bluuebunny/crossref_metadata_2025 huggingface dataset:
Congenital Rubella Syndrome with Rubella Virus‐associated Generalized Brownish Macules, Indurated Erythemas, Papules, and Pigmentation
Authors: Seno Akemi , Tada Joji , Matsuura Hironori , Arata Jirô , Isomura Hiroki , Kitamura Tetsuro , Oda Megumi , Katow Shigetaka
Published: April 2015

Background

We examined an infant with congenital rubella syndrome (CRS). The purpose of this report is to describe the skin manifestations in this patient and to prove that they were associated with rubella virus.

Observations

A 7‐month‐old boy presented with generalized brownish macules, indurated erythemas, papules, and pigmentation. They first appeared at around 3 months of age. His mother had contracted rubella during the 14th gestational week. At the time of examination, rubella‐specific IgM antibody was positive in both serum and cerebrospinal fluid of the baby. A physical exam had revealed deafness, mental and physical retardation, interstitial pneumonitis, and hepatosplenomegaly. A skin biopsy specimen showed a dense infiltration mainly of lymphocytes, with B cells predominant in the deep dermis. Electron microscopically abundant tubuloreticular structures were observed in capillary endothelial cells, lymphocytes, and dermal fibroblasts. Polymerase chain reaction (PCR) analysis suggested that rubella virus RNA was present in the patient's skin specimen, cerebrospinal fluid, and total blood.

Conclusions

The cutaneous manifestations of our patient were extraordinary and informative. These prominent skin lesions should be recognized as cutaneous markers of CRS.
Photocontact Allergy Due to Suprofen
Authors: Kuno Yoshinori , Numata Tokio
Published: April 2015

A 79‐year‐old Japanese woman developed edematous erythema on sun‐exposed areas 3 months after applying Sulprotin® ointment, which contains 1% suprofen (SP), a phenylacetic acid derivative. A patch test with Sulprotin® ointment as is was negative, but a photopatch test with Sulprotin® ointment as is was positive. A photopatch test with 10–3% SP was positive, as was that obtained with an SP analogue, 3% ketoprofen, but that with the ointment base of Sulprotin® was negative. Photopatch tests with other SP analogues such as flurbiprofen, ibuprofen, and pranoprofen were negative. She developed abnormal erythema with monochromatic irradiation in the range from 320 to 380 nm on the uninvolved abdominal skin where 1% SP had been applied 24 hours (h) before irradiation. The action spectrum for this erythema agreed with the absorption spectrum of SP in the range of UVA. The MED after applying SP was below that after applying w. pet. in the range from 250 to 290 nm and from 300 to 320 nm. Positive intracutaneous test results were obtained with an irradiated mixture of human serum albumin (HSA) and SP at 48 and 72 h after injection and negative ones with a mixture of HSA and irradiated SP.
Melanosis Riehl‐like Facial Pigmentation in a Japanese Case of AIDS
Authors: Hanada Katsumi , Hashimoto Isao , Baba Takako , Tamura Toyokazu , Kishibe Susumu
Published: April 2015

An AIDS patient with the cardinal complaint of severe pigmentation on the face is reported. Hyperpigmentation is an unusual symptom of AIDS. This is a Japanese patient who presented melanosis Riehl‐like discoloration. The importance of pigmented lesions in patients who have not been given any anti‐HIV agents has not been emphasized in the literature.
Relationship between Porphyria Cutanea Tarda (PCT) and Viral Hepatitis
Authors: Tsukazaki Naoko , Tanaka Keiichi , Irifune Hiroko , Yoshida Hikotaro , Watanabe Masahisa , Ohgami Taro , Nonaka Shigeo
Published: April 2015

Recent reports have revealed the high prevalence of serological markers of viral hepatitis in porphyria cutanea tarda (PCT). We present two cases of PCT associated with hepatitis C and discuss the relationship between PCT and viral hepatitis. Case 1: A 50‐year‐old Japanese male noticed blisters, erosions, and fragility on sun‐exposed areas of his skin in November of 1990. He had no history of excessive alcohol intake. He had been taking analgesics for eighteen years. Case 2: A 64‐year‐old Japanese male was referred in October of 1989 because of pigmentation on sun‐exposed areas of his skin. He had been drinking alcohol excessively for 43 years. The hepatitis C virus (HCV) antibody was present in each case. Tests for the HCV antibody and hepatitis B serological markers were run in 5 other patients. HCV antibody was present in 3 of them. The two cases negative for the HCV antibody exhibited the hepatitis B antibody. We speculated that viral hepatitis infection may play an important role in precipitating PCT in cases with a history of a long term excessive intake of alcohol or chemicals.
Photoleukomelanodermatitis (Kobori) Induced by Afloqualone
Authors: Ishikawa Takeshi , Kamide Ryoichi , Niimura Michihito
Published: April 2015

We reported a case of photoleukomelanodermatitis (Kobori) type drug eruption due to afloqualone (Arofuto®). The patient was given afloqualone and imipramine hydrochloride (Chrytemin®) for cervical spondylosis from November of 1990. Edematous erythema with slight itching appeared on the sun‐exposed areas in December of 1990. As drug eruption was suspected, drugs were ceased, and the cutaneous lesions almost disappeared but pigmentations and depigmentations developed in spots in sun‐exposed areas in March of 1991. Photopatch and oral challenge tests were positive.
Giant Metastatic Malignant Melanoma with an Unknown Primary Site
Authors: Morita Kazumasa , Kudo Hitoshi , Fujii Kimio , Okamoto Hiroyuki , Matsubara Kunio , Kanauchi Hideo , Imamura Sadao
Published: April 2015

We report a case of malignant melanoma of unknown primary origin which presented with a giant metastatic tumor in his right inguinal region. A 94‐year‐old man noticed a small subcutaneous tumor in the right inguinal region 3 years earlier, which eventually became as large as 9 cm in diameter without treatment. Although a histological examination of the lesion showed malignant melanoma, extensive examination did not reveal its primary lesion or any metastasis other than that to the right inguinal area. Our case took an interesting course in that this well‐growing metastatic tumor was localized in only one region and supported a previous report indicating that malignant melanoma with unknown primary origin has a low tendency to metastasize and a relatively good prognosis.
Lichen Sclerosis et Atrophicus with Prominent Teleangiectasia
Authors: Kanekura Takuro , Kawamura Kyoko , Kanzaki Tamotsu
Published: April 2015

Lichen sclerosis et atrophicus is characterized by the development of well demarcated, depigmented macules with epidermal atrophy. Hemorrhage occurs occasionally; however, teleangiectasia is seldom remarkable.

We studied a case of lichen sclerosis et atrophicus with striking teleangiectasia which involved a 62‐year‐old male who was suffering from this disorder on his upper back. An initial lesion had been excised 15 years earlier. Thirteen years after the original surgery, he noticed a similar skin eruption accompanied by teleangiectasia that had recurred around the surgical scar.

We present here a detailed description of this case and provide a short review of the literature.
Comparative Study of Staphylococcal Flora on the Skin Surface of Atopic Dermatitis Patients and Healthy Subjects
Authors: Ogawa Tadatomo , Katsuoka Kensei , Kawano Kyoko , Nishiyama Shigeo
Published: April 2015

Bacterial samples were obtained from the facial and forearm skin of atopic dermatitis (AD) patients and healthy subjects in humid summer weather. Staphylococcus (Staph) species bacteria were selectively sampled by a plate‐contact technique using mannitol salt medium‐coated film. Staph species were isolated from the film after the number of colonies was counted, and the species were determined by the API‐Staph system and coagulase test. Large numbers of S. aureus were isolated in the samples from the facial skin of patients with severe dermatitis, as previously reported. The number of S. aureus colonies in the samples from the forearm skin of the patients was significantly greater than from the healthy subjects; the mean and standard deviation of colony forming units per 10 cm2, expressed as log10 value, were 1.64 ± 0.96 for patients and 0.02 ± 0.07 for healthy subjects (p<0.01). One hundred and seventeen strains were isolated, and their sensitivities to ten antibiotics were tested. Ten of the strains were resistant to some antibiotics; all of these were isolated from patients. Penicillin type antibiotics had weak effects, but cephem type had strong effects. The number of S. aureus colonies isolated in this study was compared with the number isolated during the winter, in our previous study, in order to identify seasonal variations. The only significant seasonal difference was on the forearm skin of the AD patients, which had significantly more S. aureus colonies (p<0.01) in this study. There were no significant seasonal differences in S. aureus numbers on the facial skin of patients or healthy subjects.
Accuracy in the Clinical Diagnosis and Pattern of Malignant Melanoma at a Dermatological Clinic
Authors: Lindelöf Bernt , Hedblad Mari‐Anne
Published: April 2015

The diagnostic pattern of malignant melanoma and clinical suspicion rate has been investigated at a dermatological university clinic. Of 174 histologically proven malignant melanomas, 60 (34%) were not clinically suspected as melanomas. The accuracy of clinical diagnosis increased with level of experience. Physicians with <1 year experience in dermatology were able to detect malignant melanoma as the first diagnosis in 31% of the cases in contrast to 63% for those with >10 years experience. Of 50 patients immediately referred from the dermatologic clinic to surgery departments, 12 did not have melanoma.
Pathogenesis of Mucocutaneous Lesions in Behçet's Disease
Authors: Inoue Chiyuki , Itoh Rie , Kawa Yoko , Mizoguchi Masako
Published: April 2015

Behcet's disease (BD) is characterized by recurrent oral aphthae, skin lesions, eye lesions, and genital ulceration. To determine the pathogenesis of BD, we performed histological and immunohistochemical studies of these mucocutaneous lesions, an assay of neutrophil activity, and HLA typing.

Dense dermal or subcutaneous infiltrations of polymorphonuclear cells (PMN) without leukocytoclastic vasculitis were found in 28 of 57 lesions. Immunohistochemically, deposits of C3 on the vessels were found in 12 of 31 lesions. Deposits of immunoglobulin were not found except for one of IgM. C3 deposits and PMN infiltrations were significantly related (p<0.05). PMN activity by polarization was enhanced; however, the results did not show a significant relationship with the PMN infiltrations or the C3 deposits. The incidence of HLA‐B51 was significantly high in BD, but no significant relationship was found between HLA‐B51 and the results of other examinations.

These results suggest that the pathogenesis of BD lesions differs from that of collagen diseases and that C3 deposits on the vessels may play an important role in the development of mucocutaneous lesions where PMN have mainly infiltrated.
Systematized Epidermal Nevus with Profuse Papillomatous Flexural Lesions
Authors: D'Souza Mariette , Garg Bhagat Ram , Ratnakar Chiganti
Published: April 2015

A case of systematized epidermal nevus with profuse papillomatous flexural lesions is reported for its striking morphologic features and unusual variations in histopathology at different sites.
Bilateral Periorbital Eccrine Hidrocystoma
Authors: Yasaka Nami , Iozumi Ken , Nashiro Kiyoko , Tsuchida Tetsuya , Seki Yoshihito , Furue Masutaka , Takayama Osami , Shimada Shinji , Tamaki Kunihiko
Published: April 2015

We saw four patients showing identical features as cystic lesions on the bilateral external canthi. Histological examination showed cystic cavities in the dermis. Histological and enzyme histochemical findings suggest that these cystic tumors are of eccrine origin. Thus we diagnosed these cytic tumors as eccrine hidrocystoma with characteristic clinical feature. The recognition of this feature would help to correctly diagnose these eccrine hidrocystoma.
Infantile Myofibromatosis: Report of Two Cases
Authors: Sonoda Tadashige , Itami Satoshi , Seguchi Syunnichiro , Kurata Sotaro , Takayasu Susumu
Published: April 2015

Two cases of solitary type infantile myofibromatosis (IM) were presented. Case 1 was a 6‐month‐old male infant with a firm, dark red, fixed tumor on his right knee. A computerized tomographic scan revealed that the tumor was attached to the underlying muscle. Case 2 was a 1‐month‐old male infant with a tumor on his right knee, similar to that in case 1. In neither case was there any clinical evidence of visceral involvement. Histological and immunohistochemical findings were similar. The lesions appeared histologically as non‐encapsulated nodules composed of whorled fascicles of spindle‐shaped cells and a vascular element with a hemangiopericytoma‐like appearance. The tumor cells were positively stained with PTAH. They were positive for α‐smooth muscle actin and vimentin, but negative for desmin. These findings support the myofibroblastic nature of IM. In case 2, the tumor regressed spontaneously at the age of 12 months. Unlike the multicentric form, spontaneous regression of the solitary form of IM has not previously been reported.
Subgaleal Angiomyolipoma
Authors: Tamura Atsushi , Ishikawa Osamu , Miyachi Yoshiki
Published: April 2015

A case of angiomyolipoma found in the subgaleal lesion is reported. Lipoma appearing between the galea and periosteum of the frontal bone is called subgaleal or subfascial lipoma and usually consists histopathologically of mature fat cells. We experienced a case of so‐called subgaleal lipoma; however, the distinctive histologic features of our case were the proliferation of non‐striated muscle fibers and small vessels scattered throughout the mature fat cells, which were compatible with angiomyolipoma. Extrarenal angiomyolipoma, especially cutaneous angiomyolipoma, are very rarely mentioned in the literature. Our case is the second reported patient with angiomyolipoma in the subgaleal location.
Identification of a Novel cDNA Clone Encoding Protein Tyrosine Kinase in Murine Skin
Authors: Kawachi Yasuhiro , Nakauchi Hiromitsu , Otsuka Fujio
Published: April 2015

Tyrosine phosphorylation is widely recognized as playing important roles in cell differentiation, proliferation, and carcinogenesis. We have used the polymerase chain reaction (PCR) method to identify protein tyrosine kinases that are expressed in the skin. Mixed oligonucleotide probes were used to amplify and screen a neonatal murine skin cDNA pool for clones encoding amino acid contiguities whose conservation is characteristic of the protein tyrosine kinase family. When the PCR products were sequenced, 13 distinct clones were found, of which one is novel to date and has provisionally been named tks (for tyrosine kinase identified from skin). Sequence homology comparison showed that the tks gene is homologous to the src and fes/fps families. Northern blotting using PCR products of tks as a probe revealed that the mRNA of tks is detected ubiquitously and weakly in other tissues such as brain, lung, liver, thymus and kidney. This fact suggests that the tks gene is expressed in widely distributed cell types.
Growth‐promoting Effect of Bacterial Products from Clostridium perfringens on Human Keratinocytes
Authors: Takada Akiyoshi , Hashimoto Koji , Yoshikawa Kunihiko
Published: April 2015

Wound healing substance (WHS) from cultured Clostridium perfringens has been reported to be effective in the treatment of wounds. The effects of WHS, now named SNK‐863, on proliferation and differentiation of human keratinocytes were examined.

The characteristics of WHS are as follows: 1) WHS stimulates human keratinocyte growth and DNA synthesis; 2) WHS and EGF show some additive effects on human keratinocyte growth; 3) WHS does not interfere with the binding of EGF to its receptor; 4) WHS does not counteract the growth inhibitory effects of TGF‐β or vitamin D3 on human keratinocytes; 5) WHS has no significant effect on human keratinocyte differentiation. These results indicate that the growth‐promoting effect of WHS on keratinocytes may contribute to the treatment of wound healing.
A New Approach to the Evaluation of Broad‐spectrum Sunscreens against Ultraviolet and Visible Light‐induced Delayed Tanning
Authors: Kawada Akira , Morimoto Koukichi , Hiruma Masataro , Noda Toshiaki , Ishibashi Akira
Published: April 2015

Protection against UV and visible light‐induced delayed tanning (DT) and immediate tanning (IT) of two broad‐spectrum sunscreens with the same sun protection factor was investigated. Protection factors (PFs) against DT (24 h and 7 days) of the sunscreens differed significantly, but PFs against IT did not. This study indicates that using PF against 24 h DT is more appropriate for an evaluation of broad‐spectrum sunscreens against UVA and visible light than IT.
Sympathetic Ganglion Blockade for the Management of Hyperhidrosis
Authors: Kobayashi Kinuko , Omote Keiichi , Homma Eiji , Abe Tatsuhiko , Iitoyo Miyuki
Published: April 2015

We present three patients with severe primary hyperhidrosis, refractory to conservative medical treatment, who were successfully managed with sympathetic ganglion blockade with ethanol. We also summarize 10 patients with hyperhidrosis who underwent sympathetic ganglion blockade in the past 2 years. This closed percutaneous method offers the patients considerably less discomfort and less stress with minimal morbidity and has a efficacy similar to that of surgical sympathectomy, which has previously been the only effective and permanent therapy for severe primary hyperhidrosis. It is concluded that chemical sympathectomy is an effective and useful method for treating severe hyperhidrosis which has advantages over surgical sympathectomy.
Male Genital Herpes Complicated with Urethral Infection
Authors: Yoshida Masami , Hondo Ryo , Tezuka Tadashi , Hiruma Masataro
Published: April 2015

A 26‐year‐old man had a primary infection or reinfection of genital herpes due to herpes simplex virus (HSV) type 2 complicated with herpetic urethritis. By analysis of the restriction endonuclease digestion pattern of the viral DNA, two isolates, one from the penile lesion and one from the urethra, were identified as the same strain.
The Effects of Sunscreens on UVB Erythema and Langerhans Cell Depression
Authors: Miyagi Tsuguna , Bhutto Abdul Manan , Nonaka Shigeo
Published: April 2015

Langerhans cells (LCs) are epidermal antigen‐presenting cells capable of initiating a specific T lymphocyte‐mediated immune response. It is a well known fact that ultraviolet light B (UVB) suppresses LC number and function.

In this study, we confirmed that the sunscreens CITY BLOCK, and TOTAL SUN SHIELD 28 (Clinique Laboratories Tokyo, Japan) protected the epidermis against the depletion of LC number. We also investigated whether or not sunscreens could provide LC protection from ultraviolet ray (UVR) damage other than the prevention of the decrease in the total number of cells.

Our data showed that the LC population was depressed after irradiation by 100 mJ/cm2 or 10 mJ/cm2 of UVB, but recovered to within normal levels after 16 days. Both sunscreens provided protection against erythema and LC depression due to UVB irradiation. However, despite the fact that these sunscreens had completely suppressed UVB erythema, shrinkage of LC dendrites was seen. Apparently, sunscreens prevent UVB erythema, but do not protect against functional changes in LC due to UVB.

Recently, it has been reported that sunscreens are less effective in protecting against systemic immunosuppression that against inflammation. The shrinkage of LC dendrites despite sunscreen application may help explain this discrepancy.
Diagnostic Approach to Autoimmune Blistering Diseases Using Immunoblotting with Chemiluminescence
Authors: Kitamura Tetsunori , Tamada Yasuhiko , Takama Hiromichi , Yokochi Kikuka , Nitta Yukiko , Ikeya Toshihiko
Published: April 2015

Autoantibodies in sera from patients with autoimmune blistering diseases were detected by immunoblotting with chemiluminescence. This method provided the high sensitivity in the detection of autoantibodies against human epidermal extract. It was useful for detecting low titers of autoantibodies, and identifying small amounts of autoantigens in antigen extracts.
Pyoderma Gangrenosum in Childhood: Case Report
Authors: Venkateswaran Sri , Garg Bhagat Ram , Reddy Belum Sivanagi , Ratnakar Chaganti
Published: April 2015

Two cases of pyoderma gangrenosum occurring in children after an exanthem are reported because of rarity and clinical interest.
Ultrasonographic Demonstration of a Skin Metastasis of Adenocarcinoma
Authors: Ichioka Shigeru , Yamada Atsushi
Published: April 2015

A case of skin metastasis of adenocarcinoma on the back of a 69‐year‐old female was reported. The ultrasound appearance of the tumor indicated a malignant lesion prior to the detection of a primary lung carcinoma.
Wegener's Granulomatosis Successfully Treated with Prednisolone and Potassium Iodide
Authors: Torinuki Wakio
Published: April 2015

Wegener's granulomatosis has traditionally been treated with steroids and cyclophosphamide. We used potassium iodide in conjunction with prednisolone to treat a patient with a limited form of this disease who had gangrenous rhinitis and skin involvement including necrotic papules and ulcerations. After three months of this therapy, the mucosal and cutaneous lesions had almost completely disappeared.
Detection of Human Papillomavirus Type 60 in Plantar Cysts and Verruca Plantaris by the In situ Hybridization Method Using Digoxigenin Labeled Probes
Authors: Kawase Masaaki , Honda Manko , Niimura Michihito
Published: April 2015

Background

Since 1987, many cases have been reported in which human papillomavirus (HPV) could be associated with epidermoid cysts of the palms and soles. In 1989, the HPV found in an induced epidermoid cyst was cloned and named HPV 60.

Objective

Our purpose was to examine the relationship of HPV 60 to plantar cysts.

Methods

Ten cases of plantar cysts and two cases of verruca plantaris containing single inclusion bodies were obtained by biopsy and examined by the in situ hybridization (ISH) method with a digoxigenin labeled HPV 60 DNA probe.

Results

Six of ten cases were found to have cytopathic effect (CPE) in the cyst wall and inner contents of the cyst. HPV 60 was detected in these cases by ISH. Two cases of verruca plantaris showing CPE also demonstrated the presence of HPV 60. Of the six HPV type 60 positive cases, four cases also showed CPE in the overlying epidermis.

Conclusion

At first, punctate keratotic lesions are induced by HPV 60. HPV 60 induces irregular elongation of the rete ridges into the dermis. Plantar cysts probably form as a result of the traumatic implantation of HPV 60 infected epidermis with irregularly long and narrow rete ridges into the dermis.
Immunopathologic Demonstration of MAC387+ UCHL1+ Cells in Bullous Skin Diseases
Authors: Zou Ming‐xi , Chen Qi‐jie
Published: April 2015

Immunopathologic aspects of bullous skin diseases were studied in paraffin sections of thirty‐three skin biopsy specimens utilizing monoclonal antibodies directed against histiocytes, helper/inducer T lymphocytes, and Langerhans cells in skin lesions. Laboratory examinations revealed that either more or fewer of the standard number of helper/inducer T lymphocytes (UCHL1+) were observed in the upper dermis in 84.8% of the cases examined, particularly in the various forms of pemphigus; histiocytes (MAC387+) were also found to occur in the upper dermis in 45.5% of the cases and in blisters in 27.3% of the cases, particularly in pemphigus erythematosus and dermatitis herpetifomis. In 54.5% of all the cases, both UCHL1+ and MAC387+ cell infiltrates predominated in the upper dermis. These findings suggest that a cell‐mediated immune response may also be important in the pathogenesis of bullous skin diseases. It may be possible that antigen from keratinocytes can produce ETAF, and that IL1 activating T lymphocytes and histiocytes also produce IL1 activating T cells, particularly helper/inducer T cells. Such activities would further promote the increase of B cell function and immunoglobulin synthesis.
Clinical and Immunohistochemical Studies of Skin Eruptions: Relationship to Administration of Interferon‐α
Authors: Toyofuku Kazutomo , Imayama Shuhei , Yasumoto Shin‐ichiro , Kiryu Hiromaro , Hori Yoshiaki
Published: April 2015

We observed transient, erythematous skin eruptions in 6 patients during the intravenous administration of interferon (INF)‐α for chronic active hepatitis C. The eruptions appeared 5 to 14 days (mean: 6.8 days) after initiating its administration. They were localized or disseminated and consisted of edematous, erythematous, and/or papular changes. Vesicles and petechiae also appeared in some cases. The eruptions disappeared in 10 to 14 days, despite the continuance of INF‐α and without specific treatment.

Histological examination obtained from skin eruptions revealed perivascular infiltration of lymphoid cells, the majority which were CD4‐positive, of the upper dermis. Edematous changes were present in the papillary dermis. Vascular endothelial cells in the upper dermis expressed both intercellular adhesion molecule‐1 (ICAM‐1) and endothelial leukocyte adhesion molecule‐1 (ELAM‐1), while the epidermal keratinocytes produced neither. These findings suggested a nonallergic mechanism for such eruptions.
An Aggressive Spindle Cell Squamous Carcinoma Arising in a Patient with Long‐standing Erythroderma
Authors: Matsumura Tetsuri , Kumakiri Masanobu , Sato‐Matsumura Kazuko C. , Koizumi Hiroko , Ohkawara Akira , Tanifuji Junji , Yoshida Yutaka
Published: April 2015

Spindle cell squamous carcinoma (SCSC) of the left hand arising in a patient with longstanding erythroderma is reported. Histopathologically, spindle shaped atypical cells were observed neighboring the cells of well differentiated squamous cell carcinoma. These two types of tumor cells, spindle cells and well differentiated cells, were present side by side and merged into each other. The erythroderma had been present for over 20 years, and both clinical and histopathological findings suggested cutaneous T cell lymphoma, but were not diagnostic for mycosis fungoides, Sézary syndrome, or adult T cell lymphoma. Flow cytometry of peripheral blood cells showed a low CD4/CD8 ratio which suggested impaired T cell function. Multiple metastases of SCSC occurred in a short period and the patient died ten months after his first visit to us. The aggressive course of this case was unusual, and may be due to immunological abnormalities associated with the long standing erythroderma with impaired T cell function.
Functional Morphology of Lesions of Psoriasis Vulgaris Transplanted into Nude Mice at an Early Stage
Authors: Ueda Keiichi , Yanagihara Makoto , Nakagawa Shigemitsu , Fujita Tomozou
Published: April 2015

We examined the growth and differentiation of transplanted psoriatic skin in nude mice at an early stage. Psoriatic lesions from three patients were biopsied. Each biopsied specimen was cut into five blocks, which were individually transplanted to nude mice by the embedding method. Two weeks later, growth and differentiation of transplanted specimens were examined by bromodeoxyuridine (BrdU) labelling method and by electron microscopy. Electron microscopically, basal cells were longitudinally high, and the cellular processes were elongated. Basal laminae were multilayered. In the cytoplasm of the basal cells, many mitochondria, endoplasmic reticula, and ribosomes were seen, and tonofibrillar formation was poor. In cell groups in the upper parts of these lesions, both nuclei and cytoplasm showed degeneration. Psoriatic skin transplanted to nude mice exhibited newly formed psoriatic skin and initial epidermal necrosis. The BrdU labelling method labelled cells scattered in the lower part of the epidermis. Psoriatic skin transplanted to nude mice resembled that before transplantation in both ultrastructural findings and growth pattern.
A Case Report of Infiltrating Ductal Carcinoma Originating from Aberrant Breast Tissue
Authors: Youn Sang No , Kim Young Keun , Park Young Lip
Published: April 2015

We report a case of carcinoma originating from aberrant breast tissue in a 32‐year‐old female who had a soft subcutaneous mass on the anterior axillary fold. Histopathologic examination showed an infiltrating ductal carcinoma of aberrant breast tissue without metastasis to lymph nodes. We believe that subcutaneous nodules of uncertain origin around the periphery of the breast and especially in the axilla should always be viewed with suspicion and treated by early excision.
Calcification of Eccrine Poroma
Authors: Yamamoto Toshiyuki , Irifune Ayumi , Katayama Ichiro , Nishioka Kiyoshi
Published: April 2015

Two cases of eccrine poroma with calcification were described, both of which were those of the Winkelmann‐MacLeod type. They occurred on the face and lower leg. We supposed that calcification in both cases was dystrophic in nature due to minor pressure or injury.

The feature of calcification within the nests of eccrine poroma has rarely been reported. However, it seemed to be physiologically consistant that calcification occurs in eccrine poroma which originates from eccrine sweat glands.
The Correlation of Kampo Formulations and Their Ingredients on Anti‐bacterial Activities against Propionibacterium acnes
Authors: Higaki Shuichi , Hasegawa Yoshinori , Morohashi Masaaki , Takayoshi Yamagishi
Published: April 2015

The correlation between the susceptibilies of Propionibacterium acnes strains to two Kampo formulations and these to their ingredients (Kampo crude drugs) was examined. Two out of 19 Kampo crude drugs, Coptidis Rhizoma (CR) and Phellodendri Cortex (PC), inhibited the growth of P. acnes significantly. The patterns of distribution of the minimal inhibitory concentrations of Keigai‐rengyo‐to (KRT) and of Seijo‐bofu‐to (SBT) were almost the same as those of the Kampo crude drugs, except CR and PC.

Furthermore, no correlations between MICS of Kampo formulations and those of their ingredients against P. acnes were found. This might be due to mutual inhibition or to differences in anti‐bacterial mechanisms between the two Kampo formulations and their ingredients. The Kampo formulations, composed of CR, PC and a few other kinds of Kampo crude drugs, might be more susceptible against P. acnes, since higher concentrations of the effective ingredients can be achieved.
Histopathologic and Ultrastructural Studies of Angiokeratoma Corporis Diffusum in Kanzaki Disease
Authors: Yokota Michiko , Koji Masato , Yotsumoto Shinichi
Published: April 2015

A novel metabolic disease, angiokeratoma corporis diffusum (Kanzaki), was the subject of an extensive histopathologic and ultrastructural study. Findings included dilated lymph and blood vessels in the upper dermis with an orthokeratortic, thickened, horny layer in well developed angiokeratoma. In the early papules, a few sporadic dyskeratotic keratinocytes were present in the epidermis with or without a thickened horny layer. Vesicular clear vacuolation was clearly observed in the cytoplasm of the secretory portion of the eccrine sweat glands, but none was observed in the vascular endothelial cells with hematoxylin‐eosin staining. Using electron microscopy, lysosomal vacuolation was observed in many cell types, including eccrine sweat gland cells, vascular endothelial cells, dermal fibroblasts, dermal neural cells, lymphocytes of peripheral blood in the skin, and glomerular endothelial cells, but none was noted in the epithelial cells of the kidney. Widely dilated vacuoles were found to contain only a small amount of fuzzy filamentous material in the vascular endothelial cells, filamentous or electron‐dense granular substances in fibroblasts, and electron‐dense, lamellated or homogeneous structures in eccrine sweat gland cells and in neural cells. Ultracytochemical examination revealed glycoconjugates in dilated lysosomes. Characteristics of Kanzaki Disease were shown to differ from those of Fabry disease or any other lysosomal storage disease.
A Case of Urticarial Vasculitis Associated with Macroglobulinemia (Schnitzler's Syndrome)
Authors: Morita Akimichi , Sakakibara Shigeru , Yokota Michiko , Tsuji Takuo
Published: April 2015

We report a case of urticarial vasculitis associated with macroglobulinemia in a 50‐year‐old woman. She suffered from intermittent fever with wheals persisting for more than 24 hours. Skin histology revealed perivascular neutrophilic infiltrates with nuclear dusts. Laboratory study demonstrated leucocytosis and a high serum IgM level (2350 mg/dl) with an M component. No overt lymphoid proliferative disease was found. As far as we know, this is the first report of such a case in Japan. Predonizolone and nonsteroidal anti‐inflammatory drugs have proved transiently effective for controlling the urticaria, but not for the IgM gammopathy.
Giant Seborrheic Keratosis on the Frontal Scalp Treated with Topical Fluorouracil
Authors: Tsuji Takuo , Morita Akimichi
Published: April 2015

Giant seborrheic keratosis was observed on the frontal scalp of a 44‐year‐old man. The lesion was successfully treated with topical fluorouracil.
Cortisol Status in Different Types of Leprosy
Authors: Bansal Rakesh , Garg Bhagat R. , Adithan C. , Vasireddi Srinivas S. , Kumar Vijay , Chandra Dinesh
Published: April 2015

Basal plasma cortisol levels in 12 controls and 60 patients with different types of leprosy were within normal limits. They were significantly lower in multibacillary leprosy patients; this abnormality might be due to long standing stress leading to adrenal exhaustion. The plasma cortisol level significantly increased after the ACTH (Synacthen) stimulation test in all of the varieties of leprosy tested, which suggests that the adrenal reserve is maintained in such cases.
Remission of Pustular Psoriasis after Cholecystectomy: Role of Focal Infection in Pustularization of Psoriasis
Authors: Nomura Kumiko , Mizutani Hitoshi , Inachi Shin , Shimizu Masayuki
Published: April 2015

We report an 81‐year‐old male with long lasting psoriasis with exacerbation who showed remission of skin lesions after cholecystectomy. He consulted our clinic for impetiginous skin lesions and was treated with oral antibiotics without improvement. Several days later, he developed right hypochondralgia and was diagnosed with acute cholecystitis with gallstones. After cholecystectomy, the skin lesions significantly improved and disappeared within three weeks. Laboratory examination data indicated that acute inflammatory parameters normalized simultaneously. Although the role of focal infection in psoriasis is obscure, our case emphasizes the importance of focal infection in the pathogenesis of unstable psoriasis.
Treatment of Cutaneous Sarcoidosis with Tranilast
Authors: Yamada Haruyoshi , Ide Akiko , Sugiura Makoto , Tajima Shingo
Published: April 2015

Tranilast is an anti‐allergic drug clinically used for the treatment of atopy or urticaria. The drug has been shown to have an anti‐fibrotic effect as well. We treated two cutaneous sarcoidosis patients with tranilast, resulting in remission within three months of administration. This drug should be an excellent tool for the treatment of other granulomatous diseases.
Staphylococcus aureus Isolated from Nostril Anteriors and Subungual Spaces of the Hand: Comparative Study of Medical Staff, Patients, and Normal Controls
Authors: Namura Shoko , Nishijima Setsuko , Higashida Toshiaki , Asada Yasuo
Published: April 2015

An epidemiologic investigation of methicillin‐resistant Staphylococcus aureus (MRSA) and Staphylococcus aureus (S. aureus) colonization was conducted at Kansai Medical University Hospital between 1990 and 1991. The incidence of nasal and subungual positivity for S. aureus was examined in a total of 156 subjects including inpatients, physicians, and nurses at a ward for dermatology, plastic surgery, and emergency patients, outpatients with atopic dermatitis and other skin diseases, and normal controls. Inpatients were most heavily colonized with MRSA (40.8%), but S. aureus colonization was most frequent in outpatients with atopic dermatitis (95.5%). Not only nostrils, which have been much discussed as a reservoir of S. aureus, but also subungual spaces seemed to be havens of S. aureus. Twelve out of 22 atopic dermatitis patients were positive for S. aureus on skin regions, and coagulase and phage testing showed a correlation between the nasal and skin‐colonizing S. aureus. Coagulase type II and phase type NT (not typable) were the predominant types of S. aureus, including MRSA.
Verrucous Plaque: Unique Morphological Expression of Post‐Kala‐Azar Dermal Leishmaniasis (PKDL)
Authors: Gautam Ram K , Sehgal Virendra N. , Singh Navjeevan
Published: April 2015

Relatively unusual verrucous plaque as well as other expressions of P.K.D.L. are reported in a 46‐year‐old male. The diagnosis was confirmed by the documentation of Leishman‐Donovan bodies in the tissue smears as well as in the cytoplasm of the histiocytes in the tissue section.
A Case of Bowen's Disease with Tissue Eosinophilia
Authors: Nakayama Hidetoshi , Mihara Motoyuki , Mishima Erika , Shimao Shuhei
Published: April 2015

An 85‐year‐old Japanese man with Bowen's disease on the left inguinal area is reported. Most of the inflammatory cells adjacent to the tumor were eosinophils. Tissue eosinophilia spontaneously improved after biopsy.
Bilateral Basal Cell Carcinoma of the Breasts in a Woman
Authors: Núñez María , Marqués Alicia , de las Heras M. Elena , Miralles Enrique S. , Ledo Antonio
Published: April 2015

Basal cell carcinomas (BCC) on covered sites of the body are rare (1). A case of a young woman with superficial basal cell carcinoma of both breasts is described. No history of sun bathing, X‐ray, or arsenical exposure was reported. Simple excision of both lesions was performed without recurrence.
Elevated Serum Insulin‐like Growth Factor‐1 (IGF‐1) Levels in Women with Postadolescent Acne
Authors: Aizawa Hiroshi , Niimura Michihito
Published: April 2015

The purpose of this study was to measure the serum levels of IGF‐1 in women with postadolescent acne compared to normal controls, and evaluate the relationship of these levels to the levels of androgens, in order to investigate the possible role of IGF‐1 in the pathogenesis of acne. Eighty‐two female patients with acne between 20 and 25 years of age and thirty‐one age‐matched control women were studied. We measured the serum levels of total testosterone (T), free testosterone (FT), dihydrotestosterone (DHT), dehydroepiandrosterone sulfate (DHEA‐S), and insulin‐like growth factor‐1 (IGF‐1).

The levels of IGF‐1 in patients with acne (1.26 ± 0.52 U/ml) were significantly (p<0.001) increased over those of controls (0.96 ± 0.32 U/ml). Of 82 acne patients, six (7%) had IGF‐1 levels which exceeded the normal range, but there were no significant correlations between IGF‐1 and T, FT, DHT or DHEA‐S levels or between IGF‐1 and acne severity. Since the measurement of serum IGF‐1 levels is a convenient indicator of GH secretion, the increase of serum IGF‐1 levels seen in some acne patients might reflect an increase of GH.
A Case of Linear Type of Lichen Sclerosus et Atrophicus?
Authors: Izumi Tatsuya , Tajima Shingo
Published: April 2015

We report a case of the linear type of lichen sclerosus et atrophicus (LSA). The patient had linear atrophic lesions from the left upper back to the left hand. Histological findings obtained from the upper back were those of typical LSA. Histology of the forearm showed mild changes suggestive of LSA. There were no histological features suggesting any association with localized scleroderma in either specimen. The relation between LSA and localized scleroderma is unclear at present. This case suggests that there is a linear form in LSA as already recognized in localized scleroderma.
Ichthyosis Bullosa of Siemens: Report of a Sporadic Case
Authors: Kim Soo‐Chan , Hur Won , Won Jin Hyoung , Ahn Sung Ku
Published: April 2015

We report a sporadic case of ichthyosis bullosa of Siemens occurring in a Korean boy. In this report, the varied findings of the clinical features in one subject over five years are presented along with an investigation of the ultrastructural alteration. The patient had suffered from blistering, superficial peeling, and dark‐grey colored lichenified patches on the extremities since infancy. As he grew older, the lesions were more localized to the elbows, knees, buttock and the dorsal aspects of the hands and feet, and were replaced by yellowish, lichenified plaques. Since the original report of Siemens in 1937, nine families including one sporadic case have been reported in the literature. To our knowledge, this is the second report of sporadic case of IBS.
Serum Levels of Soluble CD23 in Patients with Bullous Pemphigoid
Authors: Maekawa Noriko , Hosokawa Hiroshi , Soh Hiromu , Kasahara Mika , Izumi Hiroshi , Yodoi Junji , Asada Yasuo
Published: April 2015

In this study, we tested the serum levels of soluble CD23 (sCD23) in 27 bullous pemphigoid (BP) patients and compared them with the disease activity. Soluble CD23 is the cleaved portion of the low affinity Fc receptor for IgE (FcɛRII/CD23) which has an affinity for IgE and regulates IgE synthesis. Although bullous pemphigoid (BP) is a subepidermal blistering disease characterized by IgG class autoantibodies against the basement membrane of stratified squamous epithelia, several IgE‐related phenomena have been reported. Recently, we have shown that FcɛRII‐expressing and IgE‐bearing cells are detectable in the lesional skin and concluded that an IgE‐FcɛRII/CD23 system may be involved in the pathogenesis of this disease.

The serum level of sCD23 in BP patients was significantly higher than healthy controls (p<0.01). In 11 out of 12 patients, the alteration of serum sCD23 levels correlated well with the disease activity. Thus the serum level of sCD23 is useful as a new parameter for assessing the level of disease activity in BP. High levels of sCD23 may represent part of an IgE‐mediated immune reaction which may play a role in the pathogenesis of BP.
The Atrophic Dermatofibroma: A Delled Dermatofibroma
Authors: Requena Luis , Reichel Martin
Published: April 2015

Atrophic dermatofibroma has been proposed as a term to designate a new and specific type of dermatofibroma. We report the clinical and histopathological findings in two cases of atrophic dermatofibroma. The peculiar morphology of these lesions simply represents a conspicuous example of the frequently seen central depression in dermatofibroma. On histopathology, no authentic atrophy is present, because the thinning of the dermis compared with that of the adjacent non‐lesional skin results from this depression rather than from loss of tissue of the dermis. Delled dermatofibroma is a more appropriate appellation than atrophic dermatofibroma, because of the striking shape of these lesions.
Primary Lymphocutaneous Nocardiosis Due to Nocardia otitidiscaviarum: The First Case Report from Japan
Authors: Suzuki Yutaka , Toyama Keiji , Utsugi Kouichi , Yazawa Katsukiyo , Mikami Yuzuru , Fujita Masaru , Shinkai Hiroshi
Published: April 2015

We report a case of lymphocutaneous syndrome caused by Nocardia otitidiscaviarum (formerly known as N. caviae) in a 78‐year‐old woman who underwent long‐term therapy with prednisolone for bronchial asthma. Histological examination showed granulomatous reaction with multiple polymorphonuclear leukocytes and revealed a Gram positive filament in the dermis. Grampositive, slightly acid‐fast branched filaments were also found in the smear of the purulent material. The cell wall constituents of the isolate were meso‐diaminopimelic acid, arabinose, and galactose; the mycolic acid pattern of the isolate was Nocardia type. The organism decomposed xanthine and hypoxanthine, but not tyrosine or casein, which distinguished it from N. asteroides and N. brasiliensis. The skin lesions responded to minocycline and later to a combination of doxycycline and ofloxacin. This primary lymphocutaneous nocardiosis due to N. otitidiscaviarum is the first in Japan.
Treatment of Granuloma Annulare with Tranilast
Authors: Yamada Haruyoshi , Ide Akiko , Sugiura Makoto , Kurihara Sei‐ichi , Tajima Shingo
Published: April 2015

Three cases of granuloma annulare which did not exhibit a self‐limited course were treated with tranilast at the dose of 300 mg/daily. The treatment resulted in the resolution of skin lesions within three months of administration. Although spontaneous resolution is often observed in granuloma annulare, tranilast may provide an alternative therapy for the treatment of cases resistant to spontaneous healing.
Group D Xeroderma Pigmentosum: A Case with a Number of Nevocellular Nevi
Authors: Inoue Yuji , Yamaizumi Masaru , Ono Tomomichi
Published: April 2015

A 12‐year‐old boy was diagnosed as having group D xeroderma pigmentosum based on the results of unscheduled DNA synthesis (UDS) tests and complementation tests. More than 200 moles were distributed all over his body, including the unexposed areas of his torso and scalp. All of eight removed specimens were compatible histologically with nevocellular nevi.
Acquired Coccygeal Nodule Due to Repeated Stimulation by a Bicycle Saddle
Authors: Nakamura Atsushi , Inoue Yuji , Ishihara Tsuyoshi , Matsunaga Wakatoshi , Ono Tomomichi
Published: April 2015

Four Japanese male students, aged 14, 16, 18 and 19, were found to have a nodule in their coccygeal regions. The typical lesion was a rugby‐ball‐shaped, normal‐colored or slightly erythematous nodule measuring 5 to 6 cm in its long axis. Histopathologically, it showed hyperplasia of collagen fibers and slight acanthosis. All four students rode to school by bicycle over long distances and long periods; three of them developed the nodule after they started bicycle riding to school. We found that the nodule shape corresponded to the saddle of the bicycle. X‐ray abnormalities included bending or anterior dislocation of the coccyx in all cases and spina bifida in two cases. These nodules may have developed as a result of irritation of this region by the saddle of the bicycle.
Detection of Epidermal Cellular DNA Content and Its Clinical Significance in Psoriasis Vulgaris
Authors: Ke‐Jian Zhu , Tie‐Cheng Zhu
Published: April 2015

Epidermal cellular DNA content was detected by flow cytometry on 14 samples of normal skin and both lesional and nonlesional areas of 36 patients with psoriasis vulgaris. The results showed that the proliferative activity of epidermal cells increased in nonlesions and even more in lesions of patients from the levels in normal skin. These differences were significant (p<0.05). Clinical features and histopathological changes were observed, and self comparisons of 6 patients before and after treatment were also done. The clinical significance of these changes was discussed.
A Case of Steatocystoma Multiplex with Prominent Cysts on the Scalp Treated Successfully Using a Simple Surgical Technique
Authors: Kanekura Takuro , Kawamura Kyoko , Nishi Masayuki , Kanzaki Tamotsu
Published: April 2015

The case described is a 35‐year‐old male with multiple cysts on the upper half of his body. This patient was diagnosed as having steatocystoma multiplex, based on clinical and histological findings. The lesions consisted of widespread and unusually prominent cysts, which were removed by a simple surgical technique using a dermatological trepan and artery forceps. We provide here a detailed description of the surgical procedures employed.