Ichiro Kikuchi

Natural history of the Mongolian spot.

Mongolian spots are characterized by racial variations in incidence as well as by spontaneous regression in childhood. In this paper, various types of the Mongolian spots and their natural courses will be discussed. Mongolian spots may be classified in according to their various characteristics. Some spots are fast fading, others fade slowly and the rest are persistent. They may be located over the lumbosacral region, on the back or on other areas of the body. Pigmentation can be deep blue in color, moderate or very faint. Some are diffuse, and others spotty. The relation of the Mongolian spots to their natural courses will be the subject of the present communication. We would like to classify them into three main types: I) Common Mongolian spot 2) Extensive Mongolian spot 3) Persistent Mongolian spot The most common Mongolian spots are, according to our definition, found on the lumbosacral region and the back; they disappear at a constant speed, especially those in the lumbosacral region. The incidence of Mongolian spots has been determined in 10,248 schoolchildren in Okinawa, Japan (I). In this survey, the sacral spots disappeared at a constant speed, in comparison with the extrasacral type. An interesting feature of dermal melanocytoses is the fact that there are certain areas which are never affected. This may imply that migration of dermal melanocytes is prevented

PLAQUE TYPE SYRINGOMA

Special types of syringoma include eruptive syringoma (1) and syringoma on the vulva and on the upper extremities (2). We present a large one, 1×5 cm in size, found on the right side of the neck, and preoperatively diagnosed as nevus sebaceus.

CONGENITAL ONYCHODYSPLASIA OF THE INDEX FINGERS: A POSSIBLE EXPLANATION OF RADIALLY-PRONOUNCED INVOLVEMENT OF THE NAIL IN THIS DISORDER

Two cases of congenital onychodysplasia of the index fingers (COIF), one of them with an abnormal range of active motion of the digits, were reported. The characteristic location of a nail, or nails in micronychia and polyonychia of COIF and the involvement of the nail and the bone may be explained by the anatomy of the digit. That is, the radially more pronounced involvement of the nail may be related to the relatively smaller size of the artery of the radial aspect. This may support the transient ischemia theory of Ohta and Haseda (1) in fetal life, though the true etiology of COIF still remains obscure.

Mongolian spots remaining in schoolchildren a statistical survey in Central Okinawa.

10,248 schoolchildren in central Okinawa were examined by one observer for remaining Mongolian spots. The spots were found in 783 schoolchildren (7.64%). Sacral Mongolian spots disappeared smoothly, while extrasacral Mongolian spots showed a general tendency toward disappearance. There were interesting but unexplainable differences in the rate of disappearance of Mongolian spots among city dwellers, suburban inhabitants and rural people in the area examined.

A Case of Cryoglobulinemic Gangrene in Myeloma with Fatal Outcome Despite Successful Skin Grafting

Extensive necrosis of the skin, muscle and bone was produced after prolonged cooling in a case of myeloma with cryoglobulinemia. Skin grafting was beneficial.

REFLECTION ULTRAVIOLET PHOTOGRAPHY IN DERMATOLOGY: PART 1: EQUIPMENT

Our experiences in reflection ultraviolet (UV) photography with special and conventional equipment are described. Although special lenses have advantages over conventional lenses such as in the transmission of ultraviolet radiation, it is established that reflection UV photography is possible with usual 35 mm single lens reflex cameras and 60 mm twin lens reflex cameras. Photography of semitranslucent material revealed that ultraviolet radiation is reflected from upper layers than visible light.

ACQUIRED PERIUNGUAL FIBROMA

It has been confirmed that an acquired periungual fibroma which developed in a 44 year‐old Japanese male X‐ray technician arose either in the dermis proximal to the nail matrix or between the proximal nail fold and the nail matrix. This disease may be a topographical variant of acquired digital fibrokeratoma.

Two sisters with guttate psoriasis responsive to tonsillectomy: case reports with HLA studies.

An 11‐year‐old girl and her 7‐year‐old sister, both with guttate psoriasis, both showed chronic tonsillitis and proteinuria. The ASO titer of the elder sister was 480 units and that of the younger sister 320 units. Tonsillectomies were performed on both sisters because they developed guttate psoriasis after colds with severe sore throats and proteinuria. Skin lesions improved markedly and proteinuria disappeared, but ASO titers did not change significantly. HLA studies were made of the sisters and their parents; A1 and B37 were confirmed in both sisters and their mother.

Reflection ultraviolet photography in dermatology. Part 2: photography of skin lesions.

Because reflection ultraviolet photography in dermatology records the reflected ultraviolet radiation (UVR), the data include information on relatively superficial changes such as of the skin. Dermatologic applications are discussed in detail. UV photography is indicated when one wants 1) to reveal minute changes of the surface 2) to intensify the changes of the upper skin and to erase the changes of lower skin and 3) to find if there is any change in the reflection of UVR in a given skin lesion.

TWO CASES OF NEVUS FUSCOCAERULEUS WITH PAIN, INCLUDING A CASE OF PILAR NEUROCRISTIC HAMARTOMA

Two patients with nevus fuscocaeruleus over the back and simultaneous pain were reported. Although the significance of this association remains to be clarified, it is interesting because the dermal melanocytes and nerves are of neuroectodermal origin. Histology of one case revealed findings consistent with those of pilar neurocristic hamartoma (1). Electron microscopy revealed dermal melanocytes in the neighborhood of a nerve. Photographic studies confirmed Morikawas view (2) that the location of melanin may be examined by reflection ultraviolet photography, conventional photography, and infrared photography.