectively reviewed the recurrence and survival rates of nodular melanoma observed. The proportion of nodular melanoma, once comprising only 24% of all melanomas, showed a sharp increase to 40% after 1982. The anatomical sites of the primary tumor were the hands and feet (29%), extremities excluding hands and feet (27%), head and neck (23%), and trunk (21%). Comparison of the stages of nodular melanoma when diagnosed showed that the proportion of stage III remained highest throughout the whole period, but that of stage II melanomas increased after 1982. After treatment, local recurrence occurred far more frequently in nodular melanoma (19%) than in ALM (1%). The prognosis of nodular melanoma was also less favorable than that of ALM, although it slightly improved after 1982; the 5‐year survival rates before and after 1982 were 34 and 50%, respectively. Twenty‐eight patients with nodular melanoma had underwent simple excision or incisional biopsy of the primary tumor at another institution and were later referred to us for further intensive care or for the treatment of local recurrence and/or metastases. The rate of local recurrence of melanoma in such referred patients was higher than that in those who underwent an initial excision with wide margins in our hospital. Concurrently, the prognosis in the former group was significantly lower than that in the latter group; the 5‐year survival rate for the group of narrow initial margin was 22% in contrast to that of wide margin (56%). Combination therapy including initial surgical excision with wide margins as well as the careful follow‐up apparently result in a better outcome for the Japanese patients with nodular melanoma.
A Comparative Study of Axillar Hair Removal in Women: Plucking versus the Blend Method
Authors: Urushibata Osamu , Kase Kayoko
Published: April 2015

Fourteen healthy adult Japanese females were selected to participate in a comparative study of hair plucking (a temporary hair removal technique) and the blend method (a permanent hair removal technique). The effectiveness of permanent hair removal and the safety of the blend method were examined in this study. If hairs of the left axilla were removed by the blend method, then hairs of the right axilla were removed by plucking, and vice versa. Every hair was removed and the number of hairs was counted each time. Sessions were conducted every three weeks, and the experiment continued until no new hair growth was seen using the same experimental standard. Electrologists with more than 1000 hours of experience were selected to perform electrolysis. Examinations of the axilla, before and after each test, were conducted by the authors.

The results showed that the number of hairs decreased in the axilla with each session using the blend method: permanent hair removal was achieved in an average of 26.8 weeks or 9.9 sessions. However, the number of hairs did not decrease in the axilla after plucking. Also, there were no reports of hair removal related side‐effects in this study. It was thus demonstrated that the blend method is a safe and effective way of achieving permanent hair removal.
Lymphomatoid Papulosis Followed by Ki‐1 Positive Anaplastic Large Cell Lymphoma: Proliferation of a Common T‐Cell Clone
Authors: Amagai Masayuki , Kawakubo Yo , Tsuyuki Akira , Harada Reiko
Published: April 2015

We report a case of lymphomatoid papulosis (LyP) followed by Ki‐1 positive anaplastic large cell lymphoma (LCL). A 33‐year‐old man developed subcutaneous nodules in the left inguinal region and the left thigh after a seven‐year‐history of self‐healing papulonecrotic lesions of LyP. Histological and immunohistochemical examination of the subcutaneous nodules revealed LCL. DNA was isolated from a nodule of the initial stage of LyP in 1988, a subcutaneous nodule of LCL in 1993, and a papule of LyP in 1993 which appeared after chemotherapy for LCL. T cell receptor gene rearrangement analysis demonstrated an identical rearranged pattern in all the three specimens, indicating that a common T cell clone proliferated throughout the course in both the LyP and LCL lesions.
Extensive Lichen Amyloidosus Refractory to DMSO
Authors: Kobayashi Takashi , Yamasaki Yuichiro , Watanabe Tomoo , Onoda Noboru
Published: April 2015

While lichen amyloidosus reportedly may respond to dimethyl sulfoxide (DMSO) application, we present a patient whose lesions were refractory to this agent. This Japanese woman had chronic extensive lichen amyloidosus, mainly on her trunk. Her 10‐year history of using nylon towels was the suspected cause. The application of DMSO ointment had no clinical effect, and the amyloid deposits persisted in the histological specimens despite the treatment. The administration of a topical corticosteroid led to gradual clinical improvement.
A Case of Atrophoderma of Pasini and Pierini: Analysis of Glycosaminoglycan of the Lesional Skin
Authors: Tajima Shingo , Sakuraoka Kouichi
Published: April 2015

We report a case of atrophoderma of Pasini and Pierini. We determined the glycosaminoglycan content in the involved skin. Dermatan sulfate content in the involved skin (1.88 μg uronic acid/mg dry skin) was greater than that in the uninvolved skin (1.05 μg uronic acid/mg dry skin). No significant differences in hyaluronic acid, chondroitin sulfate or heparan sulfate content between involved and uninvolved skin were observed. These results suggest that abnormal metabolism of dermatan sulfate may be involved in the pathogenesis of atrophoderma; this pattern has been observed in systemic or localized scleroderma.
Dermatofibroma with Myxoid Changes in a Patient with Psoriasis
Authors: Yamamoto Toshiyuki , Yokoyama Akiko , Katayama Ichiro , Nishioka Kiyoshi
Published: April 2015

A 38‐year‐old female with psoriatic arthritis developed a dermatofibroma (DF) on her upper arm. Its position was not exactly on a psoriatic plaque; however, psoriatic lesions were present diffusely around the DF lesion. Histological examination revealed the typical features of DF with myxoid changes in the portion between the tumor nest and the overlying epidermis. The mast cell number was significantly increased over that of solitary DFs without myxomatous lesions. It was suggested that mast cells may play a role in induction of the myxoid changes in the DF lesion in this case.
Pustular Psoriasis Precipitated by Acetazolamide
Authors: Kuroda Kei , Kojima Takayuki , Tanabe Emiko , Fujita Masaru , Shinkai Hiroshi
Published: April 2015

We report a case of pustular psoriasis precipitated by acetazolamide, a carbonic anhydrase inhibitor. A 28‐year‐old man suffering from 20 years‐standing generalized pustular psoriasis developed psoriatic arthritis and glaucoma and experienced a precipitation of pustular lesions and widespread erythema after initiation of oral acetazolamide for glaucoma. The cutaneous lesions and systemic symptoms improved after restriction of acetazolamide and administration of oral etretinate. Readministration of acetazolamide confirmed that generalized pustules arose within 24 hours.
Erythemas Associated with Essential Thrombocythemia
Authors: Tsuji Takuo
Published: April 2015

Two cases of erythemas associated with essential thrombocythemia (ET) are reported.

Case 1: A 64‐year‐old woman, whose ET had been treated with myebronitol for about 10 years, developed erythematous plaques on her trunk after she stopped taking the medicine.

Case 2: A 58‐year‐old man, who had had gallstones and ET, developed annular erythemas on his thighs, arms, and trunk. Operation for the gallstones had no effect on the eruption.

In both cases, remission of thrombocythemia induced by myebronitol was associated with the disappearance of these erythemas.
Case Report: Cheilitis Granulomatosa with Periodontitis
Authors: Takeshita Taizo , Koga Tetsuya , Yashima Yutaka
Published: April 2015

We report a case of cheilitis granulomatosa with periodontitis in a 39‐year‐old Japanese man. Biopsy specimens from both areas showed noncaseating epithelioid cell granuloma. Dental examination revealed that the lower left first molar had periodontitis. The lower left first molar was removed, and antibiotics and anti‐inflammatory drugs were administrated. After 2 months of periodontitis therapy, the lips returned to normal size without recurrence and the swelling of the buccal mucosa regressed.
Angiogenesis
Authors: Swerlick Robert A.
Published: April 2015

The formation of new blood vessels, angiogenesis, is a complex process which is central to normal development and homeostasis. However, uncontrolled angiogenesis plays a critical role in both inflammatory and neoplastic disorders. Our understanding of angiogenesis has expanded greatly over the past two decades due to the development of in vivo and in vitro models to study this important process. A variety of cytokines and growth factors have been shown to induce new blood vessel formation in vivo, and in vitro studies have been able to define whether agents have direct or indirect effects upon vascular endothelial cells. Our improved understanding of the mechanisms which regulate angiogenesis has now created important opportunities for the development of new therapies for the treatment of inflammatory and neoplastic skin disease.
Keratinocyte‐derived Cytokines and UVB‐Induced Immunosuppression
Authors: Kondo Seiji , Sauder Daniel N.
Published: April 2015

Ultraviolet radiation (UVB) in sunlight is known to have multiple effects on the immune system. Evidence suggests that UVB‐induced immunosuppression is mediated in part by immunosuppressive and immunoregulatory cytokines. Our studies have utilized gene‐targeted mutant mice to determine key molecular requirements essential for the development of UVB‐induced immunosuppression. Preliminary results from our laboratory suggest that TNF‐α plays a regulatory role in contact hypersensitivity, but is not a crucial factor for UVB‐induced immunosuppression, and that multiple factors are involved in the induction of UVB mediated immunosuppression.
Prognosis and Clinical Relevance of Recurrent Oral Ulceration in Behçet's Disease
Authors: Bang Dongsik , Hur Won , Lee Eun‐So , Lee Sungnack
Published: April 2015

There is no way of predicting whether a patient with recurrent oral ulcerations (ROU) will develop Behçet's disease (BD). In the absence of a valid laboratory test to exclude BD, such oral ulcerations result in a diagnostic problem when they occur as the sole and earliest manifestation of disease.

We assessed the prognosis of ROU by performing prospective evaluations of 67 patients who had only a history of ROU and were registered at the Behçet's Disease Specialty Clinic at Severance Hospital of Yonsei University, Seoul, Korea.

Thirty‐five patients (52.2%) developed overt manifestations of BD at an average of 7.7 years after the onset of ROU. The frequency of recurrence was 9.8 times per year in progressive cases.

From these results, it appears that highly recurrent ROU is a warning signal for BD. Careful examinations of patients, including their minor symptoms, additional laboratory tests, and regular follow‐ups by physicians are required for proper diagnosis.
The Relationships of Onset and Exacerbation of Pustulosis Palmaris et Plantaris to Smoking and Focal Infections
Authors: Akiyama Tomoko , Seishima Mariko , Watanabe Hisayo , Nakatani Akemi , Mori Shunji , Kitajima Yasuo
Published: April 2015

Clinical data, including focal infection and habitual cigarette smoking, were obtained from 203 male patients with pustulosis palmaris et plantaris (PPP) (age: 43.3 ± 13.4) and 266 female patients (age: 44.0 ± 13.7) for the 20 years from 1975 through 1994 to evaluate the relationship between the onset or severity of PPP and smoking. Seasonal incidences of onset were also studied. The incidence of onset of PPP symptoms was highest in June, when it is the most humid in Japan, and lowest in December. The most common infectious disease associated with PPP was tonsillitis. The percentages of heavy smoking (more than 20 cigarettes per day) were 74.7% and 32.9% for male and female patients, while those in the normal control population in Japan were 37.2% and 9.8% for males and females. These results suggest that heavy smoking, tonsillitis, and seasonal factors such as high humidity and high temperature may be related to the onset and exacerbation of PPP.
Sebaceous Adenomas, Squamous Cell Carcinoma and Skin Infections in a Patient with Carcinoma of the Colon, Rectum and Bladder
Authors: Abraham Zeev , Glück Zahava , Lahat Nitza , Kinarty Amalia
Published: April 2015

Sebaceous adenomas and squamous cell carcinoma developed in a male patient in addition to viral, mycotic and bacterial infections, several years after the removal of three malignant tumors from his lower gastrointestinal and urinary tract. Skin tests with trichophytin, candidin, and mixed bacteria were negative. Various aspects regarding cutaneous changes associated with colorectal and bladder carcinomas are discussed.
Late Onset Systemic Lupus Erythematosus Diagnosed in an Elderly Man with Unusual Skin Eruptions and Sudden Death
Authors: Iijima Shigeruko , Takita Takashi , Otsuka Fujio
Published: April 2015

A rare case of late onset SLE in an elderly man presented with generalized toxicoderma‐like eruptions. The rash first appeared at age 64 years and was characterized by dark or purplish erythematous eruptions disseminated over the body surface. Histological examination revealed marked liquefaction degeneration and leukocytoclastic vasculitis. Direct immunofluorescence study and serological examination results were suggestive of SLE; however, the patient had no episodes of photosensitivity, malar erythema, or arthralgia. He was diagnosed as having SLE 11 months after his first visit and died suddenly 16 months after onset. Elderly men with SLE can present with unusual clinical manifestations; careful examination of these patients is required to reach a correct diagnosis.
A Case of Sarcoidosis Which Relapsed Twice after Successive Parturitions
Authors: Kishimoto Saburo , Yasuno Hirokazu , Ikada Junji
Published: April 2015

A 30‐year‐old Japanese woman relapsed into sarcoidosis after two successive parturitions. The cutaneous lesions consisted of scar sarcoidosis, papular type, nodular type, and subcutaneous nodules with histologically typical “naked tubercles”. Hypergammaglobulinemia, elevation of both serum angiotensin converting enzyme and lysozyme levels, and bilateral hilar lymphadenopathy were found in the acute and subacute stages, and spontaneously returned to normal levels 16 months after the onset. Our case suggests that parturition may trigger the onset of sarcoidosis.
Partial Unilateral Lentiginosis Associated with Segmental Neurofibromatosis
Authors: Lee Won Soo , Yoo Min Seok , Ahn Sung Ku , Won Jin Hyung
Published: April 2015

Partial unilateral lentiginosis associated with segmental neurofibromatosis is rare. Therefore, we describe here a patient with partial unilateral lentiginosis associated with ipsilateral segmental neurofibromatosis who developed multiple, rice‐sized, brown macules on the right side of her face, trunk, and upper arm and several bean‐sized, café‐au‐lait spots on the right upper arm and right upper back. To our knowledge, partial unilateral lentiginosis associated with ipsilateral segmental neurofibromatosis has not been reported in the English literature.
Drug Related Involvement of Specific Sites in Fixed Eruptions: A Statistical Evaluation
Authors: Sharma Vinod K. , Dhar Sandipan , Gill Amar Nath
Published: April 2015

Different drugs produce fixed eruptions over different parts of the body. However, the significance of preferential site involvement in fixed eruptions due to specific drugs has not been statistically evaluated. One hundred and twenty five patients of fixed drug eruption (FDE) were studied to examine this question.

Different sites affected by individual drugs were classified as lips alone, genitalia alone, lips and genitalia together, trunk alone, trunk and limbs together, and generalized. Statistical analysis was carried out for 7 common drugs causing FDE in 5 or more patients.

Cotrimoxazole, a combination of sulfamethoxazole and trimethoprim, was the most common offender for FDE (32.8%), followed by analgin (12%), tetracycline (8%), pyrazolones (8%), metronidazole (6.4%), ciprofloxacin (5.6%), and phenytoin sodium (4%). Major sites involved by FDE were trunk and limbs (24%), lips alone (20.8%), genitalia alone (20%), generalised (14.4%), lips and genitalia together (11.2%), and trunk alone (8.8%). Seventy‐two (57.6%) patients had multiple lesions; 33 (42.4%) had single lesions. Involvement of mucocutaneous junctions of lips and genitalia by FDE was frequently caused by cotrimoxazole and tetracycline; trunk and limbs, by analgin and pyrazolones. Generalised eruptions were commonly caused by cotrimoxazole and phenytoin.

The present statistical analysis confirms the clinical impression that genitalia alone are frequently involved in FDE due to tetracyclines (p<0.001). FDE over trunk and limbs was significantly associated with analgin (p<0.001), and generalised eruptions, with phenytoin sodium (p<0.001). The association of FDE over lips with cotrimoxazole was statistically not significant.
Pemphigus Vulgaris Exacerbated by Exposure to Sunlight
Authors: Muramatsu Tsutomu , Iida Takashi , Ko Toshiko , Shirai Toshihiko
Published: April 2015

We report two cases of pemphigus vulgaris who showed exacerbation of their bullous skin lesions after exposure to sunlight These cases indicate that ultraviolet light is an aggravating factor, not only for pemphigus foliaceus, but also for pemphigus vulgaris.
A Comparative Study of the Therapeutic Effect of Probucol and Pravastatin on Xanthelasma
Authors: Fujita Masaru , Shirai Kohji
Published: April 2015

We examined and compared the effects of probucol and pravastatin on the regression of xanthelasma. Thirty‐six cases treated by probucol and 18 cases by pravastatin were evaluated for 12 months. Thirteen of the 36 cases treated with probucol showed regression of xanthelasma. However, one of the 18 cases treated with pravastatin showed regression. These data were statistically significant. The average total cholesterol value in both groups decreased during drug therapy. However, the average of HDL‐cholesterol values in the probucol treatment group showed significant decreases, but those in the pravastatin treatment group did not. We discussed the mechanisms of the two drugs on the regression of xanthelasma and the mechanisms of development of xanthelasma.
A Case of Bednar Tumor Recurring after 23 Years
Authors: Mochizuki Yoshiko , Narisaw Yutaka , Kohd Hiromu
Published: April 2015

We reported a patient with a Bednar tumor who developed local recurrence 23 years later. The recurrent Bednar tumor showed the histopathological features of dermatofibrosarcoma protuberans (DFSP), and expressed CD34. We favor the term “Bednar tumor” rather than pigmented DFSP and consider that Bednar tumor is an intermediate type between cellular blue nevus and DFSP.
Chronic White Plaque of the Vulva in Postmenopausal Women
Authors: Inazumi Toyoko , Tajima Shingo
Published: April 2015

We report 13 cases of white lesions of the vulva in postmenopausal women. Nine cases had clinical and histological features typical of lichen sclerosus et atrophicus (LSA). Two cases exhibited mild histological changes suggestive of LSA. Two cases had normal‐appearing histology without significant histological changes. Considering the relatively short duration of the disease and relatively small lesions in the last two cases, they may be considered to represent the initial stage of LSA.
Lymphedema Due to Chronic Penile Strangulation: A Case Report
Authors: Tanabe Noboru , Muya Munenobu , Isonokami Masaaki , Kozuka Takehito , Honda Tomohito , Ohtani Hiroshi
Published: April 2015

A 62‐year‐old man was admitted with swelling of the penis caused by long term use of a penis enlarging ring. For the previous 20 years, he had noticed small pruritic nodules on his penis. He had no micturitional or ejaculatory impairment.

The penis had a diameter of 6 cm, a length of 10 cm, and was covered with thickened skin. The penis and the scrotal skin were covered with scattered, small, hemispheric nodules and papules ranging in size from 2 mm to 1 cm.

Pathologic examination of the biopsied specimen from a nodule revealed enlargement of the lymphatic vessels of the dermis and fibrosis. This was compatible with lymphedema due to chronic strangulation by the ring.

Scar resection and full thickness skin grafting was performed to prevent malignant changes in the lesions.
Selective Expansions of T cells Expressing Vβ38 and Vβ13 in Skin Lesions of Patients with Chronic Cutaneous Lupus Erythematosus
Authors: Furukawa Fukumi , Tokura Yoshiki , Matsushita Kayo , Iwasaki‐Inuzuka Kayoko , Onagi‐Suzuki Kazue , Yagi Hiroaki , Wakita Hisashi , Takigawa Masahiro
Published: April 2015

There are several clinical types of cutaneous lupus erythematosus (LE), including acute cutaneous LE (ACLE), which occurs in 50–60% of patients with systemic LE (SLE), chronic cutaneous LE (CCLE), which is almost the same as discoid LE (DLE), and subacute cutaneous LE (SCLE). Although several important hypotheses have been proposed to explain cutaneous LE, the pathomechanisms still remain complicated and obscure. Of special interest is whether and how the T cell receptor (TCR) repertoire of infiltrating lymphocytes is involved in the development of the different types. To address this issue, we immunohistochemically examined the Vβ usage of infiltrating T cells in skin lesions, as well as in peripheral blood mononuclear cells (PBMC) of patients with cutaneous LE. The number of Vβ3.1 CD3+ cells in the PBMC of patients with ACLE and CCLE was significantly lower than in controls. In contrast, the number of Vβ3.1 CD3+ cells was elevated in the skin lesion of CCLE over that in psoriasis vulgaris or atopic dermatitis. Furthermore, skin lesions in CCLE patients showed a higher incidence of Vβ8.1 CD3+ and Vβ13.3 CD3+ cells than did those in ACLE patients. These results suggest that skin lesions of CCLE are oligoclonally associated with selective expansions of TCR Vβ chains and may be induced by antigen stimuli, including superantigens.
A Case of Sézary Syndrome Associated with Cutaneous Transformation
Authors: Sakai Hiroyuki , Matsuo Shinobu , Matsumoto Mitsuhiro , Iizuka Hajime
Published: April 2015

Sézary syndrome is a leukemic variant in the spectrum of cutaneous T cell lymphomas. In some cases of cutaneous T cell lymphoma, the skin tumors or lymph nodes show morphologic changes indistinguishable from those of a large‐cell lymphoma; this has been termed transformation. We report a case of Sézary syndrome who developed multiple skin tumors that showed transformation, loss of multiple pan T‐cell markers (CD3, 4, 5, 7, 8), and a concomitant expression of CD30 during the course of the disease. Some of the tumors spontaneously regressed following incisional biopsy or traumatic wounds. The patient died of pneumonia five years following the transformation.
Lichen Striatus in an Adult
Authors: Mitsuhashi Yoshihiko , Kondo Shigeo
Published: April 2015

A 58‐year‐old Japanese woman with lichen striatus had asymptomatic multiple erythemato‐papular plaques in arranged linear or band‐like patterns over the right half side of her chest, back, and the right upper and lower extremities, following Blaschko's lines. A biopsy specimen demonstrated a dermoepidermal interface inflammation with a lichenoid lymphoid cell infiltrate into the upper and middle dermis. All lesions spontaneously cleared within 2 months. Lichen striatus in an adult should be differentiated from other acquired erythemato‐papular dermatoses which may follow Blaschko's lines. Its histopathological features may mimic those of lichen planus, but it can be distinguished because of its consistent distribution on Blaschko's lines, not only in children but also in adults.
Histamine: The Quintessential Mediator
Authors: Greaves Malcom W. , Sabroe R.A.
Published: April 2015

Histamine is unique in being the only substance described to date which fulfils all of the criteria established by Dale for an inflammatory mediator. Thus, histamine is known to cause the “Triple Response” of Lewis and to act via H1 and H2 receptors to produce vasodilation and increased vascular permeability; elevated levels of histamine are found in inflamed tissue; histamine is produced and stored in mast cells and mere are established mechanisms for histamine release via mast cell surface receptors; and antihistamines alleviate the clinical manifestations of histamine release.

There have been several recent advances in our understanding of histamine pharmacology and of the pathomechanisms of chronic idiopathic urticaria (CIU), a disease in which histamine plays an important role. Two new histamine receptors have been identified, the inhibitory (H3) receptor and the intracellular (Hic) receptor involved in cell proliferation. There is now evidence that mast cell derived histamine release in patients with CIU is due to an autoimmune disease, mediated by autoantibodies to the α‐subunit of the high affinity IgE receptor on mast cells and basophils. Removal of these autoantibodies by plasmapheresis, or treatment with intravenous immunoglobulins may cause clinical remission. Cyclosporin A has also been found to be of benefit to some patients with CIU probably due to a mast cell “stabilising” effect, leading to reduced release of histamine and other mediators.

This article reviews our current knowledge on histamine, its role, receptors and mechanisms for release.
Multiple Basaloid Cell Hamartoma with Alopecia and Autoimmune Disease (Systemic Lupus Erythematosus)
Authors: Akasaka Toshihide , Kon Saiichi , Mihm Martin C.
Published: April 2015

We report a 22‐year‐old Japanese woman with multiple basaloid cell hamartoma with alopecia and autoimmune disease (systemic lupus erythematosus). She presented with infiltrated large annular, brown‐violet, erythematous plaques with atrophic areas in the center on her right cheek, left abdomen and left knee. She also had progressive multiple follicular keratotic papules on her scalp, face, neck, and both axilla and hair loss from her scalp, eyebrow, and axilla. Serologically, reumatoid factor (+++), rheumatoid arthritis hemagglutination test (x1280), and anti‐nuclear antigen (x160) were positive. Histological findings of the annular lesion showed liquefaction degeneration of basal cells, lymphocytic infiltration around hair follicles and capillaries, and panniculitis with lymphoid cell infiltration, which was diagnosed as lupus erythematosus profundus. The histological findings of multiple follicular papular lesions of the scalp and neck showed aggregations of basaloid cells, partially with hair‐bulb‐like structures, which was diagnosed as trichoepithelioma. Taken together, the histogenesis of multiple basaloid cell hamartoma is thought to share the same basis with autoimmune disease.
Squamous Cell Carcinoma Arising from Lupus Vulgaris on an Old Burn Scar: Diagnosis by Polymerase Chain Reaction
Authors: Hagiwara Keisuke , Uezato Hiroshi , Miyazato Hajime , Nonaka Shigeo
Published: April 2015

A 66‐year‐old Japanese woman with a squamous cell carcinoma (SCC) arising from lupus vulgaris (LV) on an old burn scar on the left lower extremity is described. Ziel‐Neelsen stain of a direct smear from the surface exudate showed acid‐fast bacilli. Repeated culture for tubercle bacilli was negative, probably due to a technical error. The diagnosis of LV was successfully made by polymerase chain reaction (PCR). LV and burn scar are common preceding diseases for SCC. The former is rare in the U.S., Europe, and Japan. We were unable to determine whether only one of the two conditions or a combination of both was the true predisposing factor responsible for the development of this SCC. However, this case may be the first report of SCC arising from coexistent LV and a burn scar in which the diagnosis was confirmed by PCR.
A Case of Localized Pemphigus Foliaceus
Authors: Yamamoto Shoko , Kanekura Takuro , Gushi Akira , Sekiyama Mitsuhiro , Shimada Tokihiko , Shimada Katsuhiko , Kanzaki Tamotsu
Published: April 2015

Pemphigus foliaceus (PF) is most commonly observed on the face, scalp, chest and back at the onset of the condition. The case described here is that of an 81‐year‐old female with a single PF lesion localized to the right cheek. A review of the literature published in English and Japanese disclosed only 3 cases of PF in which the patient presented with a single lesion, and 2 of these cases were referred to as “localized pemphigus foliaceus”.
Association of Melkersson‐Rosenthal Syndrome with Rosacea
Authors: Bose Sumit Kumar
Published: April 2015

A rare case of Melkersson‐Rosenthal syndrome with all the cardinal signs of the triad, including facial swelling, facial nerve palsy and glossitis, is described. The additional feature of this case was an association with rosacea.
Anti‐Ribosomal P Protein Antibodies in a Japanese Patient with Systemic Sclerosis
Authors: Fujimoto Manabu , Kawakami Tamihiro , Takehara Kazuhiko , Soma Yoshinao
Published: April 2015

A 56‐year‐old Japanese woman developed Raynaud's phenomenon and digital ulcerations at the age of 50. She showed rapid and diffuse skin sclerosis; visceral involvement was mild. She showed no symptoms or laboratory findings suggestive of other collagen diseases, including systemic lupus erythematosus and Sjögren's syndrome. Based on the clinical and histological findings, she was diagnosed as having diffuse cutaneous systemic sclerosis (SSc). The patient's serum produced nucleolar and cytoplasmic staining by indirect immunofluorescence analyses on HEp‐2 cell substrate and reacted with P0, P1 and P2 proteins in immunoblotting using purified ribosomal antigens. She was negative for anti‐topoisomerase I, centromere, and U1RNP antibodies. Anti‐ribosomal P protein antibodies are considered highly specific for systemic lupus erythematosus; this is the first case report of an SSc patient with anti‐ribosomal P protein antibodies. The clinical features of SSc patients with these antibodies need to be clarified by an accumulation of cases.
A Low Grade Scirrhous Carcinoma of Eccrine Gland Origin in Adolescence
Authors: Yamamoto Osamu , Yasuda Hiroshi , Asahi Masakazu
Published: April 2015

We report a rare occurrence of adnexal carcinoma in an adolescent A 17‐year‐old Japanese girl had a gradually enlarging tumor on the elbow. Histopathologically, the exophytic tumor showed asymmetrical lobules of tumor embedded in a thickened collagenous stroma. The lobules were composed of various patterns of tumor cell nests ranging from tubular to solid forms. Invasive growth patterns were also observed in the stroma. Two types of the cells, cuboidal and elliptically polygonal, were noted. Immunohistochemistry revealed the presence of S‐100 protein and cytokeratin 8 and the absence of gross cystic disease fluid protein‐15 in the tumor cells. Electron microscopic observation showed a ductal or glandular differentiation and fragmented basal laminae around the nests. Light and electron microscopic findings of this tumor are suggestive of a low‐grade sweat gland carcinoma.
Unusual Cases of Syringoma of the Forehead
Authors: Kim Soo Jung , Ahn Sung Ku , Choi Eung Ho , Lee Seung Hun
Published: April 2015

Syringoma involving the forehead is rare and can be confused with other diseases that are common on the forehead. Therefore, we describe here three patients with syringoma who developed numerous skin colored papules on the forehead. To our knowledge, syringoma of the forehead was reported previously only once by Tagami et al.
Disseminated Superficial Porokeratosis with Amyloid Deposition
Authors: Yasuda Kayo , Ikeda Mitsunori , Ikeda Masami , Kodama Hajime
Published: April 2015

Two patients with disseminated superficial porokeratosis (DSP) with amyloid deposition are reported. The skin lesions were distributed over both sun‐exposed areas and sun‐protected areas. No exacerbation by sun exposure was noted. Abundant amyloid substances were deposited at the papillary dermis, not only beneath the cornoid lamellae but also within the annular margin. The skin lesions and amyloid deposition regressed with topical application of dimethyl sulfoxide in one patient, suggesting that DSP is one of the clinical phenotypes of primary localized cutaneous amyloidosis. Another possibility is that amyloid substances are produced by poorly differentiated keratinocytes in DSP.