Miki Aso

A case of secondary cutaneous amyloidosis: epidermal keratinocytes produce amyloid in the cytoplasm.

A case of secondary localized cutaneous amyloidosis associated with a seborrheic keratosis is reported. Amyloid was observed both in the stroma and in the tumor. Light and electron microscopy revealed amyloid within the cytoplasm of the tumor cells. This intracytoplasmic amyloid was seen in basaloid cells or in the border areas between basaloid cells and squamous cells, but it was not seen in squamous cells. The amyloid was positive for anti‐keratin antibody and contained disulfide bonds. It is suggested that either abnormal keratinization or the degeneration of basaloid cells produced abnormal keratin proteins that formed this amyloid.

Pilomatricomas: Association with Myotonic Dystrophy

The association of pilomatricomas with myotonic dystrophy is rare. The following is the 11th case. Some clinical characteristic features suggest that patients with myotonic dystrophy have a predisposition to develop pilomatricomas.

Proteus Syndrome: Report of the First Japanese Case with Special Reference to Differentiation from Klippel‐Trenaunay‐Weber Syndrome

This is the first report of a Japanese girl with Proteus syndrome. She presented with growth acceleration and precocious development of the left breast as well as macrodactyly, hemihypertrophy, a subcutaneous preaxillary mass, portwine stains, connective tissue nevi, and a depigmented macule. All these abnormalities were confined to the left side of her body. Although most of the manifestations fit those of Proteus syndrome, the presence of the portwine stains and hemihypertrophy also suggested Klippel‐Trenaunay‐Weber syndrome. The findings in our patient suggest that the most important characteristic distinguishing Proteus syndrome from Klippel‐Trenaunay‐Weber syndrome is the presence of functional abnormalities such as a growth spurt and precocious breast development. Proteus syndrome may be genetically different from the Klippel‐Trenaunay‐Weber syndrome.

PAPILLOMAVIRUS-INFECTED KERATINOUS CYST ON THE SOLE : A HISTOLOGIC, IMMUNOHISTOCHEMICAL, AND ELECTRON MICROSCOPIC STUDY

A 17-year-old boy had a keratinous cyst on the sole. The keratinous cyst and its overlying epidermis had solitarily scattered keratinocytes, which contained a peculiar intracytoplasmic inclusion body above the lower spinous layer. Immunohistochemistry and electron microscopy revealed that the nuclei of these cells had virions of papillomavirus. These virions appeared above the spinous layer. The inclusion bodies were highly eosinophilic masses in the viable layer, and slightly basophilic, fine granules in the cornified layer. Their number at any time was usually one. Their histologic and ultrastructural features and their N-(7-dimethylamino-4-methylcoumarinyl)-maleimide staining property were different from those of keratohyalin and from those of amyloid or hyaline body. Also the keratinous cyst was associated with colloid bodies, showing the lamellated figure in the subepithelial area.

THE EFFECTS OF POTENT TOPICAL CORTICOSTEROIDS ON ADRENOCORTICAL FUNCTION

Forty‐eight patients were treated using nine potent corticosteroid ointments administered by simple application and their adrenocortical function was examined during treatment. Adrenocortical function was not suppressed by beclomethasone dipropionate, betamethasone valerate, or fluocinonide; was moderately suppressed by diflucortolone valerate, budesonide, and halcinonide; and was markedly suppressed by clobetasol propionate, desoximetasone, and diflorasone diacetate.

Pseudotail associated with spinal dysraphism

A 5-year-old girl had a caudal appendage and her left buttock was larger than the righ buttock. X-ray examination revealed spina bifida and bony defect of sacrum; computed tomography demonstrated the extension of the tumor from subcutaneous tissue to the spinal canal. Histologically, the pseudotail contained lobulated fatty tissue which was consistent with lipoma. It emphasizes the fact that even lesions that are not situated in the median line should be carefully explored before excision.

Paget's disease of the male breast--report of a case and histopathologic study.

We report a 61‐year‐old male with mammary Pagets disease. Physical examination revealed a slightly exudative erythema at the areola and a reddish, enlarged left nipple. No tumor or left axillary lymph nodes was palpable. He underwent a left modified radical mastectomy. Histologically, there was an intraductal carcinoma in the upper portion of the mammary ducts. The axillary lymph nodes that were examined were free of metastasis. Paget cells had neither estrogen nor progesterone receptors. We speculated that the histogenesis of Paget cells involved carcinoma cells that invaded the epidermis of the nipple.

A Case of Cutaneous Involvement by Sinus Histiocytosis with Massive Lymphadenopathy

A 44‐year‐old woman developed an erythematous indurative plaque and papules on the right scapular region. Histological and ultrastructural findings were consistant with sinus histiocytosis with massive lymphadenopathy. However, lymphadenopathy was not demonstrated clinically and the lesion was limited to the skin.

A Tumor with Sebaceous Differentiation Showing Intraepidermal Epithelioma

A sixty‐year‐old woman had a small papule within a plaque on the left arm. Histologically, the papule was similar to irritated seborrheic keratosis or inverted follicular keratosis and the plaque was intraepidermal epithelioma. However, both lesions included mature sebaceous cells showing sebaceous differentiation. This tumor may be closely related to the pilo‐sebaceous unit or sebaceous gland. To our knowledge, no similar tumor has been reported in the literature.

Systemic effects of 0.064% betamethasone dipropionate ointment and cream by simple application - with emphasis upon the suppression of adrenocortical functions.

Forty‐six patients with various skin diseases applied 0.064% betamethasone dipropionate (BD) ointment and cream simply for 3 to 6 weeks, and serum cortisol, blood sugar, and peripherocirculatory eosinophyll counts were measured.