Atsushi Kukita

Tinea faciei Caused by Microsporum canis in a Newborn

A case of tinea faciei caused by Microsporum canis in a 14-day-old infant is reported. The incubation period was seen to be 1 week. This was a familial infection which also affected the infants grandmother and their pet cat and dog. Topical treatment with clotrimazole controlled the infection in the baby. A review of 14 cases (including our own) of dermatophytosis in newborn infants reported in the Japanese literature showed that newborn infants might be infected by several of these agents.

Influence of Cell Dissociation on Normal Epidermal Cells in Hailey-Hailey’s Disease and Darier’s Disease

The effects of cell dissociation in HHD and DD on normal outgrown epidermal cells in explant culture were investigated, and the results were obtained as follows: The outgrown epidermal cells from skin fragments of patients with HHD or DD reveal characteristic dissociative behavior in explant culture. This phenomenon is considered to be acantholysis at the level of tissue culture. The outgrown epidermal cells from the normal skin fragments can dissociate when they are cultured together with those from patients with HHD or DD. The latter exhibits distinct dissociative behavior. These cell dissociations can be stopped by changing the medium to a new one. These dissociations reappear by decreasing the amount of the medium to a certain low level. The dissociation of outgrown epidermal cells from normal skin fragments occurs on transference of the medium in which the cell dissociations were observed.

Skin Typing, Sun Exposure, and Sunscreen Use in a Population of Japanese

Distribution of Japanese skin types (JSTs), sun‐exposure habits, and sunscreen use were surveyed in 379 new outpatients. The largest number of subjects belonged to JST class J‐II (65%), J‐I was second (24%), and J‐III was third (11%). Eighty‐eight percent of those studied had occasional or habitual sun exposure during the summer, and many were exposed for more than three hours per exposure day (80% of those with occasional exposure; 62% of those with habitual exposure). More younger persons had occasional sun exposure than older persons. More males had habitual sun exposure than females. Sunscreens were used by 41% of the subjects, but 77% of these used them without accurate understanding of the definition of the sun protection factor. More J‐I subjects used sunscreens than J‐II and J‐III subjects. More females than males used them.

Tissue Culture of Epidermal Cells in Some Acantholytic Dermatoses

The explant culture of small skin specimens is a good model of in vivo epidermal growth. In this model epidermal cells are not dislodged and remain in vitro under the influences of the original mesenchyme, at least during early growth. Recently we attempted to grow epidermal cells from the skin lesions of some acantholytic dermatoses (Dariers disease [DD], Hailey-Haileys disease [HHD], and pemphigus vulgaris [PV]) in explant culture, and we observed the behavior of outgrown epidermal cells for a relatively short time after explantation. The cell outgrowth from the skin of a patient with PV, which seemed to be apparently normal but showed positive Nikolskys sign, formed a well organized flat sheet 48 to 96 hours after explantation, as seen in cultures of normal human adult skin. In contrast, the outgrown cells from the skin lesions of three patients with DD, as well as those from three patients with HHD, showed a characteristic disorganized outgrowth. They did not form the well-organized flat sheet, but showed a marked cell dissociation and conspicuously increased locomotive ability. These findings seems to clearly exhibit the processes of acantholysis in vitro and strongly suggest that the cells from these 2 latter dermatoses have a genetically determined insufficiency or defect in cell adhesion. From these results the authors conclude that the mechanism of cell dissociation in DD and HHD is fundamentally different from that in PV.

Reproduction of the Skin Lesions of Polymorphous Light Eruption: A Case Report and a Review of the Japanese Literature

A case of polymorphous light eruption with plaque‐type lesions is reported. A 55‐year‐old male had pruritic erythemas and plaques on the head, the face, the nape, the back of the hands, and the left loin within days following sun exposure. The patients minimal erythema dose (MED) (60 mJ/cm2) of sunlamp irradiation for ultraviolet (UV) B was normal. Three once‐daily exposures to 2 MED of UVB (Epsteins repeat phototest technique) produced pruritic papules with a similar microscopic appearance to that of the patients skin lesion, indicating that the action spectrum causing the lesion seemed to be within the UVB waveband.

Systemic Effects and Percutaneous Absorption of Topically Applied 0.1% Hydrocortisone 17-Butyrate

The systemic effects of topically applied 0.1% hydrocortisone 17-butyrate during treatment with and without occlusion were measured in terms of the functions of the pituitary-adrenal axis. Corticosteroid levels in the blood were determined by the modified method of MURPHY, a competitive protein-binding radioassay. Circulating eosinophils were counted and the urinary 17-OHCS and 17-KS excretion were also determined. Percutaneous absorption following the topical application of 14C hydrocortisone 17-butyrate 1 (HC 17-B, Locoid) was measured by means of autoradiography. The application of the corticosteroid to the normal skin without occlusion did not induce systemic effects, whilst the application of the drug under occlusive dressing showed that systemic effects may possibly be induced. The number of circulating eosinophils, corticosteroid levels in the blood and urinary 17-OHCS excretion all decreased. However, these values returned to normal about 2 days after the withdrawal of the application, so we consider the systemic effect induced by the topical corticosteroid to be of a temporary nature. The percutaneous absorption of the corticosteroid was proved by an autoradiographic technique using 14C-labelled HC 17-B. At various intervals after the application, radioactive substances were observed as silver grains in the horny layer of the epidermis and skin appendages, and the density of the silver grains gradually increased with the course of time. It may be surmised that locally applied HC 17-B will be retained in the horny layer of the epidermis at a very early stage after the application and then absorbed in the blood via the epidermis and skin appendages. The reservoir of the corticosteroid in the skin was demonstrated 24 h after the withdrawal of the application.

Coexistence of Papular Mucinosis and Systemic Amyloidosis Associated with λ-type IgD Paraproteinemia

The patient is an obese, 55‐year‐old woman. She noticed purpura at several sites when she was 49 years old. She visited our clinic with a chief complaint of exertional dyspnea at 51 years of age. Physical examination revealed localized edema in the left chest wall and lower abdomen with translucent papules in the center. Macroglossia, hemorrhagic macules, loss of axillar and pubic hairs, and goose‐egg sized swellings of submaxillar lymph nodes were also found. Laboratory data were within the normal range except an increase of IgD and low ECG voltage. Bone‐marrow puncture revealed an increase (27%) of plasma cells with some atypicality. Serum immunoelectrophoresis clarified IgD λ‐type paraproteinemia and λ‐type Bence Jones proteinemia.

Thirteen cases of squamous cell carcinoma experienced in the Department of Darmatology of the National Defence Medical College, Saitama Prefecture.

当教室で経験した有棘細胞癌13例について, その病理組織像を検討し, TNM分類, Broders分類, レベル分類をおこない, さらにそれらと治療成績との関連について検討した。その結果自験例13例では, TNM分類による病期分類が進むにつれて, 再発・転移が増加した。