Yoshie Asai

Treatment of Onychomycosis by ODT Therapy with 20% Urea Ointment and 2% Tolnaftate Ointment

20 patients with distal onychomycosis were given daily application of an ointment containing 2% tolnaftate and an ointment containing 20% urea under ODT. Following this, 17 of 20 patients developed onychomalacia and seven of these developed onycholysis 1 or 2 weeks later. The separated nails were cut as short as possible. Similarly to those patients with onychomalacia alone, occlusive dressing technique was continuously performed until the newly developed nails became macroscopically normal and no fungi were observed microscopically (responders). Following treatment, out of 20 patients, 14 responded. 5 patients who had a short course of treatment did not respond. Side-effects such as pain, hemorrhage and infection did not occur.

Drug-Induced Lymphocyte Transformation in Peripheral Lymphocytes from Patients with Drug Eruptions

In some types of drug eruptions, a positive blastoid transformation is frequently seen in peripheral lymphocytes when they are stimulated in vitro with the causative drug in the presence of autologous serum. In these cases, a soluble fraction prepared from guinea pig skin can replace the autologous serum in inducing the lymphocyte transformation, whereas either the mitochondrial or microsomal fraction of guinea pig skin instead of the autologous serum is less effective. Moreover, in fixed drug eruption, the addition of soluble skin material fractionated by gel filtration with Sephadex G-100 (FrD1 is as effective as the autologous sera in inducing lymphocyte transformation. These results suggest that the soluble fraction of skin is related to the pathogenesis of fixed and exanthematic drug eruptions as a carrier substance of drugs.

Macular amyloidosis with patchy filamentous degeneration of collagen islands

Unusual patchy filamentous degeneration of collagen islands, found in a typical case of macular amyloidosis, is described. This phenomenon was found to begin in intact islands scattered among the amyloid islands in the papillary and upper reticular dermis. Since the patches varied in size, they were thought to have grown gradually with time. They were derived from the degeneration of collagen fibrils and demonstrated a tropocollagen‐like structure. Although the small patches preserved some characteristic structures of collagen fibrils or tropocollagen, the large patches showed amyloid‐like filamentous masses surrounding the collagen islands.

High melanosome engulfing activity of cutaneous fibroblasts in macular amyloidosis: an electron microscopic study

Six patients with macular amyloidosis were investigated by electron microscopy and various morphological changes in fibroblasts were identified. Many cells, which seemed to be macrophages by light microscopy, proved to be fibroblasts. The digesting action of fibroblasts was well developed and many melanosomes were taken into the cells making the cells resemble melanophages. The fibroblasts extended long, thin and branched cytoplasmic processes to surround the amyloid mass, and the cells selectively extended these into the narrow spaces between collagen and amyloid. The fibroblast showed highly developed endocytotic activity and probable ingcstion of amyloid by pinocytosis or phagocytosis. The developed rough cndoplasmic reticulum contained much protein and was active in secretion.

Histochemical and Ultrastructural Studies on the Pigment Abnormality in Cutaneous Amyloidosis

In a localized form of primary cutaneous amyloidosis, the main clinical types are papular (lichen) amyloidosis and macular amyloidosis. Macular amyloidosis shows a diffuse brownish pigmentation with a characteristic ripple pattern, and papular type also shows hyperpigmentation. It is rarely known that there are disseminated depigmented spots in lesions of macular type1) or amyloid deposits in lesions of vitiligo-like depigmentation2).