Tsutomu Ohtsuka

Nailfold capillary abnormality and pulmonary hypertension in systemic sclerosis

Background

STATISTICAL DEFINITION OF NAILFOLD CAPILLARY PATTERN IN PATIENTS WITH PSORIASIS

Background. The microvasculature plays an important role in the pathogenesis of psoriatic skin lesions. Our purpose was to try to define a psoriatic pattern in the nailfold capillary, to clarify the relationship between nailfold capillary microscopic changes and nail involvement and to note the general clinical features of psoriasis.

Image analysis of nailfold capillaries in patients with undifferentiated connective tissue syndromes.

Several studies have reported patients that show nailfold capillary abnormality without fulfilling any of the criteria for rheumatic diseases. Our objective was to define how many patients with undifferentiated connective tissue syndrome (UCTS) have nailfold capillary abnormalities and to determine the correlation between capillary abnormality and clinical findings. We analyzed videograph images of nailfold capillaries in 75 patients with UCTS, comparing them with 22 normal controls (NL) and 55 patients with systemic sclerosis (SS), using standardized canonical discriminant analysis. Sixty patients with UCTS showed the SS type pattern and 15, the NL type pattern. The SS type pattern in patients with UCTS significantly correlated with Raynauds phenomenon, telangiectasia, and anti‐nuclear antibody. The UCTS patients with nailfold capillary abnormalities correlated with symptoms of SS have a possibility of progressing to SS. The follow up study of these patients will show whether progression to SS occurs.

Surgical Treatment for Dacryocystitis Accompanied by Skin and Bone Defects

88歳の女性。当科受診の4ヵ月前に左内眼角部の腫脹がみられ，涙嚢炎の診断のもとに，眼科医による治療を受けていた。その後，同部に皮膚および骨欠損を来したため，当科を訪れた。初診時，左内眼角部に17×17mmの皮膚および骨欠損が認められた。起炎菌は同定出来なかったが，涙管に排膿が認められたため涙嚢炎と診断した。難治性であったので外科的療法を試みた。まず，肉芽の増生を抑える目的でデブリドマンと植皮を行い，その後，腔を閉鎖する目的で皮弁形成術を施行した。その後再発はなく経過は良好である。