Yozo Yamada

Docetaxel: a therapeutic option in the treatment of cutaneous angiosarcoma: report of 9 patients.

Effective treatment options are limited for patients with cutaneous angiosarcoma (AS). Docetaxel, a member of the taxane family of drugs, reportedly has been effective in the treatment of lung, head and neck, and breast cancers. Another taxane drug, paclitaxel, reportedly had unique activity in the treatment of AS of the scalp and neck and acquired immunodeficiency syndrome‐related Kaposi sarcoma. Therefore, the authors hypothesized that docetaxel may be of value in the treatment of cutaneous AS that is resistant to conventional therapy. However, there were only 3 case reports of the successful treatment of AS in elderly patients using docetaxel in combination with surgery and radiotherapy.

The inhibition spectrum of solar urticaria suppresses the wheal-flare response following intradermal injection with photo-activated autologous serum but not with compound 48/80

Background: The inhibition spectrum (IS) in solar urticaria was identified mainly in Japanese patients with solar urticaria, although the mechanism of action of the IS has not been elucidated.

Thiodiglycolic acid as a possible causative agent of fixed drug eruption provoked only after continuous administration of S‐carboxymethyl‐l‐cysteine: case report and review of reported cases

pinpoint to 1 cm coalescent nonpruritic papuloerythematous lesions on her face and trunk. Her WBC count was normal (4Æ8 · 10 L), and her lymphocytes count decreased to 0Æ6 · 10 L. She had no eosinophilia (0Æ6 · 10 L). With the discontinuation of all drugs except for carbamazepine and topical corticosteroid, she had rapid improvement of the skin lesions in a few days. Because PAV therapy was very effective for her brain tumour and there was no definite report of eruptions caused by vincristine, PAV therapy was continued but all the other supplementary drugs were changed. This time she was injected with vincristine alone according to the protocol on 27 February. For the prevention of a drug allergic reaction, granisetron hydrochloride was changed for azasetron hydrochloride. On 4 March, she had pruritic papuloerythematous lesions on her face and body. She had a little decrease of her WBC count (3Æ2 · 10 L), and the lymphocyte and eosinophil counts were preserved (0Æ7 · 10 L and 0Æ6 · 10 L). Four days after the onset of the second eruption, her eosinophils increased slightly (1Æ4 · 10 L). She had no dysfunction of other organs throughout the course of these episodes. The second eruption also cleared with topical corticosteroid in a few days after the injection of vincristine. Histological examination of a skin biopsy from affected skin on her upper arm revealed a superficial perivascular lymphocytic infiltration. Patch tests were performed with 1% and 10% vincristine (in physiological salt solution) on 29 March, but the result was negative after 48 h. A drug lymphocyte stimulating test (DLST) was not performed. Our patient developed a papuloerythematous eruption on the whole body 6 days after the first injection of vincristine, and had rapid improvement after the termination of treatment with vincristine. Furthermore, a similar eruption appeared 6 days after the second injection of vincristine despite the fact that all the other drugs were changed. The reappearance of the eruption after the change of all other drugs indicates that vincristine was the cause. The differential diagnosis included cutaneous eruption of lymphocyte recovery (CLR), which is also associated with a maculopapular eruption at the earliest recovery of peripheral lymphocytes after chemotherapy. It occurs with a decrease of WBC count within 3 weeks after chemotherapy. However, in our case it was unlikely because her WBC count was about 4Æ0 · 10 L before chemotherapy and the decrease of her WBC count was less than that of reported CLR patients (0Æ3–1Æ8 · 10 L). Besides, her eosinophils increased 4 days after the onset of her second eruption. This supports the idea that some allergic reaction played a role in the eruption. Collectively, although the patch test was negative, we diagnosed her as having vincristine-induced skin reaction. Allergic skin reactions against oncology drugs have been described. They can induce various allergic skin reactions, for example, urticaria, angioedema, maculopapular eruptions, vasculitic lesions, erythema multiforme and toxic epidermal necrolysis. However, there was no previous report of an allergic reaction to vincristine although it has been used for various kinds of chemotherapy for neoplasia. Our unusual case suggests that we should note this agent as a causative drug that can induce a cutaneous allergic reaction.

Addition of lafutidine can improve disease activity and lead to better quality of life in refractory cholinergic urticaria unresponsive to histamine H1 antagonists

Abbreviations: CU, cholinergic urticaria; H1RA, H1 receptor antagonists; H2RA, H2 receptor antagonists; QoL, quality of life; DLQI-J, Dermatology Life Quality Index. * Corresponding author at: Department of Dermatology, Kurume University School of Medicine, and Kurume University Institute of Cutaneous Cell Biology, 67 Asahimachi, Kurume, Fukuoka 8300011, Japan. Fax: +81 942 31 7853. E-mail address: hashimot@med.kurume-u.ac.jp (T. Hashimoto).

A Case of Classic Kaposi's Sarcoma in a Japanese Man: Detection of Human Herpes Virus 8 (HHV-8) Infection by Means of Polymerase Chain Reaction and Immunofluorescence Assay

The recently discovered human herpes virus 8 (HHV‐8) has been implicated in the pathogenesis of Kaposis sarcoma (KS). Because classic KS in Japan is rare and the detection of HHV‐8 DNA by polymerase chain reaction (PCR) has heen successful only in limited cases, the frequency and role of HHV‐8 infection in KS in Japan remain unclear. Herein we report a case of classic KS in a Japanese man whose HHV‐8 infection was confirmed by the detection of lesional viral DNA and serum antibodies against lytic antigen.

Case of Mycobacterium haemophilum misdiagnosed as Mycobacterium intracellulare due to one base insertion in the bacterial genome

Mycobacterium haemophilum is a slow‐growing, non‐tuberculous mycobacteria that causes cutaneous infection. We describe a case of cutaneous infection in a 68‐year‐old Japanese man with polymyositis. This was caused by M. haemophilum harboring one base insertion in gene sequence. At first, the causal microorganism was misidentified as M. intracellulare by COBAS® TaqMan® MAI test. However, poor growth on Ogawa media and growth enhancement on 7H11C agar around a hemin‐containing disk prompted us to reinvestigate the causal microorganisms, which were revealed to be M. haemophilum. Amplified polymerase chain reaction products were sequenced, and the 16S rRNA gene, rpoB, hsp65 and internal transcribed spacer region sequences showed a 100%, 100%, 99.66% and 99.7% match, respectively, with the corresponding regions of M. haemophilum, but it harbored a novel gene sequence in hsp65. The sequences determined by gene analysis of the M. haemophilum strain were deposited into the International Nucleotide Sequence Database. Although numerous cases of M. haemophilum infection have been reported in other countries, only six cases have been reported in Japan to date. It could be possible that this novel mutation lead to misdiagnosis. As M. haemophilum prefers a lower growth temperature (30–32°C) and it requires iron in the culture medium, M. haemophilum could be misidentified or overlooked. Accordingly, a M. haemophilum infection should be considered in cases of cutaneous infection of the body sites, of which surface temperature is low.

Unilateral eruptive seborrheic keratoses associated with hepatic hemangiomas.

Seborrheic keratosis often develops as multiple lesions [1]. A sudden increase in the number and size of pre-existing seborrheic keratoses associated with internal malignancy is called the sign of Leser-Trelat [2, 3]. However, unilateral eruptive seborrheic keratoses associated with a benign or malignant tumor have rarely been reported. Here, we describe a case of unilateral eruptive seborrheic keratoses associated with hepatic hemangiomas and review reported cases of unilateral eruptive seborrheic [...]

Complete clinical remission of tumor‐stage granulomatous mycosis fungoides after treatment with PUVA, skin electron irradiation, oral etretinate and systemic interferon‐γ

in Indonesia, known as Kerik. Other ethnic terms include Kuong in Loas and Kos khyal or Koo kchall in Kampuchea. In North America, very few cases of Gua Sha are known; it was only in 1995 that Gua Sha appeared in the English literature. Wife and husband domestic abuse could be mistakenly suspected if these practices are not recognized in an adult. A careful physical exam showing linearity and symmetry of lesions is important to determine differentiating features. Gua Sha is a harmless folk remedy that should not be critically viewed by physicians, as this only alienates the patient and makes appropriate diagnosis, therapy, and follow-up less likely. Awareness and knowledge of these cultural practices will hopefully allow physicians to be more comfortable with differentiating abuse from Gua Sha.

Atypical subacute cutaneous lupus erythematosus presenting as lichen planus pemphigoides with autoantibodies to C‐terminus of BP180, desmoglein 1 and SS‐A/Ro antigen

pigmentation in adult-onset Still’s disease. Dermatology 2001; 202: 333– 335. 3 Lee JY, Yang C, Hsu MM et al. Histopathology of persistent papules and plaques in adult-onset Still’s disease. J Am Acad Dermatol 2005; 52: 1003–1008. 4 Kawaguchi Y, Terajima H, Harigai M et al. Interleukin-18 as a novel diagnostic marker and indicator of disease activity in adult-onset Still’s disease. Arthritis Rheum 2001; 44: 1716–1718. 5 Chen DY, Lan JL, Lin FJ et al. Proinflammatory cytokine profiles in sera and pathological tissues of patients with active untreated adult onset Still’s disease. J Rheumatol 2004; 31: 2189–2198.

Localized cutaneous fusariosis after long-term topical application of corticosteroids in a healthy elderly woman.

ejd.2012.1753 Auteur(s) : Yozo Yamada1 yozoymd@med.kobe-u.ac.jp, Goro Nishioka2, Koichi Makimura3, Masahiro Oka4 1 Department of Dermatology, Kakogawa West City Hospital, 384-1 Hiratsu Yoneda-cho, Kakogawa 675-8611, Japan 2 Nishioka Dermatology Clinic, Kakogawa 675-0064, Japan 3 Teikyo University, Mycology and Genome Research Center, Hachioji 192-0395, Japan 4 Division of Dermatology, Kobe University Medical School, Kobe 650-0017, Japan The genus Fusarium, from the hyphomycetes, comprises a large [...]