Shin-ya Takahashi

Localized cutaneous cryptococcosis successfully treated with itraconazole. Review of medication in 18 cases reported in Japan.

A case of localized cutaneous Cryptococcosis successfully treated with oral Itraconazole is reported. The patient, a 63‐year‐old Japanese housewife, had had an erythematous and partly eroded lesion in the area of her right earlobe for about 10 months. No findings suggesting a primary focus of Cryptococcus infection were found In the lung, central nervous system or other Internal organs. The isolate obtained from the lesion was identified as Cryptococcus neoformans based on the demonstration of encapsulated blastospores and its biological characteristics. The clinical course shifted toward healing in parallel with a decreased serum level of anticryptococcal antibody after initiation of treatment with oral Itraconazole in a dose of 100 mg once daily. The treatment was discontinued after 13 weeks. There were neither subjective nor objective side effects. Furthermore, this paper reviews the medications employed in 18 cases with cutaneous cryptococcosis reported in Japan during the nearly 40‐year period between 1952 and 1989.

A Case of Solitary Mastocytoma Suggesting a Divided Form of Mast Cell Nevus

The case of a 10‐week‐old boy with a solitary mastocytoma is reported. The lesion, noticed at birth, was located in an area extending from the dorsum of the left hand to the proximal phalanx of the ring and little fingers. It appeared as a coin‐sized, flattened dome‐shaped, round tumor with occasional blistering. The web between the two fingers was free of cutaneous changes. The diagnosis was confirmed by the histological characteristics: a densely mastocytic infiltration into the dermis. The present case of solitary mastocytoma, referred to as “mast cell nevus”, is unique because of its previously undescribed divided form.

Experimental chronic dermatophytosis in human skin grafted to nude mouse: inoculation of Trichophytons and histopathological evaluation.

Two strains of T. rubrum and one strain of T. mentagrophytes were inoculated into human skin grafted onto BALB/c nude mice by the needle puncture method. Infection was established in 1 of the 10 animals inoculated with fluffy colony type T. rubrum, 2 of the 10 animals inoculated with powdery colony type T. rubrum, and 7 of the 10 animals inoculated with granular colony type T. mentagrophytes, suggesting that the skin grafts are infectible by anthropophilic and zoophilic strains of dermatophytes. T. rubrum infection continued for a maximum of 9 weeks and T. mentagrophytes infection for more than 11 weeks. In the animals inoculated with T. mentagrophytes, fungal elements were localized in the stratum corneum of the human skin grafts. In the acute stage, microabscesses consisting of neutrophils were observed under the stratum corneum in contact with fungal elements; in the chronic stage, epidermal thickening and infiltration, mainly consisting of histiocytes and a smaller number of lymphocytes, was noted in the upper and middle dermis. Ultrastructural findings from the parasites were similar to those of dermatophytosis in man. This experimental system should be useful as a model of chronic dermatophyte infection in the human skin.