bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical Expression of Secondary Syphilis in a Patient with HIV Infection
Authors: Rodríguez‐Díaz Eloy , Morán‐Estefanía Manuel , López‐Avila Angel , Piris Javier Bravo , Fernández‐Blasco Guadalupe , García Jesús Iglesias , Armijo Miguel
Published: April 2015

There are increasing reports of unusual clinical features and atypical courses of syphilis in patients with acquired immunodeficiency syndrome. Recently, we had the opportunity to study an HIV‐positive female patient with strong manifestations of secondary syphilis. The case is discussed together with the implications of secondary syphilis in her concomitant ocular affliction. Moreover, we comment on the clinico‐therapeutic controversies brought about by the association of infection with Treponema pallidum and HIV.
Sweet's Syndrome with Small Cell Carcinoma of the Lung
Authors: Yamamoto Toshiyuki , Furuse Yoshiro , Nishioka Kiyoshi
Published: April 2015

We report a 59‐year‐old male with Sweet's syndrome who developed small cell carcinoma of the lung one year after the initial diagnosis. To the best of our knowledge, this is the first report of Sweet's syndrome in conjunction with lung cancer. In cases of Sweet's syndrome, a search for not only hematologic disorders but also for solid tumors should be made.
A Case of Bullous Transient Acantholytic Dermatosis
Authors: Yoo Jae Hak , Cho Kwang Hyun , Youn Jai Il
Published: April 2015

We report a case of a bullous variant of transient acantholytic dermatosis in a 59‐year‐old female. Each bullous lesion lasted several weeks and healed without scarring. The lesions were migratory and recurrent without a cleared period. Histopathologic examination revealed an intraepidermal vesicle low in the epidermis. The lesions cleared after 2 months of isotretinoin therapy.
An Adult Case of Histiocytosis X with a Vulvar Ulcer and Multiple Bone Lesions
Authors: Takata Minoru , Taniguchi Akira , Imai Toshio , Hirone Takae , Nonomura Akitaka , Fukui Yonemasa
Published: April 2015

A 62‐year‐old female with histiocytosis X presented with a vulvar ulcer. Multiple osteolytic lesions were later detected. Histological examination of the ulcerated skin showed diffuse proliferation of histiocytic cells with folded nuclei and pale eosinophilic cytoplasm. Immunohistochemistry revealed S100 protein and vimentin as well as CD1a, CD4, and HLA‐DR antigens in the proliferating cells. Electron microscopy demonstrated Birbeck granules in the cytoplasm of the cells. The patient was successfully treated by complete surgical excision of the ulcer followed by radiotherapy for recurrent vulvar erythema.
A Case of Linear IgA Bullous Dermatosis with Atypical Clinical and Ultrastructural Manifestations
Authors: Isonokami Masaaki , Hashimoto Koji , Horiguchi Yuji , Yoshikawa Kunihiko
Published: April 2015

We report a case of linear IgA bullous dermatosis which presented with atypical clinical and ultrastructural findings. The patient initially manifested small, subepidermal blisters scattered only in the seborrheic region. On follow‐up, grouped vesicles developed in a circular form similar to dermatitis herpetiformis. They subsided after treatment with diaminodiaphenyl sulphon. Immunofluorescent study showed predominant linear IgA deposits accompanied with IgG and C3 along the basement membrane zone. These deposits existed at the floor of the blister. Ultrastructurally, immunoreactants were demonstrated beneath the lamina densa while separation occurred at lamina lucida.
Action Spectrum for Bergamot‐Oil Phototoxicity Measured by Sunburn Cell Counting
Authors: Yasui Yuhko , Hirone Takae
Published: April 2015

The present study investigated the phototoxic effect of bergamot oil and its photosensitive component, bergapten, on sunburn cell (SBC) production in guinea pig skin. The back skin was pretreated with bergamot oil or bergapten and exposed to monochromatic light under various conditions. After irradiation, skin specimens were excised, and histological sections were prepared. The number of sunburn cells in the interfollicular epidermis was counted. The SBC formation by bergamot oil or bergapten plus UVB radiation was the same as that without pretreatment with any photosensitizer. In contrast, a significant number of SBCs were induced by bergamot oil or bergapten plus UVA radiation, but no SBCs were found after the treatment with UVA alone. The result indicates that bergamot oil or bergapten was photosensitized by UVA irradiation. The SBCs were linearly increased in a UV‐dose dependent manner. On the basis of the regression lines, an action spectrum and spectral peak for the photosensitizers plus UVA were obtained. The action spectrum for bergamot oil‐ and bergapten‐induced SBC formation was in the ranges of 325–365 nm and 325–350 nm, and their spectral peaks were at 335–345 nm and 335–350 nm, respectively. The data are in good accordance with those estimated from skin erythema reactions. Therefore, counting SBCs is a very useful parameter for quantitative evaluation of phototoxicity.
Efficacy of Silver Nitrate Pencils in the Treatment of Common Warts
Authors: Yazar Şahin , Başaran Erdal
Published: April 2015

Common warts are an important issue, especially in children and young adults. The methods proposed for common wart treatment are painful, destructive, and require special experience and devices. The chemical cauterization effect of silver nitrate on warts is noted in the classical pharmaceutical textbooks. In order to test this effect for this purpose, a placebo controlled clinical study was performed on 70 patients.

On 35 randomly selected patients, a silver nitrate stick was used, and, on the other 35 patients, black ink was used. At the end of this study, of the patients treated with the silver nitrate stick, 15 (43%) were completely healed, 9 (26%) were partially healed, and 11 (31%) were not healed. Of the patients treated with black ink, 4 (11%) were completely healed, 5 (14%) were partially healed, and 26 (74%) patients were not affected. Thus the silver nitrate stick affected the warts of 24 (69%) patients. Therefore, this method appears to be an effective, economic, and easily applicable treatment for common warts.
Seborrhoeic Dermatitis: Treatment with Anti‐Mycotic Agents
Authors: Sei Yoshihiro , Hamaguchi Taizo , Ninomiya Junya , Nakabayashi Atsuhiro , Takiuchi Iwao
Published: April 2015

In order to elucidate the effectiveness of anti‐mycotics in treating seborrhoeic dermatitis, an attempt was made to isolate Malassezia from seborrhoeic lesions of patients of seborrhoeic dermatitis. The results revealed that, in male patients, 46/49 cases were positive for Malassezia furfur on the face and 30/48 cases were positive for M. furfur on the scalp. In female patients, 7/13 cases were positive for M. furfur on the face, and 6/17 cases were positive for M. furfur on the scalp. Anti‐mycotic agents were excellent in 50% and good in 31% of the spore‐positive cases, yielding an overall efficacy rate of 81%. In contrast, the treatment of the face with vehicle alone showed only one excellent result out of 8 cases. Although clinical improvement was rapid on the side treated with a topical corticosteroid in the half‐side‐test, numerous fungal elements remained. While the improvement with anti‐mycotic agents was slower than that with the corticosteroid, clinical improvement became evident by the third week of administration and fungal elements disappeared.
A Case of Acquired Lymphangioma Due to a Suspected Old Filariasis and a Review of Literature
Authors: Hagiwara Keisuke , Toyama Kensei , Miyazato Hajime , Nonaka Shigeo
Published: April 2015

A 65‐year‐old man presented in 1992 with multiple papular lesions on the scrotum and foreskin. His medical history revealed that, at the age of 25, he was diagnosed as having filariasis and treated conservatively at a hospital in Hawaii. The histologic study of the scrotal skin showed large, dilated vascular spaces in the upper dermis lined with a single layer of endothelial cells that were negative for Factor 8‐related antigen. The diagnosis was acquired lymphangioma due to a suspected old filariasis infestation, although serologic tests for filarial antibodies were negative. The paper also presents a review of the literature of acquired lymphangioma in Japan with a brief discussion of etiology and nomenclature.
Psoriasis Is a Visible Manifestation of the Skin's Defense against Micro‐organisms
Authors: Rosenberg E. William , Noah Patricia W. , Skinner Robert B.
Published: April 2015

The recent discovery that human epidermal cells themselves make and secrete the components necessary for activation of the alternative complement pathway appears to provide an explanation for how human skin is ordinarily able to avoid colonization by molds and other organisms. It also helps clarify the mechanisms underlying clinical and laboratory findings seen in chronic mucocutaneous candidiasis, dandruff, and psoriasis. Psoriasis seems best explainable as a visible, late stage of the inflammatory sequelae of activation of the alternative complement pathway in the epidermis.
Bullous Eruption of Systemic Lupus Erythematosus
Authors: Miyagawa Sachiko , Shiomi Yuko , Fukumoto Takaya , Nishikawa Kiyoshi , Ako Hirofumi , Hashimoto Takashi , Shirai Toshihiko
Published: April 2015

A bullous eruption is now recognized as a specific complication of systemic lupus erythematosus (SLE). We described a 22‐year‐old woman with SLE whose vesiculobullous eruptions exacerbated with a flare of visceral manifestations of the disease and resolved when the systemic disease was controlled by oral prednisolone.
Annular Elastolytic Giant Cell Granuloma: Response to Cyclosporin A
Authors: Tsutsui Kiyohiro , Hirone Takae , Kubo Katsuhiko , Matsui Yutaka
Published: April 2015

A case of annular elastolytic giant cell granuloma with a good response to cyclosporin A is reported. A 62‐year‐old man developed multiple annular patches on the trunk with elevated and indurated borders. Biopsy specimens from the border showed granulomatous inflammation in the mid dermis with phagocytosis of elastic fibers by giant cells. Biopsy specimens from the center showed dense collagen formation without inflammation. Immunological investigation of perivascular infiltrating cells in the lesions revealed a predominance of CD4+ cells over CD8+ cells. Our case showed a good response to cyclosporin A (5 mg/kg/day) for eight weeks. There were no adverse effects and no recurrences for one month after discontinuation of cyclosporin A.
Generalized Vitiligo Preceded by a Generalized Figurate Erythematosquamous Eruption
Authors: Arata Jirô , Abe‐Matsuura Yoshiko
Published: April 2015

The pathogenesis of vitiligo is still unknown. We saw a patient with vitiligo who may support an immunological pathogenesis for this disease. A 77‐year‐old man developed sharply demarcated, irregularly shaped, figurate, erythematosquamous plaques on most of the areas of his body. Histologically, lymphocytic cells invaded the lower epidermis. The lesions were gradually replaced by vitiliginous macules of the same configuration. Histologically, there were no active malanocytes in the vitiliginous lesions. We believe that the present patient presents an extraordinary example of inflammatory vitiligo and may provide an indication of an immunological pathogenesis for vitiligo.
An Evaluation of the Residual Activity of Antiseptic Handrub Lotions: An ‘In Use’ Setting Study
Authors: Namura Shoko , Nishijima Setsuko , Asada Yasuo
Published: April 2015

An evaluation of the residual activity of quick‐drying agents (alcoholic solutions) used for hygienic hand disinfection is described. We looked for residual efficacy following hand disinfection with soap and water alone or followed by one of two alcoholic handrub lotions supplied from an automatic hand washing machine. The bacterial counts on the hands obtained before and within 2 successive hours after disinfection showed that alcoholic chlorhexidine was the most effective for 10 minutes after contamination of the hands. WELPAS® (alcoholic chlorbenzarconium) followed this in its immediate effect and was better than soap and water alone. There were no significant differences after 30‘ or 120‘ between the three disinfecting methods.
Trichilemmal Carcinoma on the Thigh: Report of a Case
Authors: Dekio Satoshi , Funaki Mikio , Jidoi Joji , Mihara Masako
Published: April 2015

A 79‐year‐old Japanese man with a trichilemmal carcinoma (TC) on the right thigh is described. To the best of our knowledge, he is the fifth patient with a TC on the thigh reported from Japan.
Gas Gangrene Following Sacral Pressure Sores
Authors: Shibuya Hiromi , Terashi Hiroto , Kurata Sotaro , Ishii Yoshiteru , Takayasu Susumu , Murakami Isamu , Takasaki Syuuji , Nawata Tomoko , Noguchi Takahiro
Published: April 2015

We report two cases of gas gangrene developed from sacral pressure sores. The first case was clostridial and the second, non‐clostridial gas gangrene. Both patients died within two months. The first patient, a 56‐year‐old woman suffering from palsy of the lower half of the body for 3 weeks, developed a sacral pressure sore. One month later, crepitus by palpation and gas formation in the X‐ray film were detected in the hip and right thigh. A culture of odoriferous pus yielded Clostridium limosum in addition to Staphylococcus intermedius, Enterococcus faecalis, Pseudomonas aeruginosa, and Bacteroides fragilis. Blood culture yielded Bacteroides fragilis. The patient died 50 days after admission in spite of surgical debridement and aggressive therapy with high doses of antibiotics and hyperbaric oxygen. The second patient, a 70‐year‐old man suffering from diabetic nephropathy, arteriosclerosis obliterans of the lower limbs, and cerebral infarction, developed a large decubitus ulcer covering the whole sacral area. Crepitus and gas were detected in the soft tissue of the left gluteal region. Almost the entire gluteus maximus muscle was necrotic. Bacteroides fragilis, methicillin‐resistant or ‐sensitive Staphylococcus aureus and Escherichia coli were isolated from the muscle. Bacteroides fragilis was also obtained by blood culture. The patient died on the 72nd day after admission.
Areolar Sebaceous Hyperplasia with a Fordyce's Spot‐like Lesion
Authors: Tsuji Takuo , Yamauchi Ritsuko
Published: April 2015

Fordyce's spot‐like lesions were observed in both areolae of a 43‐year‐old female. The histology of the lesions showed sebaceous hyperplasia.
Primary Cutaneous Histoplasmosis in Papuloerythroderma (Ofuji)
Authors: Ohnishi Kazunori , Nagai Yayoi , Okada Katsuyuki , Ishikawa Osamu , Miyachi Yoshiki
Published: April 2015

We report the first Japanese patient with primary cutaneous histoplasmosis who was infected inside Japan. He was not an immunocompromised host but his cutaneous lesions developed on preexisting papuloerythroderma (Ofuji). The long‐term topical corticosteroid treatment for papuloerythroderma, which could have suppressed the local immunological defence system of the skin, might have been responsible for the histoplasma infection in the present case.
Effects of Etretinate on Keratinocyte Proliferation and Secretion of Interleukin‐1α (IL‐1α) and IL‐8
Authors: Zhang Jian‐Zhong , Maruyama Kohji , Ono Ichiro , Nihei Yoshimichi , Iwatsuki Keiji , Kaneko Fumio
Published: April 2015

Etretinate has proven to be effective in the treatment of psoriasis. Since abnormal proliferation and cytokine secretion are well‐known features of psoriatic epidermis, we studied the in vitro effects of etretinate on these two processes using human keratinocytes. Etretinate promoted proliferation of normal human keratinocytes (NHKs) grown in keratinocyte growth medium (KGM) but not in growth factor‐deficient keratinocyte basic medium (KBM). Moreover, etretinate partly overcame growth inhibition by PMA. Etretinate was shown to have an effect on either IL‐1α or IL‐8 secretion in unstimulated NHKs. In HSC‐1, a human squamous cell carcinoma cell line cultured in 20% FCS/DMEM, inhibited IL‐1α secretion and enhanced IL‐8 secretion. These results indicate that the effects of etretinate on keratinocyte proliferation and cytokine secretion may depend on cell type and culture conditions. Stimulation of NHKs with PMA significantly enhanced IL‐1α and IL‐8 secretion, and these effects were inhibited by etretinate. However, etretinate failed to inhibit rTNFα‐induced IL‐8 secretion, suggesting that etretinate regulation of NHK cytokine secretion may also depend on the stimulus. As treatment of keratinocytes or epidermis with PMA can induce psoriasis‐like changes, so might the experimental “anti‐PMA” activity of etretinate be related to its therapeutic benefit in the treatment of psoriasis.
Factors Responsible for Death in Patients with Pemphigus
Authors: Kanwar Amrinder J. , Dhar Sandipan
Published: April 2015

The records of 10 patients who died with pemphigus have been examined for factors affecting and contributing to death. Early initiation of therapy, the age at onset of the disease, and the mode of administration of corticosteroids, conventional or in pulse form, did not affect the survival. The cutaneous involvement was extensive in all 10 patients; it ranged between 30‐80%. Septicemia was the commonest event preceeding death; in 4 cases, it was due to Staphylococcus aureus.
Nodular Cutaneous Lupus Mucinosis Associated with Atrophie Blanche‐like Lesions in a Patient with Systemic Lupus Erythematosus
Authors: Egawa Hisao , Abe‐Matsuura Yoshiko , Tada Joji , Arata Jirô
Published: April 2015

Background

Multiple, pale, atrophic depressions surrounded by erythema developed on nodular cutaneous mucinosis lesions in a patient with systemic lupus erythematosus.

Observations

A 22‐year‐old man developed multiple nodular erythematous lesions on the upper arms, back, and chest during the course of systemic lupus erythematosus. Histologically, these nodular lesions were diagnosed as lupus mucinosis. Three years later, the patient began to have atrophic depressed lesions on several nodular mucinosis lesions. These lesions did not develop on normal appearing skin. A biopsy specimen from one of these lesions showed occlusion of blood vessels with thickening of their walls and perivascular dense lymphocytic infiltration. No leukocytoclastic vasculitis was found. Hyaline degeneration was present in some parts of the fatty tissue.

Conclusion

The atrophic depressed lesions were atrophie blanche‐like and induced by the vascular occlusion. Since these lesions developed only on the lupus mucinosis lesions, mucin deposition and vascular changes may be closely related.
Nodulocystic Acne: Oral Gugulipid versus Tetracycline
Authors: Thappa Devinder M. , Dogra Jaideep
Published: April 2015

Twenty patients with nodulocystic acne were randomly allocated to one of two treatment schedules: 1) Tetracycline 500 mg or 2) Tab. Gugulipid (equivalent to 25 mg guggulsterone). Both were taken twice daily for 3 months, and both produced a progressive reduction in the lesions in the majority of patients. With tetracycline, the percentage reduction in the inflammatory lesions was 65.2% as compared to 68% with gugulipid; on comparison, this difference was statistically insignificant (P>0.05). Follow‐up at 3 months showed a relapse in 4 cases on tetracyline and 2 cases on gugulipid. An interesting observation was that the patients with oily faces responded remarkably better to gugulipid.
Nodular Scleroderma in a Worker Using a Silica‐containing Abrasive
Authors: Yamamoto Toshiyuki , Furuse Yoshiro , Katayama Ichiro , Nishioka Kiyoshi
Published: April 2015

A patient with progressive systemic sclerosis and high levels of serum IgE developed multiple papules at/on an area of non‐sclerotic skin. Histologic examination of the papule revealed the typical features of scleroderma. For several years, the patient had been working on polishing watches with an abrasive agent composed mainly of aluminum, chromium dioxide, and silica. An association of the abrasive agent, especially of the silica component, with the scleroderma was circumstantially suspected. To the best of our knowledge, this is the first report of nodular scleroderma which occurred in the course of PSS being associated with chemical agents.
Neural Blockade, Urokinase and Prostaglandin E1 Combination Therapy for Acute Digital Ischemia of Progressive Systemic Sclerosis
Authors: Shimizu Yoshiharu , Mizutani Hitoshi , Inachi Shin , Tsuchibashi Tomoko , Shimizu Masayuki
Published: April 2015

To treat severe painful digital ulcers on progressive systemic sclerosis (PSS) patients, we developed a new combination therapy which included neural blockade, intravenous urokinase, and prostaglandin E1 infusion. All of these are already recognized treatments for circulatory disturbances in PSS. Although each of them alone has a limited effect on the painful ischemic attack in PSS; in stepwise combination, neural blockade for release of vascular spasm and pain, prostaglandin E1 for further vasodilatation, and urokinase for thrombolysis were effective in the treatment of digital ischemia in two PSS patients. This therapy reduced the necrotic areas predicted before therapy and saved fingers from amputation. It also relieved the intolerable digital pain and effected the recovery of digital function.
Mid Dermal Elastolysis: Case Report and Review of the Literature
Authors: Agha Amr , Hashimoto Ken , Mahon Michael
Published: April 2015

A new case of typical mid dermal elastolysis was studied with electron microscopy. Elastic fibers were irregularly branched or lumpy, but subcomponents of these fibers were often normal. In some fibers, loose assembly of skeleton fibrils and aggregation of dense substances were observed. Phagocytosis of normal and abnormal elastic fibers by dermal macrophages was observed.
Evaluation of the Japanese‐Chinese Herbal Medicine, Kampo, for the Treatment of Lupus Dermatoses in Autoimmune Prone MRL/Mp‐lpr/lpr Mice
Authors: Kanauchi Hideo , Imamura Sadao , Takigawa Masahiro , Furukawa Fukumi
Published: April 2015

Kampo, a Japanese‐Chinese traditional herbal medicine, has been used for the treatment of various diseases for about 3,000 years in China. Among herbal medicines, Sairei‐to is well known for improving the symptoms of rheumatoid arthritis (RA) and other collagen diseases. However, its immunosuppressive effects on autoimmune cutaneous phenomena are not completely understood. We investigated the effects of Sairei‐to on the development of lupus dermatoses in autoimmune‐prone MRL/Mp‐lpr/lpr (MRL/lpr) mice, an animal model which spontaneously develops skin lesions similar to those seen in human lupus erythematosus. Virgin female MRL/lpr mice at 1 month of age, which were treated orally with Sairei‐to, had reduced amounts of IgG deposition at the dermoepidermal junction, titers of anti‐DNA antibodies and rheumatoid factor, and lymphoproliferation. These results support the use of traditional herbal medicines in patients with human RA and systemic lupus erythematosus.
Proliferating Cell Nuclear Antigen (PCNA) and p53 Protein Expression in Bowen's Disease
Authors: Takata Minoru , Matsui Yutaka
Published: April 2015

Bowen's disease is a premalignant dermatosis comprised of a clonal proliferation of atypical keratinocytes in the full thickness of the epidermis. To elucidate the relationship between the alteration of the p53 tumor suppressor protein and cell proliferation rate, we immunohistochemically examined the expression of proliferating cell nuclear antigen (PCNA) and p53 protein in 30 cases of Bowen's disease. All the cases exhibited the full‐thickness distribution of PCNA‐positive cycling cells in the lesional epidermis. Quantitation of PCNA staining by image cytometry revealed a mean labeling index (LI) of 75.1 ± 20.3. p53 expression was detected in 13 cases (43%). Expression was diffuse (p53 LI >50) in 9 cases, but focal (p53 LI <30) in the other four. The mean PCNA LI of p53 diffusely positive cases was significantly greater than that of both p53 focally positive and p53 negative cases (89.3 ± 10.1 vs 62.7 ± 21.2, and 70.5 ± 21.6; p<0.01, respectively). These findings suggest that a high‐level accumulation of p53 protein results in a more increased cell proliferation in Bowen's disease.
Oral Florid Papillomatosis and Leukoplakia of the Esophagus Associated with Keratoderma and Showing Transepidermal Elimination
Authors: Ishii Yuko , Sayama Koji , Ohtsuka Hisashi , Shiraishi Satoshi , Miki Yoshiharu
Published: April 2015

A 37‐year‐old male presented with a cauliflower‐like tumor in the right buccal mucosa, leukoplakia of the tongue and esophagus, and keratotic papules or plaques on the extremities including bilateral palms and soles, associated with borderline diabetes mellitus and a repeated history of infections. A multi‐system keratinizing abnormality was suspected, although no distinct disease category has been found showing similar involvements.
Immediate Allergy to Rubber Gloves: A Questionnaire Study of Hospital Personnel
Authors: Mizutari Kumiko , Kuriya Norikazu , Ono Tomomichi
Published: April 2015

We conducted a questionnaire study of immediate allergy to natural rubber gloves among 2,408 medical workers who had used rubber gloves at Kumamoto University Hospital and allied hospitals. The response rate was 64.5% (1,321 workers). Among them, 8.5% (7.0–10.0% at 95% confidence limit) replied that they had experienced immediate allergy to rubber gloves. There were significant correlations among the frequency of rubber glove use, a history of atopic dermatitis or contact dermatitis, and the presence of skin lesions due to allergic reactions to rubber gloves. In 27 workers, skin lesions were associated with general symptoms. Of 59 workers who experienced immediate allergy and were tested for latex‐specific IgE, 4 persons were positive. We conclude that the frequency of contact allergy to natural rubber products is substantially prevalent among Japanese hospital personnel and that education and awareness of this allergy are important.
Allergic Granulomatosis (Churg‐Strauss) Associated with Cutaneous Manifestations: Report of Two Cases
Authors: Abe‐Matsuura Yoshiko , Fujimoto Wataru , Arata Jirô
Published: April 2015

Allergic granulomatosis (Churg‐Strauss) is sometimes associated with cutaneous manifestations. Biopsies of these manifestations are characteristic enough to allow for the diagnosis of this disease through histological examination. Case 1 involved a 34‐year‐old man who developed a low‐grade fever, blood eosinophilia, paralysis of the right oculomotor nerve, and a polymorphic eruption. In addition, he suffered from preceding asthma and paresthesia of the legs and eventually developed heart failure. The histological examination of a biopsy taken from a hemorrhagic bulla showed a dense perivascular infiltration of eosinophils in the upper dermis and basophilic degeneration of collagen fibers. Case 2 involved a 41‐year‐old man who was afflicted with urticarial erythemas, livedoid erythemas, preceding asthma, and blood eosinophilia. During the course of his illness, he also developed bilateral peroneal nerve paralysis and two small erythemato‐bullous lesions. The histological examination of a urticarial lesion revealed an abundant eosinophil perivascular infiltration; examination of a nodule revealed basophilic degeneration with a granulomatous reaction. Clinical and laboratory studies strongly suggested the diagnosis of allergic granulomatosis in both of these cases. The diagnosis was also supported by a histological examination of the skin lesions.
A Case of Secondary Syphilis with Mucous Patches on the Hard Palate
Authors: Ban Masanori , Ohtani Michihiro , Seishima Mariko
Published: April 2015

A rare case of secondary syphilis showing mucous patches on the hard palate is reported. A 31‐year‐old male had two erosive patches which were slightly raised on his hard palate. A linear lesion was also present on the inside of his right alveolar process. Many red‐brown macules on his abdomen and bilateral inguinal lymphadenopathy accompanied these symptoms. The serological tests for syphilis were positive: VDRL test 1:512, TPHA test 1:20,480, and IgM‐FTA‐ABS test 1:40. Immunohistochemical staining with rabbit monoclonal antibody to Treponema pallidum by the biotin‐streptoavidin system detected treponemal organisms in the paraffin‐embedded specimen from his mucous patch. A diagnosis of secondary syphilis was made, and he was given amoxicillin (AMPC) at 750 mg per day for 4 weeks. His eruptions, including the mucous patch, healed in a week.
Malignant Melanoma Developing in an Area of Palmoplantar Keratoderma (Greither's Disease)
Authors: Seike Takuya , Nakanishi Hideki , Urano Yoshio , Arase Seiji
Published: April 2015

We report a case of malignant melanoma arising on the hyperkeratotic sole of a patient with palmoplantar keratoderma (PPK). Hyperkeratotic lesions were also seen on the dorsa of both hands and feet and the extensor aspects of elbows and knees. The patient's PPK appeared to have been transmitted by an autosomal dominant gene. Histologically, the hyperkeratotic lesions showed acanthosis, marked hyperkeratosis without parakeratosis, and hypergranulosis.

All the findings corresponded to those of Greither's disease with malignant melanoma.
Leser‐Trélat Sign Associated with Sézary Syndrome
Authors: Ikari Yuko , Ohkura Mitsuhiro , Morita Makoto , Seki Kenjiro , Kubota Yasuo , Mizoguchi Masako
Published: April 2015

A 74‐year‐old Japanese male had developed generalized erythroderma and rapid growth of multiple verrucous lesions over the entire surface of his face, trunk, and extremities three months before he was seen. Histologically seborrheic keratoses were revealed. Laboratory examinations showed peripheral leukocytosis with atypical lymphocytes and high levels of IgE and IgG. On the basis of these clinical and histopathologic findings, we diagnosed the patient as having Leser‐Trélat sign associated with Sézary syndrome.

The erythroderma subsided after administration of oral predonisone, and no new formations of seborrheic keratosis were observed. However, because of subsequent aggravation of the generalized erythroderma, we administered chemotherapy. Six months after the initial examination, lung cancer was found, and the patient subsequently died of respiratory and renal failure.
Cutaneous Sporotrichosis and Distant Autoinoculation
Authors: Kim Han Uk , Yun Seok Kweon , Ihm Chull Wan
Published: April 2015

A 56‐year‐old woman suffering from cutaneous sporotrichosis on the right cheek and right knee is described. The sporotrichotic nodule of the knee was thought to have been caused by distant autoinoculation.
Three Cases of Chemotherapy‐induced Acral Erythema
Authors: Komamura Hiromi , Higashiyama Mari , Hashimoto Koji , Takeda Kiyoshi , Kimura Hiromi , Tani Yoshihiko , Ogawa Hiroyasu , Yoshikawa Kunihiko
Published: April 2015

Three cases of chemotherapy‐induced acral erythema are reported. All the patients had received cyclophosphamide, vincristine, adriamycin, prednisolone, and granulocyte‐colony stimulating factor (G‐CSF) for the treatment of leukemia or malignant lymphoma. From 35 to 45 days after the start of chemotherapy, painful erythematous lesions developed on their palms, soles, fingers, and toes, resulting in blister formation and desquamation. The recent higher incidence of chemotherapy‐induced acral erythema may be correlated with the popularity of G‐CSF, which allows the use of higher doses of chemotherapeutic drugs.
Association of the Acral Type of Pustular Psoriasis, Sjögren's Syndrome, Systemic Lupus Erythematosus, and Hashimoto's Thyroiditis
Authors: Kobayashi Takashi , Naka Wataru , Harada Takashi , Nishikawa Takeji
Published: April 2015

We describe a case of a 53‐year‐old Japanese female suffering from Sjögren's syndrome, systemic lupus erythematosus, and Hashimoto's thyroiditis who developed pustules, erythema, and erosions on her fingers and toes. The histological specimen showed psoriatic changes. Indirect immunofluorescent study using anti‐human IL (interleukin)‐8 antibody produced positive staining patterns in the lesional epidermis. These findings suggested the diagnosis of acral pustular psoriasis. Diaminodiphenylsulfone at 75 mg orally daily for 20 days and the application of 0.12% betamethasone valerate ointment led to gradual improvement.
Melkersson‐Rosenthal Syndrome in India: Experience with Six Cases
Authors: Dhar Sandipan , Kanwar Amrinder J.
Published: April 2015

Six patients with Melkersson‐Rosenthal syndrome (M‐R syndrome) were presented. Their ages varied from 20 to 60 years; age at onset was between 15 and 50 years. In all 6 patients, swelling started first over the lower lip. Associated facial palsy, facial edema, and scrotal tongue were found in three, four and one patients, respectively. Lip biopsies from 5 patients failed to show any granuloma. Intralesional corticosteroids produced mild regression of labial swelling in two patients after 6 injections. In one patient, near total reduction of labial swelling and facial edema was achieved after 5 months of clofazimine treatment. However, there was no improvement of facial palsy. To the best of our knowledge, this is the largest series of M‐R syndrome reported from India.
Tuberous Sclerosis: Unusual Associations
Authors: Kumar Vijay , Chander Ram , Sharma Ravi C.
Published: April 2015

Uncommon associations of tuberous sclerosis, ichthyosis vulgaris, portwine stain, and spina bifida occulta are reported in a 14‐year‐old female.
Clinical Analysis of Recurrent Hypergammaglobulinemic Purpura Associated with Sjögren Syndrome
Authors: Katayama Ichiro
Published: April 2015

Recurrent purpuric lesions are occasionally seen in patients with Sjögren syndrome. Hypergammaglobulinemia is one of the underlying precipitating factors of this condition. Clinical and histopathological analyses were performed on 5 cases of hypergammaglobulinemic purpura associated with Sjögren's syndrome, and the effects of immunomodulatory therapy were evaluated with regards to these conditions.

Three out of 5 cases were successfully treated with oral gold compound (Auranofin) and one case with a low dose of cyclophosphamide. Episodic purpura subsided two months after initiation of therapy with improved serum IgG levels. Salivary flow and serum amylase levels also improved in some cases.

Immunomodulatory therapy may be useful in managing recurrent purpura based on hypergammaglobulinemia associated with Sjögren syndrome.
Mortality of Neurofibromatosis in Japan, 1968–1992
Authors: Imaizumi Yoko
Published: April 2015

The death rate from neurofibromatosis (NF) was analyzed using Japanese vital statistics for the period 1968–1992. NF death rates for females decreased significantly year by year, but there was no significant change for males. Overall NF death rates were 0.25 per million population for males and 0.19 for females. The age‐specific NF death rate increased with age during that period. The overall mean age at death from NF was 43 years for both sexes. There were no geographical variations in the NF death rate during the period 1977–1992.
Pemphigoid Nodularis: A Case with 230 kDa Hemidesmosomes Antigen Associated with Bullous Pemphigoid Antigen
Authors: Tamada Yasuhiko , Yokochi Kikuka , Oshitani Yoshimi , Nitta Yukiko , Ikeya Toshihiko , Hara Kazuo , Owaribe Katsushi
Published: April 2015

We report a 73‐year‐old woman with typical clinical, histological and immunofluorescence features of pemphigoid nodularis. Direct immunofluorescence studies of prurigo nodularis‐like lesions and peribullous skin showed the linear deposition of IgG and C3 at the basement membrane zone. Circulating IgG against the basement membrane was also detected by indirect immunofluorescence. The serum from the patient was shown to contain the autoantibody against 230 kDa hemidesmosomal antigen associated with bullous pemphigoid antigen.
Systemic Plasmacytosis: A Case which Improved with Melphalan
Authors: Lee Dong Won , Choi Sung Woo , Park Jong Won , Cho Baik Kee
Published: April 2015

Plasmacytosis, a distinctive proliferative disorder of plasma cells, is characterized by peculiar multiple skin eruptions, lymphadenopathy and polyclonal hypergammaglobulinemia.

To date there has been no report of such cases showing remarkable responses to therapeutic agents.

We herein report a case of plasmacytosis which developed in a 52‐year‐old Korean man and showed remarkable improvement with melphalan.
Primary Sjögren's Syndrome and Psoriasis Vulgaris in a Case of OKT4 Epitope Deficiency
Authors: Tanaka Hideyuki , Mizutani Hitoshi , Okada Hiroaki , Shimizu Masayuki
Published: April 2015

We report a 29‐year‐old female OKT4 epitope deficiency patient with primary Sjögren's syndrome and psoriasis vulgaris. Immunological investigations during the prolonged clinical course of her herpes zoster revealed that she has OKT4 epitope deficiency and primary Sjögren's syndrome. She had been treated for psoriasis vulgaris for 17 years without systemic immunosuppressive therapy. Flow cytometric study revealed that her OKT4 deficiency is heterogeneous and excluded interference with the OKT4 epitope by anti OKT4 autoantibodies. The rare coexistence of primary Sjögren's syndrome and psoriasis implicates an immune disturbance due to an unusual phenotype of CD4.
Nodular Scleroderma: Focally Increased Tenascin Expression Differing from That in the Surrounding Scleroderma Skin
Authors: Mizutani Hitoshi , Taniguchi Hirotaka , Sakakura Teruyo , Shimizu Masayuki
Published: April 2015

Nodular scleroderma is a rare variant of the disease, whose pathogenesis is uncertain. Tenascin is a recently cloned extracellular matrix protein which is thought to be a marker for tissue remodelling. To further investigate the pathogenesis of nodular scleroderma, we have followed up a case of this disease and studied tenascin expression in the nodular lesions and surrounding progressive systemic sclerosis skin. Previously, we demonstrated a long‐lasting intermediate level of dermal tenascin expression in progressive systemic sclerosis; morphea and hypertrophic scar lesions showed strong but short‐lived tenascin expression. In our current patient, high levels of tenascin were found in the nodules, which rapidly resolved. Thus, the time course of the clinical and histopathological findings together with the tenascin expression were more suggestive of hypertrophic scar than progressive systemic sclerosis. These findings imply that nodular scleroderma has a supplementary pathogenesis, such as itching, in addition to the proceeding systemic sclerosis.
Langerhans Cell Histiocytosis: A Case Report and Glimpses into Its Nomenclature
Authors: Sehgal Virendra N. , Jain Sanjiv , Chander Ram , Logani Kulbhushan
Published: April 2015

Class I Langerhans cell histiocytosis (LCH) is described in a two‐ and a half‐year‐old male. The initial expression of the disease was conspicuous by the presence of extensive pustular crusted rash and, later in its course, by purpura, diabetes insipidus, otitis media, enlargement of the liver and spleen, and infiltration into the lungs. The patient expired due to extensive hemorrhage over 24 hours.
Ulcerative Colitis Associated with Preceding Systemic Lupus Erythematosus
Authors: Ishikawa Osamu , Miyachi Yoshiki , Fujita Kinichi , Takenoshita Seiichi , Nagamachi Yukio , Hirato Junko
Published: April 2015

We report a 50‐year‐old female patient who developed ulcerative colitis 31 after years being diagnosed with systemic lupus erythematosus. The overall clinical evaluation of her SLE activity differentiated ulcerative colitis from lupus colitis. Since the association of idiopathic systemic lupus erythematosus with ulcerative colitis has rarely been reported, the combination of these two diseases may be coincidental.
Coexistence of Vitiligo and Morphea: A Case Report and Review of the Literature
Authors: Finkelstein Eve , Amichai Boaz , Metzker Aryeh
Published: April 2015

A patient with both vitiligo and morphea is described. These skin diseases rarely appear concurrently in the same patient, despite the fact that both are thought to have an autoimmune etiology. Similar cases that have been reported in the literature are reviewed and discussed.
Sinus Arrest Developed during Gastric Cancer Operation in a Progressive Systemic Sclerosis Patient
Authors: Kihira Chika , Mizutani Hitoshi , Shimizu Masayuki
Published: April 2015

We report a case of progressive systemic sclerosis (PSS) who suddenly developed sinus arrest during an operation for gastric cancer under general anesthesia. No abnormalities in her cardiac, respiratory or renal functions had been detected before surgery. The cardiac functions evaluated by echocardiogram before and after pacemaking eliminated heart muscular involvement. We speculated that the operation stress induced by general anesthesia altered the asymptomatic fibrotic sinus into apparent sinus dysfunction. Care should be taken in general anesthesia for scleroderma patients who are free from detectable cardiac manifestations.
Cutaneous Ultrastructural Features of the Flaky Skin (fsn) Mouse Mutation
Authors: Morita Katsuko , Hogan Margaret E. , Nanney Lillian B. , King Lloyd E. , Manabe Motomu , Sun Tung‐Tien , Sundberg John P.
Published: April 2015

An autosomal recessive genetic disease with clinical and histopathological skin features resembling human psoriasis vulgaris occurs naturally in flaky skin mice (fsn/fsn). Affected mice are normal at birth, except for a hypochromic anemia. Subsequently, they develop hyperkeratotic plaques and acanthosis with elongation of rete ridges. Scanning electron microscopic examination revealed a greatly thickened epidermis, a sparsity of hairs and scale accumulations on the epidermal surface. Hair shafts had conspicuous pits, striations, and exophytic protrusions. Nails were bent at a 90° angle with surface irregularities and accumulations of scale at the nail base. Transmission electron microscopic examination showed increased epidermal thickness, mitochondrial aberrations, and intraepidermal invasion by neutrophils. Keratohyalin abnormalities were detected using immunocytochemical staining for profilaggrin. At the dermal‐epidermal junction, numerous macrophages and mast cells were seen in close promixity to focal dissolutions of the basement membrane. A high density of collagen fibers and cellular infiltrates were evident in the papillary dermis. This constellation of ultrastructural aberrations is typically found in psoriasis vulgaris and supports the theory that the flaky skin mouse mutation is a naturally occurring analog to one variety of human psoriasis vulgaris.
Proliferating Activity of the Hair Follicular Melanocytes at the Early and Anagen III Stages in the Hair Growth Cycle: Detection by Immunocytochemistry for Bromodeoxyuridine Combined with DOPA Reaction Cytochemistry
Authors: Sugiyama Sadao , Saga Kenji , Morimoto Yousuke , Takahashi Makoto
Published: April 2015

In order to demonstrate the existence of proliferating activity in hair follicular melanocytes during the early and anagen III stages, immunocytochemistry for bromodeoxyuridine (BrdU) incorporated in the nuclei of the melanocytes for 1 hr was undertaken at the light and electron microscopic levels in combination with DOPA reaction cytochemistry.

Light microscopically, about 30% of the nuclei of the DOPA reaction positive melanocytes at the anagen III stage of the hair growth cycle were labeled by anti‐BrdU antibody. These melanocytes were observed in about one hundred hair follicles. Electron microscopically, the nuclei of a few undifferentiated melanocytes at the anagen II stage were labeled by anti‐BrdU antibody‐affiliated secondary antibody‐gold particles. At the anagen III stage, localization of the immunogold particles in the DNA replication domains of the nuclei of the undifferentiated and redifferentiating melanocytes covered the patterns of the early, middle, and late S‐phase.

These findings suggest that the hair follicular melanocytes begin proliferation at the anagen II stage and that the melanocytes proliferate actively at the anagen III stage to repopulate the hair matrix during subsequent hair growth.
A Case of AIDS Manifesting Pruritic Papular Eruptions and Psoriasiform Lesions: An Immunohistochemical Study of the Lesional Dermal Infiltrates
Authors: Ichihashi Naoki , Seishima Mariko , Takahashi Takeshi , Muto Yasutoshi , Kitajima Yasuo
Published: April 2015

A 63‐year‐old man was referred to our department on September 14, 1992, because of multiple red papules with severe itching. Pruritic papular eruption (PPE) in a human immunodeficiency virus (HIV)‐infected patient was diagnosed based on the histological findings, the reduction in CD4, and positive results for HIV antibody. In September of 1993, papules and erythematous plaques with scales appeared on both the palms and soles. The erythema was pruritic and spread gradually to the extremities and trunk. These plaques with erythema and scales are similar to those of the psoriatic lesions seen in Reiter's syndrome, although the HLA typing was not B27. Immunohistopathological findings of the papules of PPE and plaques of psoriasiform lesions showed that perivascularly infiltrated cells in the dermis were mostly lymphocytes. The lymphocytes in PPE were positive for CD45 and negative for CD3, CD43, and CD45RO, but the lymphocytes in psoriasiform lesions were positive for CD45, CD3, and CD43. Moreover, 20–30% of these lymphocytes were also intensely positive for CD45RO. These observations were similar to those obtained in the lesional skin of HIV‐negative psoriasis, suggesting that there were no significant immunohistopathological differences in the abnormality of local cellular immunity related to the formation of psoriasiform lesions in HIV‐negative psoriasis and HIV‐positive psoriasis.
Graft Versus Host Disease with Mixed Chimerism
Authors: Morita Hideki , Kohno Junro , Kitano Yukio
Published: April 2015

We report a patient with graft versus host disease (GVHD) with mixed chimerism (MC). The patient had chronic myelogenous leukemia and received bone marrow transplantation (BMT) from his elder sister. Eighty days after BMT, erythematous lesions appeared on his chest. Histological examination from the skin lesion revealed lymphocytic infiltration into the upper dermis. Eosinophilic necrotic keratinocytes were scattered through the epidermis. Liquefaction degeneration was also recognized. Sicca syndrome appeared from 110 days after BMT. Detection of host origin Y‐chromosome‐specific DNA by polymerase chain reaction (PCR) method in bone marrow and peripheral blood showed that all bone marrow samples obtained 6 months from BMT were positive for Y‐specific DNA, while peripheral blood became positive in the 60th month after BMT. The host origin normal karyotype (46,XY) in the bone marrow samples was identified for the first time in the 60th month after BMT. These results indicate that host‐origin hematopoietic cells survived after BMT.
Bilateral Inguinal Scrofuloderma during Steroid Therapy in a Patient with Bullous Pemphigoid
Authors: Kawabata Emi , Morita Kazumasa , Matsuyoshi Norihisa , Ohta Keiji , Okamoto Hiroyuki , Ikai Kouichi , Imamura Sadao
Published: April 2015

This report described a case of scrofuloderma that developed in the bilateral inguinal regions during treatment of bullous pemphigoid with systemic corticosteroid. Analysis of the literature on scrofuloderma between 1978–1993 disclosed that the number of cases with extracervical involvement are increasing. Immunosuppression could disseminate tuberculous focuses, resulting in extracervical involvement of SD connected with the underlying extrapulmonary tuberculous lesions.