Yumie Ogasawara

Perineal Lipoma in a Neonate

Although lipoma is a subcutaneous tumor most commonly found on the trunk in adults, it is very rare in neonates. The histopathological findings show an encapsulated tumor containing normal fat cells. We report a 3‐month‐old female newborn with lipoma in the perineal region. The tumor was 4 cm in diameter, which histopathologically showed non‐encapsulated lobules composed of fat cells without cellular atypia. There were no genital abnormalities. The tumor was easily removed while the patient was under general anesthesia.

Primary cutaneous nocardiosis due to Nocardia brasiliensis in an immunocompetent patient

To the Editor: Nocardiosis is an infection caused by Nocardia spp., one of the aerobic actinomyces existing in the soil. Cutaneous nocardiosis can be the manifestation of a primary infection with skin lesions caused by traumatic implantation of the pathogen into or beneath the skin or a secondary infection with skin lesions arising from hematogenous metastases of pulmonary or visceral nocardiosis to subcutaneous tissues. We herein report a case of primary cutaneous nocardiosis due to Nocardia brasiliensis in an immunocompetent patient that resembled cellulitis caused by general bacteria. The patient was a 37-year-old, previously healthy, male high-school teacher who lived in Yamaguchi, Japan. Approximately one week before the first visit to our hospital, he was hiking when he felt a sudden pain, as if from an insect bite, in the left lateral malleolus. Three days later, a red-bean sized bulla appeared at the site. He punctured the lesion with a sterilized needle, disinfected it with povidone iodine, and then covered it with gauze. Later, flare and swelling appeared in the region surrounding the lesion. On July 28, 2002, he visited a local hospital, where cellulitis was diagnosed and he was given a prescription for cefdinir 300 mg/day. However, pain in the left popliteal lesion and pyrexia of up to nearly 39°C appeared later that day, and he visited our hospital on July 31, 2002. On the left lateral malleolus, we observed a thumb-tip-sized ulcer associated with peripheral flare and with yellowish necrotic tissue in the center (Fig. 1). Palpable, cord-like, subcutaneous indurations ascended from the lesion to the left popliteal fossa. The indurations were painful and associated with swelling and local heat covering the left lower leg. Laboratory data showed an elevated white blood The Journal of Dermatology Vol. 32: 230–232, 2005

A Case of Black Dot Ringworm Attributable to Trichophyton violaceum: A Simple Method for Identifying Macroconidia and Microconidia Formation by Fungi‐Tape™ and MycoPerm‐Blue™

An 85‐year‐old Japanese woman sought a dermatologic consultation for evaluation of a walnut‐sized alopecia with pityroid desquamation in the parietal region of her scalp. She had been admitted to a nursing home about three months earlier, and, at that time, a thumb‐tip‐sized, scaly alopecia was noted. Several hairs at the site were eroded in a black dot. Direct KOH microscopy of affected hair showed large spore endothrix infection. To isolate macro‐ and microconidia for fungal identification, we incubated the affected hair and scales and obtained giant colonies in a special enriched medium. Using Fungi‐tape™ and MycoPerm‐Blue™, we were able to collect and identify Trichophyton violaceum macro‐ and microconidia from the white, powdery, fluffy colony that slowly developed after about six weeks of growth on enriched medium. Over the past 20 years, only about 20 cases of tinea capitis caused by T. violaceum have been reported in Japan, and macroconidia have been identified in only 4 cases, including this one.

The histopathology of envenomation by Japanese viper bite.

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