Shouhei Inoue

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

PAINFUL ECCRINE ANGIOMATOUS NEVUS ON THE SOLE

A case of painful eccrine angiomatous nevus of the sole in a five‐year‐old boy is presented.

Cellular blue nevus of the scalp associated with intracranial involvement.

The authors report a rare case of cellular blue nevus located in the right frontotemporoparietal area of the scalp with local extension to the central nervous system. The diagnostic value of computed tomography is discussed.

REFLECTION ULTRAVIOLET PHOTOGRAPHY AS SURFACE PHOTOGRAPHY OF THE SKIN

Because of the physical properties of ultraviolet radiation which does not penetrate deep into the dermis, the surface of the skin is visualized better by reflection ultraviolet photography than by conventional photography under certain conditions. This technique is relatively easy, once a UV‐rich electronic flash and a UV‐transmitting, visible ray‐absorbing filter, which is known to dermatologists as Woods filter or Woods glass, are available. Representative photographs are presented, showing indications of reflection ultraviolet photography in the field of dermatology. The most important lesson of reflection ultraviolet photography is, however, to teach us the relationship between the wavelength of radiation and its reflectance from the skin.

CONGENITAL ONYCHODYSPLASIA OF THE INDEX FINGERS: -AN ABNORMAL GRIP THEORY-

Congenital onychodysplasia of the index fingers, a condition characterized by hypoplasias and dysplasias of the nails peculiarly restricted to the index fingers, is assumed to be related to a peculiar grip of the thumbs leading to ischemia of the index fingers while the baby is in utero. This is based on our observation of a case two days after birth. Major characteristics of this condition, including index finger involvement and radial‐prone involvement of the nails, can be well explained by this hypothesis, as can exceptional cases of middle finger involvement. A case of acquired polyonychia is presented which also appears to favor the ischemia theory for this condition.

THE BROAD SPECTRUM OF DOWLING DEGOS DISEASE, INCLUDING HABER'S SYNDROME—A HEREDITARY ABNORMAL REACTIVITY TO STIMULATION, INCREASING WITH AGE?—CASE REPORTS AND MANAGEMENT

Four cases of Dowling Degos disease (DDD) in one family and five cases of Habers syndrome (HS) in two families were compared. DDD and HS share many symptoms and findings in common; histopathological features of downgrowths of epithelial cells, papules of either brown or natural skin color, and various kinds of skin pigmentation. Some had pitted scars, cysts, pruritus, telangiectasia, red cheeks, xerosis, and photosensitivity. Another feature common to both conditions is the progressive course of the disease; patients and their children should be followed over their lifetimes. One case of DDD had basal cell epithelioma within the area of reticular pigmentation, but an 83‐year‐old patient with DDD indicated that general health is not involved in DDD.

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.

Radiodermatitis--an analysis of 43 cases.

Between November of 1977 and April of 1985, 15 cases of acute radiodermatitis and 28 cases of chronic radiodermatitis were studied at Miyazaki Medical College. All cases of acute radiodermatitis were preceded by malignancies and radiotherapy; 17 cases of chronic radiodermatitis were seen after radiotherapy for benign conditions and 7 cases were seen after radiotherapy for malignant conditions. The other 4 cases of chronic radiodermatitis were of occupational origin. Chronic radiodermatitis studied histologically in 23 cases revealed the following findings; atypia in the epidermis in 9 cases (poikilodermatous lesions showed the least atypia), intraepidermal carcinoma in 6 cases, squamous cell carcinoma in 7 cases, and malignant fibrous histiocytoma in one case.

POSTIRRADIATION MALIGNANT FIBROUS HISTIOCYTOMA: A CASE REPORT WITH A REVIEW OF POSTIRRADIATION SARCOMA IN THE JAPANESE LITERATURE

A fatal case of postirradiation malignant fibrous histiocytoma was reported, with a review of postirradiation sarcoma in the Japanese literature.

ERYTHEMA DYSCHROMICUM PERSTANS

Erythema dyschromicum perstans (EDP) is a peculiar pigmented condition of unknown etiology, resistant to any treatment (1–3). We report a typical case of EDP and discuss its differential diagnosis.