Akinobu Shoji

Contact sensitivity to cigarettes

A 54-year-old woman presented with a 10-month history of erythematous macules and brownish pigmentation on and above the upper lip (Fig. 1). She had itching on her lesions when she had contact with strong fragrance. She had smoked for 10 years. Patch tests were performed with the cigarettes she smoked, a cosmetic she used, the Japanese standard series, a fragrance series, tar and nicotine. Patch tests showed a positive reaction to unsmoked tobacco from the cigarettes. Doubtful (?+) reactions were obtained to smoked tobacco and smoked filter. Unsmoked filter, cigarette paper, another kind of cigarette she did not smoke, tar, nicotine and the cosmetic were negative (Table 1). A patch test to tobacco was negative in five controls. The patient recovered after she stopped smoking.

Drug eruption caused by nitrazepam in a patient with severe pustular psoriasis successfully treated with methotrexate and etretinate.

An allergic drug eruption due to nitrazepam was reported in a patient who had been administered methotrexate and etretinate as concurrent therapies for severe pustular psoriasis. The clinical manifestation included a moon face‐like appearance with edema, a diffuse erythematous rash over almost the entire body the day after taking nitrazepam and, two days later, eroded lesions developing on the cheeks, axillae and genitocrural regions. It was proved by provocation that this drug eruption had an allergic nature.

Microsporum ferrugineum Infection with Unusual Clinical Features

Unusual skin manifestations of a dermatophyte infection in a 30‐year‐old female were reported. These included a remarkable peripheral hyperkeratosis with central yellowish pus. The pinkish papillomatous lesions were covered with thick crusts. They gave off a foul smell. Abundant fungus elements were present in the crusts and keratotic layer. The trichophytin skin test was positive. Immunologic test results revealed that the patient had hypergammaglobulinemia with hypoalbuminemia. However, she had no edema or immunologic abnormalities. The skin lesions were successfully treated with topical miconazole cream, oral griseofulvin, and topical sulconazole cream. The etiologic agent was identified as Microsporum ferrugineum Ota 1922. It seemed to us that the unusual skin manifestation were induced by her immunological response to fungal and bacterial infection due to a long history of Candida granuloma.

Treatment of Psoriasis Vulgaris with Haemodialysis

4名の乾癬患者に血液透析を行ない, 皮疹の軽快を見た。症例1は60才男子で約5年前より両下肢にそう痒のある米粒大の紅色丘疹が出現し, 種々の治療に抵抗した。血液透析を行なつたところ, 皮疹の軽快が認められた。一時増悪したが, 再度皮疹の軽快を見た。症例2は37才男子で約9年前より頭部に皮疹を生じ, 3∼4年前より小指頭大∼拇指頭大の紅斑性落屑性の皮疹を呈した。血液透析終了約8週後より皮疹の中心部より軽快した。症例3は32才男子で5∼6年前より皮疹が生じ, 膿疱性乾癬の状態となつた。血液透析終了後より皮疹の軽快を見たが1週間で再発した。症例4は20才女子で約11年前より皮疹を生じた。血液透析途中より皮疹は軽快したが約1ヵ月間で再発した。以上の4例を報告するとともに今までに本邦, 外国で発表された乾癬に対する透析療法の報告をまとめ若干の考察を加えた。