Nihon Hifuka Gakkai zasshi. The Japanese journal of dermatology最新文献

A 55 year-old man with a leiomyosarcoma of the rectum and its multiple metastatic lesions in the liver was evaluated for the presence of multiple pigmented macules. The initial lesion was noticed on the face at the age of 53 years old, and then extended to the upper extremities and the back, and became darkened. On physical examination, there were extensive and multiple blue gray macules on the face, upper extremities, shoulders, and the back. Grey flecks on the both palpebral conjunctivas, blue-grey flecks on the palate and blue and brown pigmentation of the gingiva were also noticed. The serum levels of alpha-MSH and growth hormone showed about twice as much as normal range. By light and electron microscopic examinations, pigment bearing cells were identified as dermal melanocytes. From these findings, we diagnosed this case as a generalized type of acquired dermal melanocytosis.

This study investigated the cell kinetic effects of combined treatment with crude coal tar and long wave ultraviolet (UVA) radiation on the normal and n-hexadecane-induced hyperproliferative epidermis of guinea pig skin. Flow cytometry was used to determine the proportion of cells in S phase (S fraction) and G2 + M phase (G2 + M fraction). Bromodeoxyuridine incorporation was used to determine the labeling index. Conventional histologic techniques were used to observe the mitotic index. In the normal epidermis after a single treatment with tar and UVA (1 J/cm2) or tar alone, the labeling index showed an initial decrease of 4 hr duration followed by moderate increase. The initial decrease was more pronounced in the tar-UVA-treated epidermis than in the tar-treated epidermis. The mitotic index was depressed during the first 12 hr. S- and G2 + M fraction showed no changes during the first 12 to 18 hour, and then increased in varying degrees. In the hyperproliferative epidermis after two applications of tar and UVA (1 and 4J/cm2) or tar alone, the labeling index was depressed during the first 12 hr, and mitotic index was below the control level until the 36 hr. The inhibitory effects on DNA synthesis and mitosis were more pronounced in the tar-UVA-treated epidermis than in the tar-treated epidermis. The S- and G2 + M fraction exceeded the control level in varying degrees during the whole experimental period. The results indicate that tar inhibits the epidermal DNA synthesis and mitosis by itself, and that the inhibitory effects of tar are intensified by the radiation of UVA.

A case of Malignant Hemangioendothelioma (MHE) effectively treated with intra-arterial continuous infusion of recombinant interleukin-2 (rIL-2) was experienced. The Pt, a 82-year-old women, presented herself in our hospital with a complaint of the tumor in right-frontal region. Based on clinical and pathological findings, the Pt, was diagnosed as MHE. Increase of LAK (Lymphokine activated killer cell) activity was observed during treatment with intra-arterial continuous infusion of rIL-2. In addition, decrease of tumor was started when LAK activity showed high value. We mainly discussed about treatments for MHE and mechanism of these therapies by use of data of this case and other autho's papers.

Sephadex G-75 gel filtration of murine anagenic hair bulb extracts (HBE) showed two peaks with chemotactic activity. Peak I (m.w. 63 +/- 4.6 KD) was chemotactic for both neutrophils and lymphocytes, and Peak II (m.w. 47 +/- 5.6 KD) was chemotactic for lymphocytes only. The neutrophil related chemotactic activity was sensitive to treatments by trypsin, pronase, neuraminidase, or heating at 100 degrees C for 10 min. With Peak I, lymphocyte related chemotactic activity was sensitive to treatments by pronase, trypsin or neuraminidase, but was unaffected by heating at 100 degrees C for 10 min. On the other hand, the same aforementioned treatments all individually inactivated the Peak II lymphocyte related chemotactic activity. Intradermal injection of Peak I fractions into guinea pigs induced infiltration of neutrophils and mononuclear cells, and that of Peak II induced the infiltration of mononuclear cells. These findings suggest that normal C3H murine anagenic hair bulb contains three different chemotactic factors related to neutrophils and lymphocytes.

Twenty-seven cases of urticarial erythema with predominantly neutrophilic infiltration in the upper dermis were examined clinically, histologically and serologically. Their condition persisted longer than common urticaria, with transitory high fever and arthralgia being noted frequently. Based on histological examination results, the patients were divided into three groups. Ten patients with histological findings of leukocytoclastic vasculitis were diagnosed as urticarial vasculitis which was accompanied in 7 cases by systemic lupus erythematosus, Sjögren syndrome or viral hepatitis. This group frequently showed hypocomplementaemia and multiple organ involvement such as hepatitis and nephritis. An immunofluorescence study demonstrated immunoglobulin and/or complement components to be deposited in the vessel walls of upper dermis, thus implicating type III allergy in the pathogenesis. The second group consisted eight patients with moderate infiltration of neutrophils toward the vascular walls though vasculitic changes were not apparent. Systemic lupus erythematosus and Sjögren syndrome were noted in 5 of these patients but multiple organ involvement was relatively quite infrequent. Antihistamines and even systemic corticosteroids failed to have any effect in the majority of the patients on these two groups. The remaining nine patients constituting the third group showed neither neutrophilic infiltration toward vessel walls nor vascular damage and there was no multiple organ involvement. Bacterial infection of upper respiratory tract appeared to possibly be a trigger in most of these patients for whom antibiotics were effective as treatment. In conclusion, histological examination is particularly important for cases such as the present cases for accurate diagnosis and deciding appropriate treatment.

A 31-year-old pregnant woman had eruptions on her wrist, face and neck. We diagnosed her as having Sweet's syndrome from clinical symptoms, histopathological and laboratory findings. We successfully treated her with prednisolone and there are no relapses after delivery. We studied her polymorphonuclear leukocyte activity by the polarization assay with N-formyl-methionyl-leucyl-phenylalanine as a chemoattractant and it is higher than that of control. It is known that Sweet's syndrome is accompanied with collagen diseases and malignant diseases or others as underlying diseases or conditions. Three cases of Sweet's syndrome associated with pregnancy have been reported before and this is the first one in Japan.

Skin penetration of various antimicrobial agents was studied in rats. Skin concentration/serum concentration ratios were classified into three groups, i.e. group I with ratio greater than or equal to 0.7, group II with the ratio 0.7-0.4 and group III with the ratio less than or equal to 0.4. The drugs of group I were OFLX, CPFX, LFLX, FLRX, SPFX, AMK, EM, RXM, CAM, CLDM. The drugs of group II were ABPC, CVA/AMPC, CVA/TIPC, CEX, CED, CXD, CTM-HE, CXM-AX, CPZ, CBPZ, TFLX, ASTM, MINO. The drugs of group III were AMPC, CCL, CDX, CPDX-PR, CFTM-PI, CTZ, CEC, CEZ, CTM, CMZ, CZON, MCR, IPM/CS. Factors which may influence the skin penetration were discussed, but no definite conclusion has not been obtained.

Statistical observation about the clinical items of 105 patients with dermatomyositis (DMS) attending Department of Dermatology, Nagoya University Hospital and some hospitals in Aichi Prefecture, during the year of 1965 to 1989, was carried out. Clinical features of the patients with juvenile DMS obtained from the observation were as follows. 1) The male:female ratio was 1.3:1 in juvenile DMS. The evident difference such as the predominance of females in adult DMS was not found. 2) The tendency that cutaneous manifestations usually preceded muscular manifestations was observed, and the muscular manifestations except severe symptoms were seen with a high incidence throughout the entire clinical course. 3) In the laboratory examinations, the incidence of elevation of serum aldolase concentrations in children was significantly higher than that in adults (p less than 0.05). Serum aldolase concentrations were usually elevated at onset or prior to the onset of muscular manifestations. Therefore the measurement of serum aldolase levels was considered to be useful for early diagnosis of juvenile DMS. The positive rate of antinuclear antibody in children was significantly lower than that in adults (p less than 0.001). 4) None of the children had any complications such as malignant tumors, interstitial pneumonia and pulmonary fibrosis, and none of them died. With regard to the outcome, the incidence of "remission or improvement" in children was significantly higher than that in adults (p less than 0.05). In the group of "same or worse", the children mainly had the cutaneous manifestations which were difficult to treat, compared with the adults. These results suggest that juvenile DMS may be a different disorder, probably a syndrome, from adult DMS.

A 21-year-old male with SLE developed seizure, loss of consciousness and focal signs referable to involvement of the front-temporal brain regions. MRI (magnetic response imaging) image revealed high signal areas in the temporal lobes. By these findings, herpes simplex encephalitis (HSE) was suspected at first. But neither isolation of herpes simplex virus nor HSV specific IgM by ELISA was detected. Acyclovir administration by intravenous infusion was'nt effective but corticosteroid pulse therapy was effective. The level of anticardiolipin antibody was very high. Finally, the diagnosis of CNS-lupus with HSE-like characteristics was made in this case.