Shimako Mizoguchi

SUCCESSFUL TREATMENT OF SCLERODERMA WITH PUVA THERAPY

PUVA therapy was carried out on four patients with scleroderma; three of them had cutaneous manifestations of progressive systemic sclerosis and one other exhibited generalized morphea. PUVA therapy was given with daily doses of 0.25 J/cm2 or 0.4 J/cm2 for 3–8 weeks, resulting in total doses between 3.5 J/cm2 and 9.6 J/cm2. All four patients responded well to this treatment; improvements of hand closure, skin sclerosis index, and flexion of fingers or knee joints were obtained. Thus, PUVA appeared to be beneficial for treating scleroderma.

Linear Lichen planus in the Region of the Mandibular Nerve Caused by an Allergy to Palladium in Dental Metals

We observed a case of linear lichen planus extending from the right cheek to the jaw, which was accompanied by itching and an unusual sensation in the mouth. The eruption was located along the mandible and aligned with the mandibular nerve. The right molars of the patient contained metal compounds and these were considered to be the cause of his disease. Patch testing with various dental metals showed positive reactions to palladium and platinum. A biopsy specimen showed a lichenoid reaction in the lesional tissue, and dermal contact dermatitis was noted at the palladium patch test site. His dentist reported that palladium-silver-gold or nickel-chrome alloys without platinum had been used in the crown and bridge of his molars. After removal of the dental alloys, the skin eruption resolved with some residual hyperpigmentation. In addition, the peculiar mouth sensation disappeared dramatically within 2 months.

A Case of Intravascular Malignant Lymphomatosis (Angiotropic Large-cell Lymphoma) Presenting Memory T Cell Phenotype and Its Expression of Adhesion Molecules

A case of intravascular malignant lymphomatosis (angiotropic large cell lymphoma), T cell type was reported. The patient, a 59‐year‐old woman, had reddish or violaceous indurated macules scattered over the entire body surface. Neither lymphadenopathy nor hepatosplenomegaly was recognized.

Eosinophilic pustular folliculitis induced by carbamazepine

A 58-year-old man had taken a combination of acetaminophen and carbamazepine for headache and fever. Over the next 2 days, he experienced stomatitis and edematous erythema with papules and pustules on his face, neck, trunk, and extremities. This was diagnosed as a “drug eruption.” His stomatitis improved but his skin eruption persisted. Two months later, examination revealed edema of Eosinophilic pustular folliculitis induced by carbamazepine

Membranocystic lesions in a patient with cytophagic histiocytic panniculitis associated with subcutaneous T-cell lymphoma

A 51-year-old Japanese woman had erythematous, tender subcutaneous nodules on her lower legs and buttocks, as well as fever, pancytopenia, and liver dysfunction. Histopathologic examination of the nodules showed subcutaneous T-cell lymphoma with cytophagocytosis and membranocystic lesions. Our patient was unique in having the combination of cytophagic histiocytic panniculitis due to subcutaneous T-cell lymphoma and membranocystic lesions.

Human T-cell lymphotropic virus type I infects eccrine sweat gland epithelia

Human T‐cell lymphotropic virus type I (HTLV‐I) is known to be associated with several non‐neoplastic inflammatory disorders such as HTLV‐I‐associated myelopathy/tropical spastic paraparesis, arthropathy, uveitis and lymphadenitis, in addition to neoplastic adult T‐cell leukemia/lymphoma (ATLL). A strong relation between HTLV‐I infection and Sjögrens syndrome (SS) has been reported, and impaired sweating in SS is well known. We have often encountered dry skin in patients with ATLL. On the basis of these observations, we aimed to determine whether HTLV‐I infection is present in isolated sweat glands. Eccrine gland epithelia were isolated from full thickness skin biopsies from 8 HTLV‐I‐seropositive and 7 seronegative individuals using dispase in Eagles minimum essential medium supplemented with 13% fetal calf serum. We detected HTLV‐IpX sequences in samples of eccrine sweat gland epithelia from 4 samples of the 8 seropositive individuals using nested polymerase chain reaction, but all 7 samples from the seronegative donors had no signal corresponding to the sequence. Our results were confirmed by dot blot hybridization. Our results suggest that eccrine epithelium is one of the target organs of HTLV‐I infection. Int. J. Cancer 80:652–655, 1999.

Steatocystoma multiplex: a case with unusual clinical and histological manifestation.

A 35-year-old man at our clinic was found to have steatocystoma multiplex manifested by dome-shaped nodules confined to the scalp and forehead. One of four cyst biopsy specimens revealed large lining cells with granular cytoplasm adjacent to typical steatocystoma epithelial lining cells. Neither fibrosis nor inflammatory changes were noted in the surrounding connective tissue. The large granular lining cells had immunohistochemical characteristics of the macrophage/monocyte lineage. This case appears to be an unusual clinical and histological manifestation of steatocystoma multiplex.

Multiple bursitis : a case with an unusual skin manifestation

Bursitis is a periarticular rheumatism which occurs as a result of trauma, infection, metabolic disease or rheumatoid arthritis. The disease is usually manifested as a solitary lesion except in a few reported cases of multiple lesions. We describe here a case of bursitis in a 58-year-old woman with multifocal cystic lesions containing sterile bloody or yellowish fluid in the four extremities. Serological abnormalities were also noted, suggesting the presence of rheumatoid arthritis or another autoimmune connective tissue disease.