Hisashi Tamiya

Generalized eruptive histiocytoma with rapid progression and resolution following exanthema subitum

absence of the HLA-B8 ⁄ DR3 ⁄ DQ2 haplotype. It is thus suggested that there may be pathological differences between Japanese and Caucasian DH. Dapsone and a gluten-free diet (GFD) have a significant effect on DH. A GFD provides long-term disease control and also reduces the risk for development of lymphoma. Only eight of 34 Japanese patients reported to date were given a GFD. The skin lesions respond to GFD regardless of whether the GSE has been proven or not (lack of histological jejunal atrophy does not exclude the GSE). Therefore, GFD also should be the treatment of choice for Japanese patients.

Apoptosis of neutrophils resulting after emperipolesis in cutaneous Rosai-Dorfman disease: a new ultrastructural finding.

Fig. 1. A) Multiple erythematous papules extensively involve the face. B and C) Large pale-staining histiocytes show cytophagocytosis (emperipolesis) of neutrophils and lymphocytes. There is an accompanying infiltrate spanning the full thickness of the dermis (hematoxylin and eosin staining; original magnification B: ×100; C: ×400). D) Terminal deoxy-UTP nick-end labeling (TUNEL) staining of the section showed phagocytized cells exhibiting apoptosis (original magnification, ×400).

Linear lupus erythematosus profundus on the face, following the lines of Blaschko

described. One case treated with oral prednisone (60 mg/ d) resulted in mild improvement. Another case treated with 60 mg of prednisone daily for 1 week followed by 40 mg daily for 6 weeks resulted in healing of skin lesions with shallow atrophic scars; prednisone was slowly tapered and discontinued without cutaneous recurrence. A third case was treated with 40 mg daily tapered to 10 mg daily with decrease in the extent of lesions. In yet another case, shaving a verrucous nodule flat in combination with hydroxychloroquine at 200 mg twice daily resulted in resolution without recurrence. Our patient’s co-morbidities limited the use of high-dose systemic steroids, although low-dose prednisone stopped disease progression. Verrucous sarcoidosis is a rare variant of cutaneous sarcoidosis, but its presence should alert one to the likelihood of pulmonary disease and extrapulmonary systemic involvement. Additionally, systemic corticosteroids should be considered for treatment.

Dermoscopic features of pigmentation in Laugier-Hunziker-Baran syndrome.

Laugier-Hunziker-Baran syndrome (LHBS) is a rare, acquired, benign disorder of hyperpigmentation often involving the acral regions and the oral and genital mucosa and is frequently associated with longitudinal melanonychia. Because the lesions of LHBS often resemble various other mucocutaneous hyperpigmentary diseases such as Peutz-Jeghers syndrome, Addison’s disease, and malignant melanoma, detailed examination for systemic involvement is required for differentiation from these disorders. Dermoscopy is a useful noninvasive technique for more accurate diagnosis of various cutaneous pigmented lesions, and therefore it should also be applied to the lesions of LHBS, but the dermoscopic features of this disease are not well described. We report here a case of LHBS with results of detailed dermoscopic findings of the pigmented lesions.

Protective effect of hochuekkito, a Kampo prescription, against ultraviolet B irradiation‐induced skin damage in hairless mice

A Kampo prescriptions, hochuekkito (HET) has been utilized for treating functional conditions such as general fatigue, compromised state and gastrointestinal motility disorder. Recently, HET has attracted the attention of dermatologists because of its clinically positive effects in atopic dermatitis (AD) treatment. To explain this positive effect of HET, we examined its protective ability against oxidative skin stress using a murine model. The dorsal region of 8‐week‐old male HR‐1 hairless mice, which were raised on a HET (0%, 2% and 10%) mixed diet, was irradiated once with 70 mJ/cm2 of ultraviolet (UV)‐B light. After 4 days, transepidermal water loss (TEWL) and stratum corneum water content (SCWC), were determined as a measure of degree of skin dysfunction. To estimate the amount of active oxygen generated, the stratum corneum catalase activity (SCCA) and stratum corneum carbonylated protein (SCCP) content in the tape‐stripped stratum corneum samples were measured. We also measured the H2O2 scavenging ability of HET, and analyzed the changes in the expression levels of several inflammation and oxidative stress‐related genes in the skin of HET‐fed mice. In control mice, exposure to UV‐B led to significant increases in TEWL and SCCP and significant decreases in SCWC and SCCA. These UV‐B‐induced changes were reduced in mice administrated HET, and the reduction was HET dose‐dependent. Our results suggested that HET offered a protective effect against UV‐B‐induced skin damage. We also found that HET had relatively low ability to scavenge H2O2, and expression level of cyclooxygenase‐2 mRNA decreased in HET‐fed mouse.

Keratosis follicularis squamosa (Dohi) associated with pseudoacanthosis nigricans

SIR, In our article on the seasonality trends of scabies we have used the database of the Israel Defence Forces (IDF). In an earlier study, one which dealt with global scabies epidemiology, the general IDF experience with this disease was elaborated, and earlier reports both from the IDF and other sources were cited. This concise communication originated from the fact that in the IDF, scabies is a routinely notifiable condition. Therefore, the trends and seasonality analysis is based on real incidence data, which differs from other reports on the subject that are based mainly on conveniency samples or general estimates, and are thus subject to bias and error. The hypothesis of sexual transmission of scabies, first reported in 1978, has been suggested to explain the higher prevalence of the disease during the winter months. This theory, however, was not based on observations of increased sexual promiscuity during this interval, as suggested by Dr Downs. Temperature difference is a straightforward and uncomplicated explanation for the seasonal variation in scabies incidence, stemming from the prolonged survival and higher productivity of the Sarcoptes mite at lower temperatures.

Partial response of angiosarcoma of the scalp to sorafenib: association with decreased expression of vascular endothelial growth factors and their receptors

The prognosis of angiosarcoma remains very poor, even with combined, multimodal therapy. We report a case with partial response of angiosarcoma of the scalp to sorafenib, which is a new oral, molecular, targeted, multiple‐kinase inhibitor. In addition, we confirmed, using immunohistochemistry, that sorafenib suppressed the expression of vascular endothelial growth factors and their receptors on the angiosarcoma tumour cells, and decreased cell numbers by inhibiting cellular proliferation.

Recalcitrant subungual verruca of a child successfully treated with combination use of traditional Japanese herbal medicines, shokenchuto and makyoyokukanto

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