bluuebunny/crossref_metadata_2025 huggingface dataset:
Rapid Destruction of Murine and Human Melanomas by Local Injection of Absolute Ethanol: Augmentation of the Anti‐proliferative Effects with a Combination of Biological Response Modifiers
Authors: Nakayama Juichiro , Toyofuku Kazutomo , Kokuba Hisashi , Hori Yoshiaki
Published: April 2015

Percutaneous injection of absolute ethanol was found to cause rapid destruction of murine and human melanoma nodules. It took only 24–48 hr after the ethanol injection to form ulcers or scars on the lesions. Massive necrosis of murine and human melanoma nests and interstitials and infiltration of mononuclear cells into the demaged tissue were observed histopathologically after ethanol injection. The melanomas recurred approximately 1 week after the destruction of the melanoma nodules by ethanol. Biological response modifiers such as levamisole or interleukin (IL)‐2 were effective in preventing the recurrence of murine melanoma after ethanol injection. IL‐2 injection caused massive infiltration of NK cells, T cells, and macrophages into the damaged melanoma tissue. The therapeutic modality of a combination of ethanol and IL‐2 injections could definitely be useful for the local treatment of human metastatic melanoma, but other modalities such as local hyperthermia or radiation should be considered in combination to attain a permanent cure.
A Case of Acral Melanocytic Hyperplasia: A Unique Pigmented Lesion Mimicking Acral Lentiginous Melanoma In situ
Authors: Cho Kwang Hyun , Kim Byoung Kook , Lee Dong Youn , Minn Kyung Won
Published: April 2015

A mottled black pigmented patch on the sole of the foot is reported. Clinically, the lesion closely mimicked acral lentiginous melanoma in situ. However, the histologic findings revealed melanocytic hyperplasia with minimal cytologic atypia confined to the epidermis. Irregular pigmented patches in the acral region comprise a heterogenous group of lesions that range from benign melanocytic hyperplasia to acral lentiginous melanoma.
Urticarial Vasculitis with Papular Lesions in a Patient with Type C Hepatitis and Cryoglobulinemia
Authors: Kuniyuki Shuichi , Katoh Haruhisa
Published: April 2015

We describe a case of urticarial vasculitis accompanied by erythematous wheals, palpable pupura, and subsequent necrotic ulcerated papular lesions in a patient with type C chronic hepatitis and type II cryoglobulinemia (IgM‐kappa and polyclonal IgG). A 56‐year‐old man developed recurrent urticarial lesions on his lower extremities and trunk. The histology revealed leukocytoclastic vasculitis with perivascular immunoglobulin deposits. Subsequently, multiple reddish papular lesions with necrotic ulcerations appeared on the extensor aspect of his extremities and buttocks. Histology of these lesions showed cryoglobulinemic vasculitis with prominent fibrinoid necrosis of the vascular walls and cryoprecipitate within the vasculature as well as increased hyalinized collagen bundles. These papular lesions have not previously been described as cutaneous necrotizing venulitis to the best of our knowledge. It is suggested that the immune response to hepatitis C virus infection and cryoglobulins may be responsible for severe necrotizing venulitis, resulting in unusual cutaneous lesions.
Multiple New‐Onset Subcutaneous Nodules of the Upper Extremity Digits: Giant Cell Tumor of Tendon Sheath and Lipoma
Authors: Cohen Philip R.
Published: April 2015

A black woman with the concurrent onset of two subcutaneous nodules located on the digits of her upper extremities is described. Initially, a single systemic disorder was considered; yet, the lesions differed in morphology and consistency. Microscopic examination of the nodules showed a giant cell tumor of tendon sheath and a lipoma. Although Occam's “razor” suggests that multiple lesions in the same person are more likely to represent variable manifestations of a single disorder than several different diseases in that individual, the simultaneously appearing lesions in this patient represented two different conditions.
Systemic Amyloidosis with Initial Polyneuropathy
Authors: Lee Ding‐Dar , Huang Chun‐Yu , Wong Chu‐Kwan , Kao Ko‐Pei
Published: April 2015

We report a case of systemic amyloidosis with the initial sign of polyneuropathy. The patient eventually developed heart failure, macroglossia, and ecchymoses 6 years later. Biopsies from the sural nerve and normal‐looking skin both proved the existence of amyloid.
Thrombospondin Receptor (CD36) Expression of Human Keratinocytes during Wound Healing in a SCID Mouse/Human Skin Repair Model
Authors: Simon Miklós , Juhász István , Herlyn Meenhard , Hunyadi János
Published: April 2015

Using a human skin/severe combined immunodeficient (SCID) chimeric mouse model, we examined the keratinocyte expression of the thrombospondin receptor (CD36) and its ligand thrombospondin‐1 (TSP1) in acute uninflamed wounds. Positive suprabasal keratinocyte expression of CD36 was observed as early as 30 minutes after wounding in the adjacent, intact epidermis; it disappeared 4 days later. Keratinocytes of the freshly re‐epithelised wounds and those of the surrounding epidermis remained TSP1‐negative throughout the whole observation period of 7 days. Our results indicate that CD36‐positive keratinocytes, probably in connection with activated, TSP1‐positive thrombocytes, may play an important role in the early phase of wound healing.
Giant Basal Cell Carcinoma Associated with Systemic Amyloidosis
Authors: Yamamoto Shinji , Johno Masayoshi , Kayashima Ken‐ichi , Matsunaga Wakatoshi , Ono Tomomichi
Published: April 2015

A large basal cell carcinoma, 39 times 26 cm in size, is presented as second in size only to the largest basal cell carcinoma documented (40 times 30 cm), reported by Beck and co‐workers (1). A 61‐year‐old Japanese male visited our clinic with a huge ulcerating tumor on the back. He had hidden the tumor for the previous 30 years. The tumor was histologically confirmed as basal cell carcinoma. The condition was associated with anemia, hypoproteinemia, and dyspnea, and with systemic amyloidosis in the skin, in the lymph nodes, and in the intestinal canal. On admission, the tumor had metastasized to the regional lymph nodes, and, about two years after the first operation, there were metastases to bone and lung, leading to death due to respiratory failure.
Progressive Systemic Sclerosis Sine Scleroderma which Developed after Exposure to Epoxy Resin Polymerization
Authors: Inachi Shin , Mizutani Hitoshi , Ando Yoko , Shimizu Masayuki
Published: April 2015

Progressive systemic sclerosis (PSS) sine scleroderma is well known as a special form of scleroderma. Because of its rarity, its pathogenesis has not yet been elucidated. We experienced a 33‐year‐old man who developed PSS sine scleroderma while working with epoxy resin polymerization. He had short white frenulum linguae, diffuse hyperpigmentation and facial telangiectasia, positive antinuclear antibody, and pulmonary dysfunction, but not acrosclerosis or sclerodactylia. Modest dermal collagen proliferation in the forearm skin confirmed PSS sine scleroderma. Epoxy resin polymerizer appears to be a potent causative agent for PSS sine scleroderma as well as for generalized morphea‐like PSS.
Modified Thiersch Grafting in Stable Vitiligo
Authors: Bose Sumit Kumar
Published: April 2015

Medical management of vitiligo usually gives complete repigmentation in up to 60 to 90% of cases (4, 7). Modified Thiersh grafting, in which psoralen without UVA or solar radiation was used successfully, is described.
Immunohistochemical Detection of p53 Tumor Suppressor Protein in Porokeratosis
Authors: Urano Yoshio , Sasaki Shiro , Ninomiya Yoshiro , Oura Hajimu , Arase Seiji
Published: April 2015

We examined 9 Japanese cases of porokeratosis (4 of the plaque type, 2 of disseminated superficial actinic porokeratosis, 2 of disseminated superficial porokeratosis, and one of giant porokeratosis) for the expression of p53 tumor suppressor protein immunohistochemically, using two anti‐p53 antibodies, CM1 and DO1. The same results were obtained with both antibodies. The epidermis central to the cornoid lamellae was positive in 8 of 9 specimens. On the other hand, the peripheral epidermis was positive in 2 of the 9 cases. The epidermis beneath the cornoid lamellae was positive in 3 of the 9 cases. The frequency of p53 positivity was significantly higher in the epidermis central to cornoid lamellae over that beneath or peripheral to them (Fisher's exact probability test, p<0.05). The majority of squamous cell carcinoma cells arising on giant porokeratosis stained with CM1 and DO1. These data may suggest that the abnormal p53 expression has some relevance to the skin carcinogenesis of porokeratosis.
Paraneoplastic Pemphigus: Report of a Case
Authors: Izaki Seiichi , Yoshizawa Yusuke , Hashimoto Takashi , Korman Neil J. , Kitamura Keijiro , Hamamatsu Yasushi , Ohashi Norio , Ogasa Shinji
Published: April 2015

A 56‐year‐old male with chronic lymphocytic leukemia developed extensive erosive mucocutaneous lesions with histologic acantholysis. Immunopathologic studies showed IgG deposition at the intercellular space, C3 deposition at both the intercellular space and the dermo‐epidermal junction, and reactivity of the serum to rat urinary bladder epithelium. Autoantibodies in the serum to human epidermal proteins of 210 kD and 190 kD were shown by Western blotting and to proteins of 250 kD, 210 kD, and 190 kD by immunoprecipitation. All these data suggest the diagnosis of paraneoplastic pemphigus. Repeated plasmapheresis resulted in re‐epithelialization of the mucocutaneous lesions and reduction in antibody titer from 1:1280 to 1:20. Although this mucocutaneous disease was established as a new autoimmune bullous disease by Anhalt et al. (1990), cases have rarely been reported from Japan. The present patient demonstrates the major characteristics of paraneoplastic pemphigus.
Extramammary Paget's Disease with Distant Skin Metastasis
Authors: Kato Naoko , Matsue Keiko , Sotodate Akihiro , Tomita Yuki
Published: April 2015

We report a 68‐year‐old Japanese man with invasive extramammary Paget's disease (EPD) which started in the left inguinal area and enlarged to include the scrotal skin, penis, and pubic area, resulting in lymph edema of the entire left leg. Histopathological examination of one nodule revealed an intraepidermal and intradermal arrangement of solid tumor cells with characteristic pale cytoplasm. The tumor was found to have disseminated to regional and systemic lymph nodes, lungs, bones, and the left adrenal gland. In addition, the patient had a metastatic cutaneous nodule on the scalp. Histology of the skin metastasis showed that the proliferation of Paget cells was confined to the dermis. This type of metastatic spread of EPD is very rare; only two other apparent cases in Japan have been reported.
Hypopigmented Mycosis Fungoides in a White Female
Authors: Amichai Boaz , Grunwald Marcelo H. , Avinoach Ilana , Halevy Sima
Published: April 2015

A rare case of a young Caucasian female with hypopigmented mycosis fungoides is described. We reviewed and discussed the literature.
A Case of Eosinophilic Pustular Folliculitis (Ofuji's Disease) Induced by Patch and Challenge Tests with Indeloxazine Hydrochloride
Authors: Kimura Kyoko , Ezoe Kazuhiko , Yokozeki Hiroo , Katayama Ichiro , Nishioka Kiyoshi
Published: April 2015

A 73‐year‐old male developed disseminated erythema over his entire body after exposure to indeloxazine hydrochloride, a cerebral activator. Patch testing with indeloxazine hydrochloride showed a positive reaction, and plaques, vesicles and pustules developed on the face after the patch test. These had the pathologic feature of eosinophilic pustular folliculitis (EPF, Ofuji's disease). A challenge test also provoked eruptions on the face, trunk, arms and legs, which were compatible with EPF. Moreover, both the patch and challenge tests with indeloxazine hydrochloride induced eosinophilia. This is the first report of drug allergy‐induced EPF, where drug sensitivity induced an abnormal eosinophilic response mimicking EPF.
Palmar Erythema Ab Igne without Detectable Type IV Collagen at the Basement Membrane Zone
Authors: Yasuda Kayo , Wada Emi , Kitagawa Nobuko , Ikeda Mitsunori , Kodama Hajime
Published: April 2015

A 42‐year‐old baker had hyperkeratotic lesions on reticular erythema of his palms and volar digits. Attachment between the epidermis and the dermis was loose at the hyperkeratotic sites, but no blisters had formed. After he stopped work for 2 months, the skin lesions disappeared, leaving a slight scar. Immunofluorescence studies showed a normal distribution of type VII collagen and laminin, but there was almost no fluorescence for type IV collagen in the basement membrane zone. Disappearance of cytoplasmic organelles and aggregated tonofibrils was evident under electron microscopy in the basal cells which appeared shrunken under light microscopy. The structures of lamina lucida, basal lamina and anchoring fibrils were disarranged. The loose dermo‐epidermal attachment is probably due in part to this disorganized basement membrane structure lacking type IV collagen, which may have been digested by heat‐activated matrix metalloproteinases. In addition, his work‐related chronic heat exposure might have caused hyperproliferation of keratinocytes.
Three Cases of Pasteurella multocida Skin Infection from Pet Cats
Authors: Matsui Tamano , Kayashima Ken‐ichi , Kito Masato , Ono Tomomichi
Published: April 2015

We encountered three cases of Pasteurella multocida skin infection from pet cats. P. multocida wound infections are characterized by acute onset of erythema, pain, and swelling. This infection has rarely been reported in dermatology journals from Japan.
Angina Bullosa Hemorrhagica
Authors: de las Heras M. Elena , Moreno R. , Núñez María , Gómez M. Isabel , Ledo Antonio
Published: April 2015

Angina bullosa hemorrhagica is characterized by acute blood blisters, mainly on the soft palate. Elderly patients are usually affected and lesions heal spontaneously without scarring. The pathogenesis is unknown, although it may be a multifactorial phenomenon. Trauma seems to be the major provoking factor and long term use of steroid inhalers has also been implicated in the disease. No underlying hematologic or immunopathogenic disorder has been found. Treatment is symptomatic.

We present a 67‐year‐old patient with recurrent oral blood blisters which were diagnosed as angina bullosa hemorrhagica. Trauma by dental injections and use of steroid inhalers were identified as etiologic factors in this case. Erosions healed within a week.

Although this is a benign condition, it may result in acute airway obstruction. Recognition is, therefore, of great importance for dermatologists.
Relationship between Levels of Soluble Interleukin‐2 Receptors and the Types and Activity of Vitiligo
Authors: Honda Yoshihide , Okubo Yukari , Koga Michiyuki
Published: April 2015

Levels of serum‐soluble interleukin‐2 receptors (serum sIL‐2R) are thought to indicate the activation of immunocompetent cells, mainly lymphocytes. Elevated levels of serum sIL‐2R have been observed in various infectious and autoimmune diseases and also after organ transplantation. It has been hypothesized that autoimmune mechanisms are involved in the pathogenesis of vitiligo. Therefore, we studied serum sIL‐2R levels in relation to disease types and activity of vitiligo. We used sera separated from venous blood samples from 12 patients with dermatomally distributed type B vitiligo, 17 patients with non‐dermatomally distributed type A vitiligo during the active stage, 9 patients with type A vitiligo during the inactive stage, and 12 normal control subjects.

Serum sIL‐2R levels were similar in type B vitiligo patients and the controls but were significantly elevated in patients with active type A vitiligo compared with controls and inactive type A vitiligo patients. It is suggested that the immune system is activated in patients with type A vitiligo during the active stage and that autoimmune mechanisms may play a role only in type A vitiligo.
A Verrucous Lesion on Skin Grafted after Necrotizing Fasciitis in a Diabetic Patient Successfully Treated with Combined Topical 5‐FU and Tacalcitol
Authors: Sakai Hiroyuki , Fukami Yoichi , Ibe Masaki , Tamura Toshiya , Hashimoto Yoshio , Iizuka Hajime
Published: April 2015

Many complications of diabetes mellitus involve the feet. These include infections, neuropathy, vasculopathy, and poor wound healing. Neuropathy causes chronic pressure or friction on an area of sensory loss and occasionally causes verrucous skin lesions. We describe a diabetic patient, complicated by necrotizing fasciitis, who developed a verrucous skin lesion on a skin graft site. The verrucous skin lesion was treated successfully with combined topical 5‐fluorouracil and vitamin D3 application.
Rudimentary Meningocele of the Scalp
Authors: Mihara Yuko , Miyamoto Toru , Hagari Yoshitaka , Mihara Motoyuki
Published: April 2015

A rudimentary meningocele, a variant of primary cutaneous meningioma, was seen on the scalp of a 9‐month‐old Japanese boy. Clinically, the lesion on the left parietal area was round, about 1.6 cm in diameter, alopecic, and slightly elevated. Histologically, the lesion, located from the dermis to the subcutis, consisted of scattered foci of meningothelial cells, an anastomosing network of empty spaces with psammoma bodies and collagen bodies, and small vessels. Immunohistochemically, the meningothelial cells were positive for vimentin and desmin. Ultrastructurally, they had elongated cytoplasmic processes, intermediate filaments in the cytoplasm, and desmosomal junctions.
Dermatomyositis Associated with Primary Intramuscular B Cell Lymphoma
Authors: Anzai Saburo , Katagiri Kazumoto , Sato Toshihiro , Takayasu Susumu
Published: April 2015

A rare case of dermatomyositis associated with primary intramuscular malignant lymphoma is described. A 40‐year‐old Japanese woman noticed swelling of the right thigh during the treatment of dermatomyositis with prednisolone, azathioprine and cyclophosphamide. A biopsy specimen taken from the right quadriceps muscle revealed infiltration of lymphoma cells which were positive for CD20. We reviewed 12 cases of dermatomyositis associated with malignant lymphoma reported in Japanese literature between 1984 and 1996.
Sister Joseph's Nodule: A Case Report and Review of the Japanese Literature
Authors: Ishizawa Toshiyuki , Mitsuhashi Yoshihiko , Kondo Shigeo , Watabe Syuichi
Published: April 2015

We report a case of metastatic carcinoma on the umbilicus, which is known as Sister Joseph's nodule. A 65‐year‐old man with the chief complaint of a painful nodule on the umbilicus was refered to our hospital. Histopathological examination revealed moderately differentiated tubular adenocarcinoma in the dermis. Endoscopic examination found gastric cancer of Borrmann type IV. The umbilical lesion represented a metastasis from the gastric cancer. We reviewed 80 cases of metastatic carcinomas to the umbilicus that have been reported in the Japanese literature.
‘Swiss Cheese’ Lymphangiectasia in a Case of Solitary Morphea Profunda
Authors: Ahn Sung Ku , Won Jin Hyoung , Lee Seung Hun , Lee In Wook , Lee Won Soo , Choi Eung Ho
Published: April 2015

Reports of lymphangiectases that occur in lesions of morphea are rare. We describe a 24‐year‐old woman with a solitary morphea profunda associated with lymphangiectasia. Unlike previously reported cases, our case showed lymphatic dilatation resembling Swiss cheese and developed around a milium.
Congenital Ectopic Nails Reconstructed with Local Skin Flaps
Authors: Kimura Chu , Oyama Akihiko , Kouraba Sachio
Published: April 2015

Congenital ectopic nails are quite unusual and characterized by development of nail‐like tissue on the tips of one or more fingers. We present the case of a boy with congenital ectopic nails on both little fingers. To prevent tapering of the fingertips following surgery, we used subcutaneous pedicle flaps and obtained a satisfactory cosmetic result.
Papillary Tubular Adenoma with Marked Tubular Vacuolization
Authors: Hattori Naoko , Imakado Sumihisa , Kikuchi Kanako , Murakami Toshikazu , Furue Masutaka
Published: April 2015

We report a case of papillary tubular adenoma, arising on the knee joint. The overall histologic structure of the tumor is consistent with that of papillary tubular adenoma with slight interluminal papillary changes, but most of the tumor cells present vacuolization outlined by carcinoembryonic antigen staining, suggesting that this adenoma may have resulted from microlumen formation. This is, to our knowledge, the first reported case of a papillary tubular adenoma with marked tubular vacuolization.
Pseudo‐Kaposi's Sarcoma Associated with Acquired Arteriovenous Fistula
Authors: Kim Tae‐Heung , Kim Kab‐Hyeong , Kang Jin‐Soo , Kim Jae‐Hyoung , Hwang Il‐Yong
Published: April 2015

Pseudo‐Kaposi's sarcoma or acroangiodermatitis usually has underlying conditions of increased venous pressure or circulatory abnormality. We experienced two cases of pseudo‐Kaposi's sarcoma in patients with acquired iatrogenic arteriovenous fistula from hemodialysis on their forearms.

The patients complained of painful swollen crusted vesicles and purple or erythematous patches or plaques on their hands and fingers. Histologic findings included features of pseudo‐Kaposi's sarcoma such as proliferations of small vascular spaces with narrow vascular channels lined by spindle cells, extravasated erythrocytes, and hemosiderin deposits.

Percutaneous arteriography performed in Case one excluded the possible coexistence of arteriovenous malformation. In both cases, venous pressure and skin surface temperature were increased around the lesions; these may have played important roles in the development of the lesions.

Both cases improved after oral erythromycin treatment, which seemed to be safe and effective for pseudo‐Kaposi's sarcoma.
Cutaneous Horn: A Brief Review and Report of a Case
Authors: Thappa Devinder Mohan , Garg Bhagat Ram , Thadeus Joseph , Ratnakar Chaganti
Published: April 2015

A case of extensive verrucae vulgaris with cutaneous horns in a 32‐year‐old man is reported. Accompanying terminal phalangeal bone absorptive changes in the fingers of both hands, resulting from subungual warty lesions, are highlighted. The existing literature on the subject of cutaneous horn is briefly reviewed.
Asymptomatic Primary Sjögren's Syndrome in a Patient with Penicillin Drug Eruption
Authors: Takahashi Hiroyuki
Published: April 2015

A 20‐year‐old woman visited our clinic because of acral numbness and skin eruptions after administration of oral penicillin. Serological tests revealed an increase of immunoglobulins (G & M), positive rheumatoid factor, anti‐nuclear factor, anti‐SSA and ‐SSB antibodies. Ophthalmologic and otolaryngological studies were consistent with those of Sjögren's syndrome. However, a skin biopsy specimen failed to show any specific changes for Sjögren's syndrome and the diagnosis of penicillin drug eruption was considered to be more preferable. We briefly discussed the coexistence of a drug allergy and asymptomatic connective tissue disease.
The Inhibitory Effect of Anti‐Adhesion Molecule Antibodies on Eosinophil Infiltration in Cutaneous Late Phase Response in Balb/c Mice Sensitized with Ovalbumin (OVA)
Authors: Hakugawa Junichi , Bae Sang Jae , Tanaka Yoichi , Katayama Ichiro
Published: April 2015

In this study, we investigated the involvement of the adhesion molecules intercellular adhesion molecule‐1 (ICAM‐1), vascular cell adhesion molecule‐1 (VCAM‐1), very late activation antigen‐4 (VLA‐4), lymphocyte function‐associated antigen 1 (LFA‐1) and macrophage antigen‐1 (Mac‐1) on eosinophil infiltration in the cutaneous late phase response (LPR) in OVA‐sensitized Balb/c mice by two approaches, immunostaining and inhibition assays with each monoclonal antibody. The eosinophil infiltration into the skin reached a peak at 12 hr after an intradermal challenge with OVA. Infiltrated eosinophils and mononuclear cells in the skin expressed Mac‐1 (eosinophils: 38.9 ± 1.55%, mononuclear cells: 51.2 ± 2.15%), LFA‐1 (eosinophils: 33.3 ± 0.95%, mononuclear cells: 23.1 ± 1.07%) and VLA‐4 (eosinophils: 14.3 ± 1.6%, mononuclear cells: 17.2 ± 1.38%) at 12 h. Intraperitoneal administration of anti‐mouse ICAM‐1, VCAM‐1, and VLA‐4 monoclonal antibodies (mAb) before the challenge decreased the eosinophil infiltration by 66.2%, 61.0%, and 54.0%, respectively. On the other hand, pretreatment with anti‐mouse LFA‐1 mAb or Mac‐1 mAb did not significantly decrease the infiltration.

These results suggest that VCAM‐1/VLA‐4 interaction and ICAM‐1 play important roles in eosinophil infiltration in cutaneous LPR.
Diabetic Scleredema: A Case Report and Biochemical Analysis for Glycosaminoglycans
Authors: Kobayashi Takashi , Yamasaki Yuichiro , Watanabe Tomoo
Published: April 2015

We report a patient with the typical lesions of diabetic scleredema. Histological findings of the involved skin were thickening of the dermis, depositions of mucins, and fibrosis. Biochemical analysis revealed an increase in glycosaminoglycans in the involved skin as well as in the cutaneous lupus mucinosis. Mucinous materials were composed of hyaluronic acid.
A Case of Tuberous Sclerosis with a Giant Angiofibroma
Authors: Wataya‐Kaneda Mari , Yano Kenji , Hosokawa Ko , Yoshikawa Kunihiko
Published: April 2015

This is a case study of tuberous sclerosis with unusually large facial angiofibromas. The patient had other intense skin manifestations. Histological findings in the angiofibroma included large and glial‐appearing cells specific for this disease. Karyotype analysis revealed a translocation of chromosome (12q–, 15q+).
Dyschromatosis Universalis Hereditaria: An Electron Microscopic Examination
Authors: Kim Nam Soo , Im Sungbin , Kim Soo‐Chan
Published: April 2015

We report electron microscopic findings from both hyperchromic and achromic macules of dyschromatosis universalis hereditaria (DUH). The keratinocytes of the hyperchromic macules contained numerous, fully melanized melanosomes; almost all of them were aggregated to form the melanosome complex. In contrast, the melanosomes were absent from both keratinocytes and melanocytes of achromic macules, even though intact melanocytes were found. Our results suggest that DUH may be a disorder of melanosome production and distribution in epidermal melanin units rather than a disorder of melanocyte number.
Trichoblastoma with Rippled‐Pattern
Authors: Akasaka Toshihide , Imamura Yuko , Mori Yasuki , Iwasaki Masa , Kon Saiichi
Published: April 2015

The following is a case study of a 36‐year‐old Japanese man with a trichoblastoma which exhibited a rippled‐pattern on the left temporal region of the scalp. The histological findings of the tumor revealed lobular aggregations composed of immature follicular basaloid cells, lobules of squamous eddy‐like foci of incomplete keratinization or small keratinous cysts, and multiple papillary mesenchymal bodies similar to hair germ. Interestingly, a rippled‐pattern of basaloid cells and hyalinized matrixes resembling the Verocay bodies of neurilemmoma was also observed. We propose that the rippled‐pattern of the basaloid cells and hyalinized matrices is caused by the characteristic stromal induction of trichoblastoma.
A Case of Lyme Disease Diagnosed Serologically
Authors: Fujita Hiroshi , Ogusu Koji , Imaizumi Shunsuke , Masuzawa Toshiyuki , Yanagihara Yasutake
Published: April 2015

A 57‐year‐old Japanese male developed erythema migrans, arthralgia, and neurological symptoms after mountain climbing in Nagano Prefecture. On ELISA, his serum reacted to Borrelia isolated from various sources. The patient's serum reacted with a 41 kilodalton protein which was reactive with monoclonal antibody H9724 specific to flagellin of Borrelia on Western blotting. He recovered after taking minocycline 200 mg daily for 2 weeks.
Nuchal Fibroma
Authors: Abraham Zeev , Rozenbaum Michael , Rosner Itzhak , Naschitz Yohanan , Boss Yohanan , Rosenmann Eliezer
Published: April 2015

Nuchal fibroma was diagnosed in a 54‐year‐old diabetic woman with a two year history of increased skin thickness of her low‐posterior neck and interscapular region, causing discomfort and limitation of neck and arm motion. Physical and laboratory examinations excluded further disorders. The patient was released, free from symptoms, after complete excision of the soft tissue tumor.
Melkersson‐Rosenthal Syndrome—A Challenge for Dermatologists to Participate in the Field of Oral Medicine
Authors: Hornstein Otto P.
Published: April 2015

Melkersson‐Rosenthal syndrome (MRS) is a neuro‐muco‐cutaneous disorder involving remittently both the oro‐facial innervation and muco‐cutaneous tissues in a pathosis of complex origin characterized by recurrent edema, facial or other palsies, and nerval dysfunctions frequently assoiciated with plicated tongue. Biopsies taken from the edematous tissues often reveal a temporary pattern of moderate epitheloid granulomatous inflammation scattered scarcely within remarkable tissue edema. However, this histological pattern is not a prerequisite for the diagnosis of MRS. The disease usually runs an intermittent and unpredictable course over years or decades and may have, if the edemas involve the tongue or the central nervous system, an ambiguous outcome. Greatly disfiguring oro‐facial swellings often result from secondary persistence of the primarily recurrent edemas. A classification on grounds of different ‘major’ and ‘minor signs’ of MRS is proposed in the present paper. In recent years, novel therapeutic approaches involving either oral clofazimine or laser beam acupuncture (according to the principles of traditional Chinese medicine) have proven to be successful in some cases of MRS. Dermatology could play a larger role in oral medicine by taking diseases such as MRS into account in studies among specialties dealing with oro‐facial pathoses.
The Comparative Study of Anti‐Double Stranded DNA Antibody Levels Measured by Radioimmunoassay and Enzyme‐Linked Immunosorbent Assay in Systemic Lupus Erythematosus
Authors: Takeuchi Yuko , Ishikawa Osamu , Miyachi Yoshiki
Published: April 2015

Anti‐double stranded (ds) DNA antibody is an autoantibody specific for systemic lupus erythematosus (SLE). For the measurement of this antibody, radioimmunoassay (RIA) or enzyme‐linked immunosorbent assay (ELISA) is widely used in Japan. We studied the correlation of anti‐dsDNA levels in 158 sera from 53 SLE patients between RIA and ELISA. The correlation coefficient between anti‐dsDNA antibody levels measured by RIA and ELISA was 0.736 (p<0.001). The concordance rate of sera with both ELISA/RIA‐positive or both ELISA/RIA‐negative results was 82.3% (130/158 sera). Twenty sera (12.7%) of 14 patients were ELISA‐positive but RIA‐positive, and 8 sera (5.0%) of 6 patients were ELISA‐negative but RIA‐positive. Our results suggest that both methods may be equally reliable for the detection of anti‐dsDNA antibodies and that ELISA may be more sensitive than RIA. ELISA may be preferable because of its simplicity and convenience of the measurement procedure. The correlation coefficient between anti‐ssDNA levels measured by ELISA and anti‐dsDNA levels measured by RIA was 0.322 (p<0.01), and the correlation coefficient between anti‐ssDNA and anti‐dsDNA antibody levels measured by ELISA was slightly higher, 0.515 (p<0.001). These results may reflect the predominance of anti‐DNA antibodies reactive with both ss and dsDNA in SLE sera. Since the clinical significance of anti‐ssDNA antibodies remains unclear, further analysis of accumulated cases is required.
OK‐432 Therapy for Recalcitrant Warts
Authors: Inui Shigeki , Asada Hideo , Wataya‐Kaneda Mari , Miyamoto Tomoko , Itami Satoshi , Yoshikawa Kunihiko
Published: April 2015

Twelve patients with warts recalcitrant to various treatments, including cryotherapy, were treated with OK‐432 injection therapy. Six patients received only subcutaneous injection, three received only intralesional injection, and the other three received both subcutaneous and intralesional injections. Complete clearing of the warts occurred in nine (75%) of 12 patients, while the other three patients were not cured. Grouping the patients by the method of injection, the success rate of subcutaneous injection was 5/9 (55.6%), and that of intralesional injection was 4/6 (66.7%). Although five patients complained of mild fever and malaise, these side effects gradually disappeared during the repeated injections. OK‐432 injection is considered as a hopeful therapy for recalcitrant warts.
A Case of Multiple Nevoid Hypertrichosis
Authors: Chang Sung Nam , Hong Chang Eui , Kim Dong‐Kun , Park Wook Hwa
Published: April 2015

Nevoid hypertrichosis is an uncommon congenital disorder consisting of terminal hair growth in a localized distribution on flesh‐colored skin; it is not associated with any other systemic abnormalities.

A 21‐year‐old male patient had a circumscribed area of depigmented terminal hairs on his chest which had been present since 1 year of age. At the age of 18, similar lesions developed on his left shoulder and upper arm. The underlying skin was slightly hypopigmented, and no other systemic abnormalities were found. Histologic examination demonstrated terminal hair follicles in otherwise normal skin. The number of HMB 45 positive melanocytes was markedly decreased in the affected skin.

This case of multiple nevoid hypertrichosis is reported with a review of previously reported cases.
Angiosarcoma Which Developed on the Abdominal Wall: Report of a Case
Authors: Funaki Mikio , Koike Shun'ichi , Dekio Satoshi , Jidoi Joji , Ohno Hiroyuki
Published: April 2015

We report a 68‐year‐old Japanese woman with angiosarcoma (AS) on the abdominal wall. To the best of our knowledge, she is the third such patient reported from Japan.
Acanthosis Nigricans Associated with Hepatolenticular Degeneration
Authors: Thaipisuttikul Yupin
Published: April 2015

Acanthosis nigricans and hepatolenticular degeneration (Wilson's disease) developed simultaneously in a 16‐year‐old boy. The diagnosis of Wilson's disease was based on the clinical presentation, including Kayser‐Fleischer ring, hypoceruloplasminemia, hypocupremia, and hypercupriuria. His skin lesions were characterized by thick, dark brown, verrucous plaques on the dorsa of both feet, the neck, axillae, and groin. The histological findings were compatible with acanthosis nigricans. Six months after treatment with D‐penicillamine, two grams per day, his skin lesions and neurological symptoms were much improved and no complications were observed.
Pincer Nails and Alopecia as Markers of Gastrointestinal Malignancy
Authors: Jemec Gregor B.E. , Thomsen Kristian
Published: April 2015

Nail abnormalities may be markers of non‐dermatologic disease. We present a case in which pronounced pincer nails and universal alopecia developed in association with a metastasising adenocarcinoma of the sigmoid colon. It is suggested that this association represents a new ectodermal paraneoplastic syndrome.
Disseminated Superficial Porokeratosis in a Patient with Chronic Liver Disease
Authors: Park Byung Soon , Moon Sang Eun , Kim Jeong Aee
Published: April 2015

A 55‐year‐old male suffering from liver cirrhosis presented with diffuse annular hyper‐keratotic papules of abrupt onset on the trunk and extremities. Histopathologic examination revealed cornoid lamella and eosinophilic spongiosis. He did not receive any medications other than cephalosporin for spontaneous bacterial peritonitis. A review of the literature revealed that three cases developed porokeratosis when their liver function declined and that, in one case, the porokeratosis disappeared spontaneously with liver transplantation. Although the precise mechanism is unclear, there is evidence demonstrating immunoincompetence in cirrhosis. Even though we did not perform immunologic studies or exclude the possibility of drug‐induced porokeratosis in our case, it is conceivable that porokeratosis can be triggered by immunosuppression due to liver cirrhosis per se.
Scaling Lichenoid Eruptions and Sjögren‐like Syndrome: Manifestations of Nonfatal Postoperative Transfusion‐Associated Graft‐versus‐Host Disease?
Authors: Tanei Ryoji , Yamamoto Tatsuo , Yokono Hideki , Motoori Tadashi
Published: April 2015

We report a case of an 81‐year‐old woman in whom lichenoid eruptions and Sjögren‐like sicca syndrome developed 45 days after cholecystectomy. During surgery, one unit (130 ml) of unirradiated packed red blood cells from a male donor was transfused. The lichenoid eruptions cleared up with exfoliation; however, sicca symptoms remained during the follow‐up period of four years. Histological examinations of both skin and lip biopsy specimens were in agreement with those of graft‐versus‐host disease (GVHD). A Y‐chromosomal body was identified in the lymphocytes in the skin lesion by staining with quinacrine dihydrochloride and in the lip lesion by a method with in situ hybridization. The findings suggest that this case demonstrated the manifestations of non‐fatal transfusion‐associated GVHD.
Inflammatory Nodules of the Lower Legs: A Clinical and Histological Analysis of 134 Cases in Korea
Authors: Cho Kwang Hyun , Kim Young Gull , Yang Seong Gyu , Lee Dong Youn , Chung Jin Ho
Published: April 2015

We analysed 134 Korean cases with inflammatory nodules of the lower legs on the basis of clinicopathological findings, responsiveness to various therapeutic agents, and clinical course. There were 53 cases of erythema induratum (EI), 18 of erythema nodosum (EN), 40 of EN‐like lesions of Behçet's disease, 15 of other entities, including superficial migratory thrombophlebitis, cutaneous periarteritis nodosa, sarcoidosis, malignant lymphoma, Churg‐Strauss syndrome, and parasitosis, and eight unclassified cases. The unclassified group was composed of a spectrum of diseases with clinicopathologic features ranging between those typical of EN and EI. The present study revealed that the profiles of diseases featuring inflammatory nodules of the lower legs in Korea differed from those found in other areas. These geographic and demographic differences should be kept in mind when managing a patient with inflammatory nodules of the lower legs.
A Case of Triple Extramammary Paget's Disease
Authors: Koseki Shin , Mitsuhashi Yoshihiko , Yoshikawa Kenichi , Kondo Shigeo
Published: April 2015

We report a 74‐year‐old Japanese man with triple extramammary Paget's disease; the genital and both of the axillar regions were simultaneously involved. Literature review revealed that 27 cases of triple extramammary Paget's disease have been reported in Japan, but there are no reports of triple extramammary Paget's disease from countries other than Japan, although 2 cases of double extramammary Paget's disease are reported. In all 28 cases, including our case, the genital lesion preceded the axillary lesions. All cases except one were male and only the exceptional female case was reported to have an the invasive tumor in the dermis. We speculate that extramammary Paget's disease may appear multi‐centrically.
A Case of Eccrine Poroma with Multiple Transepidermal Elimination
Authors: Arai Kazumori , Fujita Hiroshi , Suzuki Makoto , Iwasaki Kayoko
Published: April 2015

The skin functions to eliminate foreign substances through the epidermis to the epidermal surface; this process is called transepidermal elimination (TEE). TEE has been observed in various skin tumors. We encountered a 64‐year‐old male patient with eccrine poroma with marked TEE. A dark brown nodular papule appeared on the anterior aspect of his right leg about 20 years ago and gradually expanded. Histopathologically, cell nests of poroma were extruded to the epidermal surface at several sites. No erosion was noted, and mild to moderate inflammatory cell infiltration was observed in the upper layer of the dermis.

According to Mehregan's classification, the TEE phenomenon observed in our case may correspond to types 2 and 3.
Microscopically Controlled Surgical Excision Combined with Ultrapulse CO2 Vaporization in the Management of a Patient with the Nevoid Basal Cell Carcinoma Syndrome
Authors: Krunic Aleksandar L. , Viehman Greg E. , Madani Shabnam , Clark Robert E.
Published: April 2015

Nevoid basal cell carcinoma syndrome is an autosomal dominant condition characterized by multiple basal cell carcinomas, skeletal abnormalities and sometimes mental retardation. The large number of tumors, which are often disfiguring, presents extreme difficulties in the treatment of these patients. Microscopically controlled excision, compared to other modalities (radiation therapy, photodynamic therapy, intralesional interferon alpha‐2b) offers the highest cure rate. However, because of the large size and involvement of wide areas of the skin, this approach is sometimes impractical. The ultrapulse CO2 laser with high energy and short pulses achieves char‐free ablation of the tumors, bloodless surgical field, minimal nonspecific thermal damage, rapid healing and diminished postoperative pain. Also, a number of lesions can be removed in a single session.

We present a 48‐year‐old man with a 6.5 × 4.5 cm large basal cell carcinoma involving the anterior abdomen and navel area. The central thick portion of the tumor was resected by microscopically controlled excision with 3 stages, and wide thinner peripheral crescentic plaque vaporized with ultrapulse CO2 laser. The laser settings were 300 mJ energy/pulse and 100 W average power, which corresponds to the fluence of 7.5 J/cm2. Computerized pattern generator (ultrascan handpiece) was adjusted to patterns of 3 (circle) and 1 (square) with sizes varying from 5 to 7, and density of 9 (60% overlapping). The tumor was vaporized with 6 passes, all the way to deep reticular dermis. A fifteen month‐follow up disclosed no recurrent disease. Subsequent biopsies revealed only a scar with postinflammatory hyperpigmentation.

Our experience indicates that combined treatment with microscopically controlled excision and ultrapulse CO2 laser ablation is a suitable modality for the large tumor plaques involving concave and convex areas of the skin respectively. Microscopically controlled excision of thicker, concave portions of basal cell carcinoma plaques, where CO2 laser surgery is less feasible, presents an effective addition that renders this combined modality a successful method for the treatment of nevoid basal cell carcinoma syndrome.
An Erythema Multiforme‐like Eruption Caused by Exposure to 1‐Chloromethylnaphthalene
Authors: Urano Shoko , Tokura Yoshiki
Published: April 2015

A young male patient developed an erythema multiforme‐like eruption following an accidental exposure to 1‐chloromethylnaphthalene (1‐CMN). In addition to the skin lesion, he suffered from liver involvement and tear insufficiency. Positive results of a patch test with 1‐CMN and an in vitro lymphocyte transformation test suggested that direct exposure of the skin to chemical compounds was the probable cause of his symptoms.
Drug Eruption (Erythema Multiforme Type) Due to a Digestive Enzyme Drug
Authors: Miyoshi Hayao , Kanzaki Tamotsu
Published: April 2015

An 84‐year‐old Japanese male had pruritic indurated erythema on his upper limb and left lower abdomen, which had developed abruptly two months before visiting our hospital. Hematological examination showed eosinophilia, 550/mm3. Histopathological findings were suggestive of erythema multiforme in response to a drug. By means of patch tests and a p.o. challenge test, Aczym®, a digestive enzyme drug, was shown to be the cause of his condition. Further study revealed that the specific ingredients involved were pancreatin and Taka‐diastase. An eruption resulting from ingestion of a digestive enzyme drug has not previously been reported.
An Autopsy Case of Dermatomyositis with Rapidly Progressive Diffuse Alveolar Damage
Authors: Nobutoh Toshiko , Kohda Mamoru , Doi Yumiko , Ueki Hiroaki
Published: April 2015

A 47‐year‐old woman visited a clinic with dyspnea which had continued for two months and was followed by general fatigue and fever. Antibiotics were not effective. Edematous erythema occurred on her face, elbows, knees and feet, and she entered our hospital. A skin biopsy revealed interface dermatitis with severe edema and mucinosis in dermis. Diffuse bilateral infiltration was observed in the chest X‐ray, and laboratory findings showed increased LDH, GPT, GOT and CPK. No antinuclear factor was detected. Her respiratory condition rapidly worsened, and she died eight days after hospitalization in spite of corticosteroid pulse therapy. The autopsy revealed that the main cause of death was diffuse alveolar damage (DAD).

Interstitial pneumonia related to dermatomyositis is not histologically uniform; the response to the therapy depends on its histological type. The patients with dermatomyositis who have poor prognosis are clinically characterized by acute onset with general symptoms and less pronounced muscle weakness; they generally show DAD in their lungs. We need to establish a simple method for distinguishing histological types of interstitial pneumonia and adequate therapy for each one.
Disseminated and Recurrent Infundibular Folliculitis (D.R.I.F.): Report of a Case Successfully Treated with Isotretinoin
Authors: Aroni Kiriaki , Aivaliotis Markos , Davaris Panagiotis
Published: April 2015

Disseminated and recurrent infundibular folliculitis, henceforth referred to as D.R.I.F., is a very rare, puritic, follicular, benign disease of unknown etiology seen mostly in black males. It is often self‐limited and usually unresponsive to local or systemic treatment. However, vitamin A, either alone or combined with vitamin E, is occasionally effective. We report a case of a patient with D.R.I.F. treated successfully with isotretinoin.
Is the Heredity of Reticulate Acro Pigmentation of Kitamura always Autosomal Dominant?
Authors: Singal Archana , Bhattacharya Sambit Nath , Baruah Manik Chand , Indrayan Abhay , Singh Navjeevan
Published: April 2015

Reticulate acropigmentation of Kitamura (RAK) in three patients and their families is described. In one family, 2 women and 2 men were affected out of 9 individuals. In the other family, 6 women had lesions of reticulate acropigmentation out of total of 27 over three generations. In the third family, one man was affected. All of the cases had palmar pits; onset of lesions was after puberty in all the cases. The apparently different hereditary patterns in these three families are striking, and autosomal dominant inheritance appears unlikely in every case.
A Case of Subungual Osteochondroma
Authors: Kim Seok Woo , Moon Sang Eun , Kim Jeong Aee
Published: April 2015

Subungual osteochondroma is a rare form of benign bone tumor characterized by distinctive histopathological and radiological findings. The major clinical manifestation is a firm mass with tenderness. It must be differentiated from other similar diseases such as subungual exostosis, glomus tumor, and enchondroma to determine the proper surgical procedure.

A 13‐year‐old boy had a history of a growing tender mass on the right third toe which recurred after simple excision. He was treated by careful dissection and total excision under local anesthesia. Histologic findings included a trabecular bone formation covered with hyaline cartilage cap and were compatible with osteochondroma.