1010日本皮膚科学会雑誌　第71巻　第９号

　　Society Transactions

　Tokyo Dermatological Society

　　　　The 388th Meeting

Chairman: Prof. Yuzuru Hashimoto

　　　　Showa Medical School

　　　　　September 17, 1960・

　　　　　　　　　　　　amination showed the considerable leukemic cell　　　　　　　　　Special Lecture

　　The Importance of Func^oas Diseases in

Immunology･

　　The Comparative Pathogenesis of System･

ic Foungous Diseases. By J.W. Wilson (Univ-

ersity of Southern California).

　　See Jap. J. Med. Mycol., 1, 299～302 (1960)｡

　　　　　　　　　　Symposium

　　Ｍ心･ｎ Ｔｈｅｍｅ.:Dermatoses induced by ln･

ｓｅｃtｓ.　ＢｖKowashi Iwashige (Sliowa　Med.

School)｡

　　　　　　　　　General Speech

　　Ａ Case of Periarteritis Nodosa Ｚ Three

Cases of Paget's Disease of the Pubic Region。

召y　Kuniaki　Nakamura, Hitoshi　Murata　and

Yoshiya Yamada (Shinshu Univ.)･

　　1）Ａ case of periarteritis nodosa. A 31-

year-old man. suffered from muscle spasm, slight

pain and languor in his whole body. Acceleration

of blood sedimentation rate,increase of serum

globulin, decrease of A/G, hypesthesia, muscle

pain, livedo racemosa-like erythema and sub-

cutaneous tubercles were observed. Diagnosis

was established as periarteritisnodosa.

　　2) Three cases of Paget's disease of the

pubic region. A 78-yeaf-old woman, a 50-year-

old man and ａ 69-year-old man presented the

lesions of Paget's disease, each had the attack

of the disease for 6 t0 13 years, al!of the cases

showed　th･e　fairly　progressed　carcinomatous

changes･

　　Skin Eruptions Observed by Myelogenous

Leukemia.　召ｙ　Syunzi　Mori (Toranomon

Hosp･）ａｎｄKeizi Mizuoka (Univ. of Ｔｏｋｙｏ）･

　　Case l. A 43-year-old man developed gener-

alized erythemas and wheals. Histologicallythe

infiltrationof few leukemic cells was observed

in the upper dermis.

　　Case 2. A 34-year-oId woman with painful

exsudative erythemas and nodules on the face.

breasts and extremities. The micrescopic ex-

infiltration in the dermis｡

　　Case 3.A 32-year-old man with dissem-

mated pinhead sized papules。The histology of

ａ papule showed non-specific changes｡

　　Ａ Case of Lymphangioma Circumscrip･

tｕｍ・　Ｂｖ Nobuyasu Sato (Branch Hosp･， Univ.

of Ｔｏｋｙｏ)｡

　　Ａ Case　of　Reticulosarcomatosis　Cutis

Terminating in Leucemia･like Blastocytemia

of　Reticnl・sarcomatous Cells.　jかAkihiro

Kawada, Kenjiro　Seki, Yoichi Nakauchi and

Kimiko Tajima (Univ. ０ｆＴｏｋｙｏ)｡

　　Ａ male aged 37, who had suffered from

multiple reticulosarcoma on the back, chest and

lower back, died of cerebral bleeding one year

after the onset. Ten days before the death.

tumor cells appeared in the peripheral blood with

leucocytosis ranging from 25，300 to 79,800. By

the autopsy, the infiltrations of reticulosarcoma-

tous cells were observed in the bone marrow.

spleen, lymphnodes, liver and kidney.　Tumor

cells in the smear of skin tumors are appeared

to be identical with pathological reticular cells

in the blood Smears｡

　　Ａ Case of Colloid Milium.　Ｂ.％. Sabur・

Kagawa (Univ. of Ｔｏｋｙｏ)｡

　　Ａ Case of Pigmented stripe of the Nail

(Lentigo Unguium)･　題y Atsuslii Kukita (Univ.

of Ｔｏｋｙｏ)｡

　　Ａ　female, aged 35, Japanese, came to the

dermatologic out-patient clinic of the University

of Tokyo complaining of ａlongitudinal pigmenta-

tion of the nail of the thumb of her left hand.

This was first noted two years before as a brown-

ish slender line at the nail. This had slowly

grown to　its present width. There are ｎひ

symptoms at all. The family and past histories

were not relevant. The thumb of the left hand

showed ａ dark brownish black linear pigmenta-･

tion measuring ３mm. in width, run万ｎ万ingparallel

to the axis of the nail and extending from the

昭和36年９月20日

proximal end to the free border in the center

of the nail plate. The nail was extracted for

biopsy and H-E staining, Dopa specimens and

Masson-Zimmermann's　staining　for　melanin

were prepared. The histological observations

･were made at　two portions of the nail, the

central part between the proximal end the free

tjorder of the thumb and the nail matrix. In

the former, melanin granules were noted in the

nail cells and Dopa positive dendritic melanocytes

and hyperpigmentation were observed　in　the

basal cell layer of the hyponychium. The bipolar

pigment containing cells. probably melanocytes

being casted off, were also observed in the upper

layer of the nail plate. In the nail matrix, the

rete pegs of the epithelium are elongated and

the proliferation of dendritic melanocytes was

noted in the tips of the elongated rete pegs,

the those cells containg highly active　dopa-

oxidase. These histopathological features are

identical　of　those　of　lentigo (Lever). The

original paper will be published elsewhere｡

　　　An Autopsy Case of Dermatitis Exfolia-

tiva Neonatorum Ritter. By Somei Saito (Chiba

Univ.)｡

　　　Ａ　study on　Alkaline Phosphatase　in

Kormal Hum皿Skin. By Tatsuji Kobori, Junro

Narumi and Kazuo Hasegawa (Tokyo Teishin

Hospよ

　　　Alkaline phosphatase in the normal human

skin was demonstrated by Gomori's method of

staining. Results were as follows:―(1) Epider-

mis showed false positive reaction for alkaline

phosphatase. (2) Cutis showed negative rea-

ction. (3) In　sebaceous　glands, the　positive

reaction was observed only in the basal memb-

rane. (4) The epithelial　cells and myoeithelial

cells of eccrine glands were found positive.（5）

？ｈｅ　false positive reaction in the ducts　of

ccrine glands. (6) The positive　reaction　in

capillaries was so remarkable that the capillary

networks and loops could be clearly ，demon-

strated｡

　　　Therapeutic　Method after the　Discon-

tinuance of Systemic Corticosteroid Therapy.

μｙ Tatsuji Kobori, Masaru Ishihara, Itsuro Ota,

Heita　Kato, Kazuo　Hasegawa　and　Hiroshi

Amagaya (Tokyo Teishin Hosp.)｡

　　　Various treatment methods were evaluated

to prevent the　recurrence　after the discon-

tinuance of orally administered corticosteroid,

1011

with fo】lowing results: (1) The most effective

methcxJ in various type of eczema･dematitis and

neurodermatitis was corticosteroid ointment and

in psoriasis, coal tar ointment. (2) In　lupus

erythematosus acutus, pemphigus and erythro-

derma there was no effective method to prevent

the recurrence. (3) Combined use of soft and

supersoft ｘ ray with ointment also was proved

to be more effective than ointment only. (4)

Substitute medicine for corticosteroids was not

present in dermatological treatment. (5) Admis-

sion and to take rest were most effective measure

to prevent the recurrence and also to take off

the orally administered corticosteroid｡

　　　　　Presentation of Clinical Cases

　　　Psoriasis Vulgaris with Involvement of

Tongue. (Tokyo Teisliin Hosp.)｡

　　　Congrenital Gctodermal Dysplasia. (Kanto

Rosai Hosp.)｡

　　　A 19-year-old male had suffered from the

sparsity of hair growth in the scalp. ０ｎ examina-

tion he was found to have sparse hairs in the

scalp, eyebrows, eyelashes and beard. The skin

was thin, smooth, g】ossy and dry.　Axillary hair.

pubic hair and body hair were scanty or absent.

The facial appearance showed depressed nasal

root and bridge, prominent frontal bulge and

thick lip. The teeth were defective in deve-

lopment as to number and form. The　patient

was unable to sweat adequately and therefore

was　intolerant　to　heat.　The　elevation　of

temperature was observed｡

　　　The mentality was not affected. Histopatho-

logy: There was total absence of sweat glands

and deficiency of pilosebaceous structures. The

collagen, the elastic fibers and the blood vessels

were normal in appearance.　Examination of the

axillary skin revealed total absence of eccrine

and apocrine glands｡

　　　Necrotizing Angitis. (Kanto Rosai Hospふ

　　　A 29-year-old male patient had suffered from

the gradually spreading nodular lesions on the

legs and feet, and then noticed tenderness with

the edematous swelling for 4 0ｒ 5 years. On

examination there were irregular, reddish brown.

indurated　patches　and　small, reddish, round

nodules with tenderness and edematous swell-

ing over the legs and feet. Blood sedimentation

rate was elevated. Examination ot urine and

blood were normal except the elevation ｏｆβ-

and 7-gIobuUn. Histology: The marked proUfera-

1012

tion of　endotheliums and　various degrees of

occulsion of the lumina with slight or severe

inflammatory infiltrationswere observed in the

small blood vessels of the dermis｡

　　　Schamberg゛ＳDisease. (Kanto Rosai Hosp.)｡

　　　A 45-year-old male had suffered from the

reddish brown pigmentation over the legs for 3

or　4　years. On examination the pigmented

patches over the legs were appeared as diffuse.

reddish brown pigmentation with outlying punc-

tate lesions. The subjective symptoms were

absent. The examination of urine and blood

were normal.　Hypercholesteremia was absent.

Rumijel-Leede's phenomenon was positive. Histo-

pathology: The subepidermal, papillary and sub-

papillary cutis contained cellularinfiltratesand

extravasation of blood in groups and band forms.

more pronounced around theｂ!ood vessels. The

infiltrating cells were small round cells,some

containing iron pigment　granules. The blood

vessels,especially capillariesin the cutis were

ｄｅ】ated｡

　　　Angioblastoma. (The　Central　Railway

Hosp.)｡

　　　A 32･pear･01d woman had developed ａ bluish

red, hen-egg-sized tumor on the distal end of

the right forearm for about 8 years. Slightly

tender with pressure. Histologically,masses of

tumor cells which tend to form vascular lumina

in the lower dermis. Marked hemosiderin deposit。

　Lichen Planus･ (The Central Railway Hosp.)｡

　　　A7-years-old girlhas developed for 6･months

white spots with reddish, pinhead-sized papules

in tbeir center, on the extfremities｡

　　　Histologically,slight hyperkeratosis, degen-

eration of the basal layer and the plateau-shaped

round cellinfiltrationin the upper dermis｡

　　　Verruca Plana JuvenlisべThe Central Rail-

way Hosp.)｡

　　　A 13-year-old boy had had papular eruptions

of 5 years' duration. The skin change consists

of　numerous round, flat papules of pinhead

size, which are scattered over tHe face, the

scalp.the neck and the back. On the scalp they

are confluent and form plaques, histologically

typical“ basket weave "，hyperkeratosis, vacuo-

lated degeneration in the granular and prickle

cell layers｡

　　　Case for Diagnosis･ (Sanraku Hosp.)｡

　　　A 47-year-old male had had dull pain in his

日本皮膚科学会雑誌　第71巻　第９号

nape and shoulder region of five years' duration.

A diffusely elevated. firm, cutaneous swelling had

appeared on his nape since three years prior to

the first inspection, which gradually developed

to the size of palm. The swelling was covered

with the apparently normal skin and had no

connection with the underlying tissue. Histo-

logically, the　marked　proliferation and　mild

degree of degeneration of collagen fibers were

observed. Elastic fibers were also found to be

fragmented. During　the　observation　for　３

months, this swelling had shown some sport-

taneous regression｡

　　Unilateral　Varicosity　Associated　with

Hypertrophy　and　Angiokeratoma. (Toho

Univ･)。

　　Ａ man aged 29, first noticed varicose veins

on the left lower leg and foot following cc

tusion at the age of 11 years, and has since been

unilaterally developing new lesions on the left

thigh, inguinal area and scrotum. Subsequently

the lesions of angiokeratひma occurred on the left

toes and on the left side (》fthe scrotum。 The

left leg was longer than that of the opposite

side in circumference and length. The roent-

genogram showed the increase in length and

thickness of bones of tibia and fibula on the

affected side, but tlie arterio-venograro showed

no　evidence　of　arterio-venous　anastomosis.

Microscopic examinations of the skin from　the

scrotum and the toe revealed the typical findings

of angiokeratoma｡

　　Poikilodermia　Vascularis. Atrophicans.

(Nihon Univ.)｡

　　Ａ man, aged 32， has had lesions of ｓiχ

months' duration on his both axillae and right

inguinal region. No itching is ever complained｡

　　In those regions he presents well defined.

goose-egg-sized, round or oval shaped, scaly

lesions. Small T>ea-aized teleangiectasia and pur-

pura are observed in the lesions. Laboratory

examinations　revealed no　particular　finding.

Histologically, relatively limited, dense cell in-

filtrations are noted in the upper corium｡

　　Mucinosis Papulosa. (Nihon Univ.)。

　　Ａ man, aged 18 years, has developed ａ num-

ber of eruptions all over the body for about

two years. Subjective symptoms were lacking･

No other noteworthy illness preceded the onset

of this complaint. Numerous papules, a ｈａ江

昭和36年９月20日

rice grain in　size, somewhat　dull　yellowish

colored, are　disseminated on　the　trunk, ex-

tremities and the scalp, especially in the epigas-

trial region. Histologically, hyperkeratosis and

papillomatosis are present. Deposit of mucin is

proved in the papillar and subpapillar layer by

mucicarmine. T払ｓ　material　is　digested　by

hyaluronidase｡

　　Parakeratosis Guttsta。 (Nihon Univ.)｡

　　Ａ male aged １７ years has had skin lesions

almost　all　over　the body without subjective

symptoms of 3 years' duration. The pea-sized。

well defined, yellowish scaly lesions are scattered

chiefly on the trunk and thighs. Histological

examination shows mild parakeratosis and dense

cell infiltrations consisting of lymphocytes in

the upper dermis｡

　　Darier's disease. (Nippon Medical School)｡｡

　　A 42 year-old man. P.H.:　Pulmonaltuber-

culosis (1954), gastric ulcer (1960). P.I.:　He has

been　troubled　with　numerous　disseminated

blackish-brown papules on　the front　of　the

chest, back and belly for about ten years. In

the biggining the itching was present but now is

almost absent｡

　　The eruptions became crust covered and

spreaded over the arms for three years.　The

ｏｒａ】mucosa is not involved. Biopsy specimen

showed hyperkeratosis, parakeratosis, mild de-

gree of acanthosis of the epidermis and lacunae

in the prickle cells layers. There are found the

isolated prickle cells and few “ round body ”in

the lacunae but not the “ grains ”｡

　　Ichthyosis Paratipica. (Univ.ｏｆ Ｔｏｋｙｏ）｡

　　Ａ boy aged 11, whose parents were con-

sanguineously married. became soon ichthyotic

in his almost entire skin after birth, but had

no neurological signs. The scalp. trunk, axillae.

external ear canal. palms and genito-femoral

region were rough and dry. and covered with

dark　brown　pigmented scales. However, no

eruption was seen on his extremities except

for the palms. Histologically moderate　hyper-

keratosis　without　parakeratosis　was　present

but, in this case, the granular layer was normally

recognized｡

　　Pemphigus Ｖ６ｇｌ６tａｎt･:(Univ･:ofTokyo)｡

　　Homme de ３２ans, depuis ５ ans. apparition

de lesions bulleuses ou ^rosives au nivean des

creux axillaires. de rombilic, et de la region

p6nn6o-ii】guinale, qui par la suite se sont trans-

1013

form6s en plaques v6g6tantes a surfaces papillo-

mateuses et crouteuses｡

　　　　Ｌ'ｅχamen histologique montre, outre la

formation de nombreuses fentes dans 1'6pideｒｍｅ，

une bulle intramalpighienne avec acantholyse

s'accompagnant　d'une　hyperacanthose　avec

papillomatose｡

　　　Ａ Case of Lupus　Vulgaris. (Univ.　０ｆ

Ｔｏｋｙｏ.)｡

　　　A 38-year･01d woman, suffered from tuber-

culous lymphadenitis of several weeks' duration

in the right Ｓ姐ｅof her neck at the age of 7，

which reulted in ulceration and was followed

by ａ granuloma formation. The granule〉matous

lesion has gradually increased in size, and the

similar　lesions appeared also on　the cheeks,

chest and right buttock. The general health

was　slightly　involved. Tuberculin　reaction

proved　strongly　positive. Middlebrook-Dubos

reaction was negative. Histology was typical

of lupus　vulgar is. 1. 0 g. ０ｆ Kanamycin was

injected every other day in ａ total of 23 9.，

accompanied with oral administration of INAH

amounting to 14g. The remarkable effect was

observed｡

　　　Granulosis Rubra Nasi. (Univ. ０ｆＴｏｋｙｏ)。

　　　Ａwoman aged １７，since about 5 years before^

has suffered from　localized hyperidrosis　and

reddish papules on the nose every summer. la

winter the eruption almost disappeared. Histo-

logical findings showed ａ cystic cavity in the

dermal portion lined by flat or cuboid formed

epithelial cells which are arranged in from ｌ to

3 layers.　The capillaries around the cyst were

dilated and slight inflammatory infiltrate in the

upper dermal portion was observed｡

　　　ＡCase of Senear･Usher SyndromeべUniv.

０ｆTokyo.)｡

　　　Ａ girl aged 15 had had thinning of the

scalp hair since 1955, and formation of builae

since 1958 0n the chest, head, trunk and ex-

tremities, accornpanied with slight itching sensa･

tion. No tendency of reddening or exsudation

was observed. Family history noncontributory.

Physical　development and sexual　maturation

retarded. Examination revealed nail-sized, dirty

brown, oozing, partially scabbed, liyperkeratotic

lesions scattered in the fronto-parietal region of

scalp, dorsal aspects of arms and thighs and

face, accompanied　with ａ　few bullae on the

trunk. Nikolsky' sign positive. Laboratory

1014

investigation revealed decrease of urinary 17-

ketosteroids and creatinine, and increase of crea-

tine. Histology　displayed　acantholytic　buUa

formation in the upper part of the dermis.

　　　Ａ　Suspected　Case　of　Lichen　Planus.

(Univ. ０ｆTokyo).

　　　Ａ female aged　31, had had for 5 weeks

itching sensation on the left side of the forhead,

followed　by development of several purplish-

brown, flat-topped papules ａ few days later.

The papules were grouped. and partially coalesc-

ed. Histology revealed no hyperkeratosis, para-

keratosis, nor hypergranulosis. Slight acantho-

sis, papillomatosis and elongation of rete ridges

were observed. ｈ

inflammatory infiltrates were present, composed

of　small　round　cells　and reticulohistiocytic

cells. Numerous　chromatophores were found

in the papillary layer.

　　　Parapsoriasis.　en Plaques. (Univ.　of

Ｔｏｋｙｏ)･　　　．

　　　Ａ girl aged 10 has had slightly itchy, red

or reddish brown plaques of varying size with

fine scales on the upper arms, abdomen. hips.

waist and thighs sicce three years before. Both

depigmented and brownish pigmented　lesions

were present on the neck, chest, abdomen and

back. Biopsy was taken from an erythemato-

squamous patch on the right upper arm.　The

epidermis showed mild hyperkeratosis. parakera-

tosis, slight acanthosis and, partially, spongiosis.

In the upper part of the cutis, the infiltrate

mainly composed of lymphocytic cells and histio-

cytes were seen especially in the perivascular

area.

　　　Morbus Darier. fUniv. of Ｔｏｋｙｏ).

日本皮膚科学会雑誌　第71巻　第９号

　　A 67-year-old ｍａ】e,fisherman and worker.

In the summer at the age of １７，itchy eruptions

appeared on his scalp and then became crusted

and emitted an offensive odor. At the age of ２３，

these eruptions spread over the limbs, the front

of the chest, the back,the inguinal and genital

regions and the loins. Usually they became

prominent in the summer and lightened in the

winter.　After　these　eruption　disappeared,

irregular pigmentation and depigmentation occurr-

ed on these areas. Status praesens :　Charac-

teristic　eruptions　such as papules, papillma-

tous and vegetating growths with dirty crust

in some places were seen all over the body

except elbow- and knee-joints and interscapular

region. Histologiとal findings :―There are lacunae

between the basa［arid prickle cell layers, where

so-called viUi and dyskeratotic cells such. as

corps ronds and grains are seen. Also in the

granular and horny layers. these cells are found.

　　　Naevus　Systematicus　Depigmentosus.

(Chiba Univ.)･

　　　Incontinentia Pigmenti　Acromians Ito ？

(Chiba Univ.).

　　Psoriasis Vulgaris. (Showa Med. School).

　　Psoriasis Vulgaris. (Showa Med. School).

　　　Dermatitis Herpetiformis Duhring.(Showa

Med. School)･

　　　Dermatitis Heipetiformis Duhring. (Sho-

wa Med. School)･

　　　Parapsoriasis　Variegata. (Showa　Ｍｅｄ･

School)･

　　　Acroderμlatitis　Chronica　Atrophicans.

(Showa Med. School).

　　　Klippel･Weber's　Disease. (Showa　Ｍｅｄ･

School).

　　　Tokyo Dermatological Society

　　　　　　　The 389 th Meeting

　　　　Chairman: Prof. Giichiro Harada

Tokyo Medical and Dental University, Tokyo

　　　　　　　　November 12, 1960

　　　　　　　　　　　　　　　　　ment of Urticaria.　召ｙ Minoru Yamada (Ｔｏｋｙｏ

　　Ｍａｉｎ

Urticaria.

　　　Symposium

Theme:　Treatment　of　Chronic

Summary of Questinnaire on the Treat･

Med. and Dent. Univ.)･

　　Results of our Method of Treating Chronic

Urticaria. By Yoshio Yamaya (Nihon Univ.).

昭和36年９月20日

　　On the Treatment of Chronic Urticaria.

柏７Yoshiya Yamada and Kihei Tanioku fShinshu

Univ.)｡

　　　　　　　　　General Speech

　　Kaposi's Sarcoma. By Kazuo Hasegawa

(Tokyo Teishin Hosp.)･

　　A 62-years-old man was seen in November

1959, at which time he presented ａ ulcerated

lesion, the size of pigeon's egg, to be surrounded

the red macule, as large as ａ man's fist,on his

forliead and many pin-head-sized nodules with

the edｅｍａon the upper eye lid. General physical

and laboratory examination were negative。Cu-

taneous biopsy was interpreted as Kaposi's sar-

coma.　χ-ray therapy was given during No-

vember 1959(total 1600ｒ･).　Suddenly he obtained

the spontaneous pneumothrax and died in Janu-

ary 1960.

　　Histologically the blood vessels of the dermis

were dilated and increased in number. There

were hemorrhage and peri vascular as well as

diffuse cellular infiltration, composed of small

round cells, eosinophiles and spindle cells. At

autopsy, there were the infiltration of　tumor

cells and distruction of the skull under the ulcer.

and many small ulcers in the stomach and

colon.

　　Two Cases of Solitary Nenrilemmoma.

勾Ｈ. Takubo and Ｋ. Nakamura (Keio Univ.).

　　Case 1. For 5 or 6 years, a man aged ３３

tad noticed ａ round subcutaneous tumor at the

right thumb, about 0.８ centimeters in diameter.

without tenderness, and it had enlarged slowly.

Microscopic section showed an orderly arran-

gement of parallel cells and intercellular fibers。

so-called palisaded pattern.

　　Case 2. For l year, a man aged ３０，had

noticed ａ tumor in the subautaneous tissue of

the right arm, no tenderness. The main mass

was rounded, 1 centimeters in diameter, but it

was not encapsulated. Microscopically, it showed

ａ typical formation of Vercxay body.

　　Ａ Case of Psoriasis Arthropathica.　称･

Giichiro Harada, Toshinao Ishii, Chohei Takino

and Toshikatsu Irimaiiri (ＴｏｋｙｏMed. & Dent.

Univ･).

　　Case.―H.N., a male aged 26. At first time

he found neuralgic pain of the right leg. As

soon as painful joint swelling was occurred. and

at this time the eruption appeared on the head.

then spreaded out whole body. The fever, 37°Ｃ

1015

t0 39°Ｃ，was remittent. The eruption was partly

exsudative. The biopsy was fit　for psoriasis.

Rentogenologically subchondral atrophy of limbs

was found especialy of the terminal phalanges･

Antistreptolysin-0 titer was high, and gradually

decreased　after　removal　of　affected tooth.

Hemolytic streptococcus and staphylococcus was

proved from decaied tooth. Massive therapy of

antibiotics was effective.

　　　About the Mental Factors in Some Disea-

ses of the Skin.　7かKo Utsumi (Chiba Univ.).

　　　On considering the correlation between the

skin diseases and the mental factors, it IS most

important to manifest the personalities corres-

ponding to the diseases of the skin. before the

psychogenity of the diseases would be discussed.

The certain psychological influences from the

skin diseases themselves are also found. There-

fore it is very difficult to establish the general

tendency of　personality of the skin patient.

picking up the psychological factors towards the

diseases　from the influences of the diseases.

　　　Personalities of 20 cases of alopecia areata.

４ cases of urticaria clironica and　ｌ case of

neurodermitis disseminata　were examined by

Rorschach Test. As control ８ cases of angioma

and ２ cases of vitiligo were examined ； for they

were suffering from the said diseases in their

face and beeing regarded that their emotional

structures would be changed by them.

　　　Altersveranderungen des Naevns Pigmen-

tosus (III Mitteilung). von Kenichi Uyeno

(Univ. of Ｔｏｋｙｏ）.

　　　Das Detail wird anderswo mitgeteilt werden.

　　　The Patch Test in the Diagnosis of some

Cosmetic Agents.　£y Nagako Kukita (Shiseido

Chemical Institute).

　　　The closed patch tests were performed on

many groups (1655 persons) of normal young

women to detect for primary irritant on ｓＯme

cosmetic agents. The results of this study

indicated that : (1) Cosmetics base containing

antiseptics brought more slightly skin irritation

than base cometics only.

　　　2) Perfumed cosmetics base brought more

frequently skin irritation than cosmetics only.

　　　3) Unperfumed cosmetics brought no skin

irritation.

　　　V.D. Control in Public Health Center.

μyl Kunio Hanai and Makoto Watanabe (Ko-

jimachi Health Center).

1016

　　studies　on　the　Staphylococci　Isolated

Recently.　Ｂｙ Keiichi Fujita, Jiro Katsuya and

Yasuo Torajima (SDF Cent. Hosp.)｡

　　From January to May in the year 1960, 199

strains of Staphylococcus aureus and 73 strains

of Staph. epidermidis were isolated from miscella･

neous skin lesions, throat and nasal swabs of

patients at our department.　The staphylococci

aurei and stapli. epidermidis were almost equally

resistant　t０　７ antibiotics, and the following

resistance rates were revealed on examination

by tube method; 100% to penicillin, 31.0 % to

oxytetracycline, 49.1 %　to　chlortetracycline.

25.1 % to tetracycline. 18.4 % to cliloramplienicol,

7.8％tｏ streptomycin. 6.6 % to erythromycin.

Tetracydine, oxytetracycline and chlortetracy-

cilne often showed cross resistance, if not always.

The strains isolated from different sites in the

same patient often showed similarities in chara-

cters and antibiograms.　And　sometimes　the

strains of Staphylococcus aureus and epidermidis

from the same subject showed precisely the same

antibiograms.　From　patients　residing　in　a

solitary island Niijima, 19 strains of aureus and

52 strains of epidermidis were isolated on June,･

1960. The proportion of aureus to epidermidis

was smaller than that in the patients of our

clinic, and those staphylodocci were less resistant

t０７ antibiotics （tｏ penicillin 85.7 %, to tetracy-

cline 1.4%, to erythromycin O％）｡

　　Clinical Observations of Atopic Dermati-

tls. By Akira Naito, Tsutomu Masuda and Shoji

Sasagawa (Univ. of Ｔｏｋｙｏ）｡

　　Experimental study　on the Autosensi-

tizati。ｎ Dermatitis. £ｙ Yuichiro Koizumi

and Kihei Tanioku (Shinshu Univ.)｡

　　We experimented in various ways in order

to make experimentally an auto-antibody to skin

in the rabbit, but it was found to be impossible

only by the injection of skin emulsion or toxin.

But when we tried the injection of mixture of

skin emulsion and　staphylococcus　toxin, the

intravenous injection of skin emulsion and the

intracutaneous injection of staphylococcus toxin

at the same time, we could make in the rabbit

an active principle which has affinity to skin｡

　　Experimental studies on the Effect of

Soft and Supersoft ｘ Ray on 伍ｅ Benign

Chronic　Inflammatory　Skin Diseases.　３y

Tatsuii　Kobori, Masaru Ishihara and Itsuro

Ota (Tokyo Teishin Hosp.)｡

日本皮膚科学会雑誌　第71巻　第９号

　　　The Comparison of the effect of the treat-

ment with ointment only (Hydrocortisone oint-

ment in in　eczema-dermatitis　and　neuroder-

matitis, Coal tar ointment in psoriasis) and with

the combined use of soft and supersoft ｘ ray

and　ointment was performed (by　controlled

method) in 29 cases of benign chronic infla-

mmatory skin diseases. The results were as

follows:(1) In almost　of　neurodermatitis,

atopic and nummular dermatitis and psoriasis

exanthemas were improved in turn as in χ＋

0,0,X. (2) Recent advantage of ointment made

the necessary dose of ｘ ray reduced. (3) 6 cases

of 13 cases with benign chronic inflaminatory

skin diseases experienced the efifect of the com-

bined use of　ｘ ray for the　prevention　of

recurrence｡

　　　　　Presentation of Clinical Cases

　　　Ａ Case of Calcinosis Localis. (Doai Ｍｅ･

morial Hosp.)｡

　　　Female, aged 67, About 30 years ago, papular

eruptions appeared on the infralateral areas of

both lower eye-lids. and then gradually increased

in size. These lesions are well demarcated.

walnut sized, yellowish, slightly elevated, hard

plaques having uneven granular surfaces. No

inflammation on the surrounding areas of these

lesions. No itching。Calcium level in serum 9.５

mg/dl.　Histologically the epidermis is thin in

general.　From beneath the epidermis to deep

corium massive deposits and individual crystalline

granules which stain deeply blue with hema-

toxylin and eosin, black with von Kossa's stain

for calcium are present｡

　　　Three Varieties of Parapsoriasis. (Central

Railway Ｈｏｓｐ.）｡

　　　Case l. Parapsoriasis en gouttes (Brocq).

Ａ man, aged 47, presents on the trunk, and the

extremities erythematous. scaly papules of about

2　years duration, which are slightly pruritic.

Recently, he developed ａ brownish, minute net

work on the neck. Histology:　Parakeratosis

with loss of granular layer, liquefaction degenera-

tion in basal layer. Slight peri vascular round

cell infiltration in the upper dermis｡

　　　Case 2. Parapsoriasis lichenoides. Ａ woman,

aged 65, whose skin changes have　been con-

tinued for 30 years　without any subjective

sensation. She presents on the trunk and extre-

mities, a compound retiform picture resembl-

ing that of radiant skin. Histology: On account

昭和36年９月20貝

of severe atrophy and liquefaction degeneration

of the epidermis, the corium seems t0 liedirect-

ly beneath the horny layer. Capillary dilatation,

incontinentia pigmenti　histologica and di症ｕｓｅ

ronud celled infiltrationin the upper dermis｡

　　　Case 3. Parapsoriasis en plaques (xantho-

erythrodermia perstans of Crocker). A 57 year-

old man developed ａ striking skm change of

about 3 years duration. The lesion consists of

bean- to ｗａ】nut-sized,fawn　colored, wrinkled

patches which shows obliqe or horizontal arran-

gement on the trunk. Sometimes　moderately

pruritic. HistologyこSlight acanthosis, exocyto-

siscombined with parakeratosis. and band-like.

comparatively dense　infiltration of round cells

in the upper dermis｡

　　　Case for Diagnosis. (ＹｏｋｏｈａｍａCentral

Hosp.)｡

　　　A18･year-old-male. Of three years' duration.

The sharply demarcated lesions located on the

face and right ear, the atrophy in the center,

papillary proliferations and　folliculitisat the

border｡

　　　Case for　Diagnosis. (Yokohama　Central

Hosp･)。

　　　A60-year-old female. She had had numerous,

well-defined,blackish brown, scaly lesions on her

back, loins abdomen thiglis and upper arms, of

one year゛ｓduration. The size of the lesions

were that of ａcoin toａhen-egg . Some of them

were coalescent forming irregular-shaped lesions.

Vascular spider,red palm, red sole and cirrhosis

of the liver were associated. Serologic tests

for syphilis found positive｡

　　　Case for Diagnosis. (Keio Univ.)｡

　　　48years old. farmer's wife. C. C.:Tumor

on the instep of right foot. p. I.:　Since ３years

ago, patient had noticed the tumor on　the

instep of right foot which gradually enlarged.

Recently the petient noticed pustules on tumor

which became painful.　Blood Wa. test (－)･

Bone χ Γay film of right foot normal. Pain on

right foot disappeared after administration of

sulfa drugs｡

　　　Pseudoχanthoiaa Elasticum. (Keio univ.)｡

　　　Ａpatient,33 years old male with pseudo-

xanthoma elasticum associated with striapigmen-

tosa retinae and atrophia retinae,was presented。

The lesions were noticed on the neck, axillae.

abdomen, tliighsand inguinal area without any

subjective symptoms.

1017

　　　Parakeratosis Variegata. (Nihon Univ.)｡

　　　A 20-year-old man has suffered from an

eruption for about one year. Subjective Symptoms

are lacking. At　the entrance, on 13, October,

1960, a number of scaling patches is present over

the trunk and the extremities. and most densely

on　the　loin,the buttock and the hypogastric

region. Partly　the patches　become　cofluent

resulting in an appearance of retiform. Histo-

logically there are parakeratosis and irregular

enlargement of the papillarlayer. It is found

that swelling and pale prickle cellsare in groups

in the lower stratum malpigliii.In the upper

corium, mild perivascular cell infiltrationscon-

sisted of mainly round cellsare observed｡

　　　Familial Benign Ｃｈｒ。inicPemphigus. (Ni-

hon Univ.)｡

　　　A 43-year-old man firstnoticed ａ recurrent

itchy eruption about 25 years ago. Since then

he has not been free from the lesion which

became worse in the summer and regressed in

the winter. On Augst, 9, 1960, the erythemato-

us plaques consisted of slightlyconically elevated

papules, a half ricecorn in size,brownish crusts

with peripheral　vesicles　are located　on　the

genital region most densely, the back of the

the neck, the axillar folds and other flexors.

Patient　says his mother had had ａ　similar

eruption. Histologicalｅχaminationshowed hyper-

keratosis, acantholysis and　mild perivascular

cellinfiltrationsin the upper corium｡

　　　Reticulosis Cutis. (Nihon Univ.)｡

　　　A　53-year-old　woman　noticed an　itchy

reddish eruption on the left knee in July, 1960.

And then the lesions gradually extended to the

both extremities. On 21, September, 1960, the

lesions are reddish papules or nodules covered

with thick white scale,a rice-corn toａfinger-tip

in size, and some of them are reminiscent of

prurigo Bodularis. Histoiogicallythere are hyper-

keratosis　acanthosis and　irregular　elongation

of the rete ridges. and dense cellinfiltrationsin

the upper corium upward the papillar layer.

where the proliferation of the reticulum cell

and the argyrophilic fiber are found｡

　　　Lichen Striatus. (Univ.　of Ｔｏｋｙｏ)｡

　　　A 18-year-old woman, two　months　before

being seen. developed ａsudden linear dermatosis,

completely asymptomatic, on the flexor surface

of right leg, ascending from the lower leg t(〉

the buttock. The lesion consisted of papules.

1018

slightly raised and flat,angu】ar in appearance.

forming plaques.　Histologic examination showed

ａ peri vascular lymphocytic infiltrate which rarely

involved　papillae and was mainly distributed

through the subpapillary corium and middle cor-

ium. There was diffuse hyperkeratosis with occa-

sional dyskeratotic cells in the granular layer.

related　to　the　underlying　infiltrated papiliae.

The　epidermis was of normal thickness and

showed　some　intercellular　and　intraceilular

edema｡

　　　Erythrodermie Cong6nitale Ichthyosifor･

me. (Univ. of Tokyo.)｡

　　　Ａ female, aged 20. Her parents were consan-

guineously married. Since her birth. she has had

generalized eryliroderma associated with iclitliyo-

tic skin. The palm, sole, flexor surface of knee

and elbow are invaded. The scalp presents scaling

and loss of hair. Histological examination shows

hyperkeratosis, papillomatosis, parakeratosis,

clubbing of the rete ridges and varying degree

of inflammation throughout the cutis, together

with dilatation of capillaries｡

　　　Dermatitis Herpetiformis Duhring ？(Ｕ逗ｖ･

べ)ｆTokyo)｡

　　　Ａ　woman aged　21, has since　６　years

suffered from recurrent eruptions of l－６months'

･duration every year.　Vesicles have never been

ヽobserved. There are raised, annular, variously

sized erythemas on the lower extremities and

ｌ〕rowish pigmented spots, some of which have

polycyclic borders on the extremities, back and

buttock. No eosinophilia. Patch test with pot-

tasiura iodide negative. Histology:―Acantholysis

negative. Edema observed in the papillary layers.

There are perivascular lymphocytic infiltrations

ヽ<;ontaining eosinophile cells｡

　　　Weber-Christian Disease. (Univ. of To-

ﾌ:･■kyo.)｡

　　　Ａ　boy aged 18, has developed thumb-tip-

sized, reddish, asymptomatic　nodules in　the

lower　extremities and lower back since　two

months ago, which have hitherto increased in

number･Some of the lesions have gradually

been enlarged and coalesced with each other

to　form large infiltrative masses, but any of

th ｅ　nodules　has　never　been　softened　nor

ulcerated. The patient has had undulant fever.

;bu t the fever does not seem to have a definite

relation　with　the　course　of　the　eruption.

心ｅ neral condition was not severely involved.

Arthralgia was not complained. Histology reveal-

日本皮膚科学会雑誌 第71巻 第９号

ed a slight necrosis of the subcutaneous fatty

tissues with nonspecific subacute inflammatory

reactions. Vascular changes were　not conspi-

cuous｡

　　Sporotrichosis. (Univ. of Ｔｏｋｙｏ)｡

　　Localized lymphatic sporotrichosis was found

on the flexor surface of the right forearm of a

29-year-old house wife. Positive skin reaction

with sporotrichin was observed. Sporotrichum

Schenckii was isolated from the cutaneous lesion.

Biopsy showed chronic inflammatory　reaction

in the dermis and the tissue form of the organism

in the granulomatous tissue both freely and

within giant cells｡

　　TeleanjEfiectosisMacularis Multiplex Acqui･

sita？(Univ. of Tokyo.)｡

　　Ａ woman, aged 48, has noticed the redness

of the skin on the　breast, upper arms　and

back since several years ago. No subjective

discomfort. Irrelevant family history and no

previous illness except obesity in these fifteen

years. Skin condition :一川defined, large, dark

red　plaques consisting of nail-　to coin-sized

erythemas on　which　pin-head･sized　purplish

spots scatter. These lesions disappear by dias-

copy.　０ｎ extremities and trunk very slight

varices.　Investigations :―Slight　liypochrome

anemia. Thrombocyte 21. 84χ10', Bleeding time

3'30", Clotting time 15'30"，Rumpel-Leede (Ht),

von. Borbery―8 cm Hg (十)，Ｎｏ abnormal bio-

chemical findings in blood including liver func-

tions. Histology :―In the uppermost portion of

the cutis small number　of　dilated capillaries

partly filledwith erythrocytes。

　　Case for Diagnosis. (ＹｏｋｏｈａｍａUniv.)｡

　　Ａ man, 23-year-old,have had follicularpapu-

les of pinhead size and brownish color on hisleft

upper chest wall about two years ago. Confluence

of　the papules　was not recognized　like so-

called paving stones. Histology revealed partial

cystic formation of hair folliclesand an increase

in smooth muscle bundles and collagenous fibers｡

　　Ａ　Case of Ulcus Rodens-Like　Fungous

(Candida ?)ll!fection of　the　SkinべTokyo

Hosp. Japan Monopoly Ｃ。rporation.)。

　　A　70･year｡０１ｄman has noticed　about　4

years ago ａ deep ulcer with slight pain on the

left sole, that enlarged slowly with no spon-taneous pain. St. pr.:―On the left sole ａ deep

ulcer can be seen, its diameter　5χ5cm, and

reached to the bone. Diagnosis: Ulcus rodens ？

But with histological examination. it was sug-

gested of ａ fungous disease.

昭和36年９月20日101９

Tokyo Dermatological Society

　　　　The 390th Meeting

　Chairman: Prof. Osamu Miura

　　　Nihon University, Tokyo

　　　　　December 10, 1960

　　　　　　　　　　　　amide, resection and cauterisationwere perform-　　　　　　　　　　　Ｓｙ皿posium

　　Ｍａｉｎ　Ｔｈｅｍｅ: On Seborrhoeic Dermatitis.

　　statistical studies on Seborrhoeic Der-

matitis. IかOsamu Miura (Nihon Univ.).

　　Classification and Nomenclature of Ecze-

ma.　勾　Kanehiko　Kitamura (Tokyo　Ｍｅｄ･

Coll.)･

　　　　　　　　　General Speech

　　　Ａ Case

Metastasis.

Tokyo).

of

勾

Reticulosaroiaa　ｗi仇　Skin

Mitsuo　Yoshida (Univ. of

　　　Ａ man, aged 58. Family history and past

historyこ―Irrelevant. History of the present

illness:―In. Sept. 1959, swelling of the retroauricu-

lar lymyhnode was noticed. In the subsequent

several months, generalized swelling of lymph-

nodes was observed. In June, 1960, itching and

eruptions occured｡

　　　Ciinical picture :―Reddish papules, nodules

and slightly reddish, infiltrated plaques on the

right chest｡

　　　Examination :―No abnormal findings includ-

ing　blood　examination. Histology :―Atypical

reticulum-cell-like tumor cells with the lattice

fibres were observed in the dermis. subcutaneous

tissue and lymplmodes. The same cells having

no lattice fibres in the blood and lymphatic vessels

were observed. Autopsy findinys :―No metes ta-

sis in the internal organs｡

　　　Naevus　Comedonicus Systematicus　As-

sociated ｗi仇Pyodermia. Bv H. Takubo and

H. Nakajo (Keio Univ.)。

　　　A 32-year-old female lias developed since

birtli nevus comedonicus　systematicus. The

eruptions are situated oa the right side of the

face, the scalp and the left side of the body.

and have been associated with pyodermia chro-

nica abscendens et suffodiens since ａ few years

ago. Cu】tures from the lesion revealed staphy

lococcus albus coagulase (十), mannitol (十)･

Histologically, the epidermis shows thinning as

ａ whole, the keratotic plugs are found in the hair

follicles,and the sebaceous glands become atro-

phic. Administration of penicillin and sulfanil-

ed in this case｡

　　　Ａ Case of Sjogren's Syndrome.　召y Ｎｏ-･

buyuki　Mizuno, Akira Hidano and Masamitsu.

Miyamoto (Univ. of Ｔｏｋｙｏ.).

A 52･year-old man of ａ typical SjOgren's syn-

drome was reported. He has been suffering:

from rheumatoid arthritis since 9.years, decrea-

se of sex desire since ７ years, xerostomia sicca

and decrease of secretion of parotids. cheilitis

and perleche, swelling and smooth surface of

tongue due to atrophy of papillae since ４ years,

keratoconjunctivitis sicca and marked decrease

of secretion of lachrymal glands since ｌ year,.

and has dry and iclithyosis-like changes of the

skin｡

　　　Results of laboratory examinations :―CRF

(3十)；　Rose reaction (十); y-G＼.by Tiselius's

method (28%) ;　slight　leukocytosis and neu-

trophilia ； slight　disturbances of　autonomous

nervous system, liver function and function of

the thyloid gland.

　　　Histologic　section　of the

atrophy of glandular structure.

lymphoadenoid infiltration.

parotid showed

lipomatosis and

　　　Two Cases of Pityriasis Lichenoides et

Varioliformis Acuta (Habermann) with the

Distinct Vascular Changes.召ｙ Tatsutaka

Furuya and Takashi Nakai (Univ. of Ｔｏｋｙｏ.）｡

　　　Case 1. A female aged ２３ has had typical

eruptions of this disease on the trunk and ｅｘ一一

tremities since about 12 years, and has been

under our clinical obser▽ation for 3 years.　Her

pregnancy brought ａ temproary healing in the･

last summer｡

　　　Case 2.Ａ man aged 45. Almost the same･

symptoms as the cace ｌ have been observed in

this case since about 5 years｡

　　　Histologic findings :―RemarkabJe　vascular

changes such as necrotizing angiitia were found

in　the dermis, partially in the subcutaneous

tissues, of both cases. It is, therefore, suggested

that the vasculitis seems to be　the primary

disorder　of　this　disease, and that　pityriasis･

lichenoides et varioliformis acuta appears to be

1020

a different entity from parapsoriasis en gouttes.

　　　An Autopsy Case of Carcinoma Erysipera-

todes.　£y　Toshiyuki　Funabashi, Takeshi

Yokozeki, and Hisashi Takahashi (Toranomon

Hosp.)･

　　　The patient, 63-year-old man, who had suff-

ered　from　the cancer　of　the　rectum　and

　　　　　　　　　　　　　　　　　　ｌundergone an radical　operation　in 1958, lias

been admitted to Toranomon hospital in 1960

because of the recent episode of erysipelas-like

painful edematous infiltration at the surface of

the scrotum, penis, perineum and upper part of

the left thigh, which histologically revealed the

lymphatic embolism　by　the　cells　of　adeno-

carcinoma. The autopsy finding shows　that

there　is extensive involvement of　the main

lymphatic　truncus such as ductus　thoradcs.

truncus lumbalis and tr. intestinalis, and is fully

stenosed by cancer cells, so it is easilly recognied

that the retrograde permiation and dissemination

of the cancer cells occured through the lymphatic

vessels　to　the skin, lungs and the peritoneal

cavities by lymphatic congestion.

　　　studies on Skin Diseases Using the Special

staining　Method Showing　Metachromasia。

勾　Nobuko Imai (Nihon Univ.).

　　　Melanocyte Within Hair. By Heita Kato

（ＴｏｋyｏTeishin Hosp.).

　　　The hairs which　show turning black to

brown　or　to white, or on the other way, lie

scattered occasionally among the black　scalp

hairs of healthy person, and in the seborrlieic

dermatitis and alopecia areata.

　　　These　portions of　the pulled hairs were

studied and　the results obtaind were as fol-

lows:－

　　　1) Melanocyte was found with or without

coarse melanin granules.

　　　2) Most of them had ２to ３heavily pigment-

ed and thick projections and others have slender

one.　But there was no fine branching that was

visible in the melanocyte of the upper part of

the hair bulb.

　　　3) Coarse rod-shaped granules stood in ａ

row and oval or comma shaped relativly large

and irregularly pigmented granules are located

between them, so they show the figure of the

melanocyte in all.

　　　4) Also the coarse granules were scattered

irregularly in tlie cCrtex.

　　　5）Ｄｏｐａ activity was not visible. but after

日本皮膚科学会雑誌　第71巻　第９号

the　reaction neither fine branch　nor　newly

formed granule was detected on or in them｡

　　Comparative studies of Lupus Miliaris

Dissminatas Faciei (LMDF) and Erythema

Nodosum (EN) with　Sarcoidosis (S). B

Nobuyuki　Mizuno, Koichi Hirokawa, Tadashi

Hirako, Osamu Hongo, Hisashi Nishida. Yasu-

tnasa　Ishibashi, Hidero　Suzuki　and Riicliiro

Mikami (Univ. of Ｔｏｋｙｏ.）｡

　　I，　By histological analysis of LMDF （59

cases) 19% sarcoid-like reaction was observed.

The distribution of age incidence of　LMDF

patients is more frequent　in younger popula-

tions than that of sarcoidosis,and that of sex

of LMDF is more frequent in female than that

of sarcoidosis.The immunologial reactions（TbR

and Middlebrook-Dubos's reaction) showed no

significantdifferences between patientsof LMDF

with sarcoid-likehistologicalstructure and those

with tubercle structure, and about one half of

the patients of LMDF showed the same reaction

as that of sarcoidosis. Dysproteinemia was not

found in LMDF, while more than half in sarcoido-

sis. No hypercalcemia in ＬＭＤＦ｡

　　II. While in Europe EN is caused mainly

by sarcoidosis and/or BHC, in Japan neither Ｓ

nor BHC was found in ２３cases of EN. In cont-

rast with that no EN in ５０cases of S. and BHC

in the Japanese literature was observed｡

　　Immunologic reactions of EN are entirely

differ from those of Ｓ｡

　　The statistical Observation and Treat-

ment of Burns. I，Ｂｖ Takashi Anzai, Shugo

Soeda, Hitoshi Murata, Hironobu Ito, Masami

Okubo and Akira Naito (Kanto Rosa: Hosp.)｡

　　See the Society Transactions of the 60 th

Annunal Meeting of the Japanese Dermatologioal

Association in this Journal｡

　　Clinical Pictures and Treatment of Con-

tageous Verrucae. By Keiichi Fuiita, Kazuyuki

Ishihara, Yasuo Torasliima and Kaoru Kato.

(S.D.F. Central Hosp.)｡

　　Presentation of Clinical Cases｡

　　Acrosclerosis. (Tokyo Teishin Hosp.).

A 46-year-old woman. She was suffering from

sclerosis and pigmentation of extensor surface

of the bilateral fingers, hands, forearms, up-

perarms, face ane　upper part of　the chest.

Besides she complained of difficultiesof breath･

ing and malaise ｅtｃ｡

　　We　treated　her　with low-phenylalanine-

昭和36年９月20日

tyrosine-diet by Dr. Nishimura's formulary for

７ months, intravenous injection of prednisolone-

sodium-hemisuccinate and ｄｅχamethasone-phos-

phate for ２ months and intramusclar injection

of chondroitin-sulfate for ２ months.

　　　Low-phenylalanine-tyrosine-diet showed some

effect　on　pigmentation, sclerosis and　general

conditions, but not on urine creatin ｅχcretion

and　elevated　blood　sedimedtation　rate. In-

tramuscular and intravenous injection of steroids

was most　effective on elevated　B.S.R., urine

creatin and various clinical signs. Intramuscular

injection of Chondron was effective on sclerosis.

　　　Thus she was showing gradual and satis-

factory recovery･

　　　Case f・ｒDiagn・sis.(Tokyo Teishim Ｈｏｓｐ.)・

　　　Reticulosarcomatosis. (Univ. ０ｆＴｏｋｙｏ.)･

　　　Ａ man, aged 31.

　　　He has noticed the generalized swelling of

lymphglands since Jan. 1960. In Oct. the reddish

skin lesions were dissemineted in ａ few days･

No subjective complaint.

　　　Skin　condition :―Reddish　papules, partly

infiltrated erythemas and dark reddish tumors

on the trunck, upperarms and thighs.

　　　Examination :―Leukopenia less than 3,000,

12% tumor cells in the circulating blood, 70%

in the bone marrow.

　　　Histology:一Each lesion shows atypical reti-

･culum-cell-like tumor cells, which pathologists

consider reticulum cells or lymplioblasts, and

hematologists myeloblast.

　　　Parapsoriasis en Gouttes Combined with

Parapsoriaais en lPaques. (Univ. of Ｔｏｋｙｏ.)･

　　　Ａ girl aged 20.

　　　About 5 years ago, she developed miliary

to pea-sized erythematous or papular eruptions

O n the back, and afterwards the same eruptions

were disseminated also on the chest and ex-

tremities. These eruptions were covered by fine

white scales. Some of those have left brown-

pigmented　or　depigmented　patches. On the

thighs, a few, up to hen-egg-sized red or reddish-

brown plaques with pityriasic scales were present･

'ＮＯsubjective symptoms were complained. Histo-

logy :―Biopsy specimens taken from both gut-

tate-form and　plaques-like　eruptions　showed

:almost the same findings which revealed slight

changes of parapsoriasis.

　　　Paget's Disease･ (Univ. of Ｔｏｋｙｏ.)･

　　　Ａ woman aged ４４.

1021

　　　Since May of this year, she developed ery-

thema, erosion, and fissure in the right nipple

where gradually indurated and infiltrated｡

　　　She has been feeling slight irritaton and

applied several ointments without success. Histo-

logical　findings show large, pale-staining cells

scattered throughout the epidermis with dense

infiltration　of lymphocytes and hystiocytes in

the dermis｡

　　　Weber･Christian's Disease. (Ｕｎｉｖ.of To-

kyo.)｡

　　　Ａ female　aged ３８presented subcutaneous

erythematous nodules of one half to ten cm in

diameter, since March 1960. The lesions occured

on the trunk and extremities, mainly on the

thighs. Fever (38～39°C) and malaise accompani-

ed their appearance.　Biopsy showed the typical

histologic picture of nonsuppurative panniculitis.

Ein　Fall　von　Pareitis　und　Makrocheilie.

(Universitat Ｔｏｋｉｏ.)｡

　　　Eine 52-jahrige Bauerin suchte unsere hiesige

Hautklinik am 2. Oktober 1959 zum erstenmal

auf. Sie hatte seit　7 Jaliren eine　anfangs

rezidivierende und dann um diese Zeit stationar

gewordene Anschwellung und ROtung des rechten

Wangenteils　gelitten. Trotz Extraktion　der

angefressenen Zahne und der Penicillingabe hat

der Grad der Anschwellung allmahlicli zugenom-

men und ging　neuerdings　sogar　zur　Wan-

genschleimhaut iiber, die ddematcis anschwoll｡

　　　Status prasens :―Rechte Gesichthaifte, ins-

besondere　Augenlider, obere　Mundlippe　und

Kiefergegend 6demat6s angeschwollen, geratet.

lamellas geschuppt und stellenweise mit Scliup-

penkrusten bedeckt. An den Augenlidern　das

Oedem　so　hochgradig, dass　die Augenspalte

vSllig ｖｅｒａchlossen war. Die Patientin klagte

uber geringe Schluckbeschwerden und Heiser-

keit｡

　　　Untersuchungsergebnisse: Hb. 70%, Eryth-

ｒ０.　4.85　Mill, Leuko. 10,800, davon　Stabk.

2.5%, Segmentk. 66,0%, Lympho. 28.0%, Mono･

2%, Eosino. 1.^%, Baso 0.5%. Ges.　Eiweiss 8.0

g%, A/G = 0.70, Seroreaktion auf Lues negativ.

Grundumsatz 6％｡

　　　Die Rontgenaufnahme des Schadels　zeigte

keinen pathologischen Befund. Das histologische

Bild zeigte ein auffallendea Oedem und eine teils

diffuse, teils　perivaskulare, iiberwiegend　aus

Lymphozyten und wenigeren Histiozyten bes-

tehende　Infiltration　im oberen　Korium, eine

Atrophie der Epidermis, die vom interspinoze-

1022

Uularen Oedem und der Degeneration der Basal-

zellen begleitet war ； und ferner ein pannikulidi-

tisches Anzeichｅｎ.das meistens aus histioplas-

mozytSrer und lymphozytarer Infiltration und

Extravasation　der Erythrozyten bestand. Kein

epitheloidzellulares Granulom vorhanden｡

　　Verlaufこ　Mittels　Kombinationsbehandlung

des Dexamethason （3 mg/T), Chloramphenicol

(2g/T) und Erythromycin （800 mglT) konnte in

einer Woche nur eine mSssige Besserung erziehlt

werden, untersteht jetzt noch dieser Behandlung

und weiterer Beobachtung。

　　Poikilodermia　Vascularis　Atrophicans ？

(Nihon Univ.)｡

　　Ａ woman, aged ３４ complained of pruritic

reddish　eruptions　of the　face of　６ months'

duration, which recently slowly enlarged peri-

pherally and increased pigmentation. Examina-

tion :―On the dorsum of fingers. hands, forearms

and almost the　whole face were not sharply

defined atrophic shiny lesions with teleangiectasis

日本皮膚科学会雑誌　第71巻　第９亭

and pigmentation which formed ａ interwoven

network. Histologically, the epidermis was thinn-

ed and slightly vacuolated. In the upper part

of the corium, basophilic degeneration, dilatation

of capillaries and perivascular infiltration consist-

ing of lymphocyte were observed.

　　Connective Tissue Nevus. (Nihon Univ.).

　　The cases were ａ house-wife aged 37 and

her daughter aged 16.

　　Parapsoriasis Gnttata et　Parakeratosis-

Variegata. (Kanto Teishin Hosp.).

　　Mycosis Funsoides ？ (Kanto Teishin Ho-

sp.)･

　　Mycosis Fungoides ？ Parapsoriasis Lich-･

enoides ？ (Kanto Teishin Hosp.)･

　　Case for Diagnosis (Elastosis Perforans ?)

(Tokyo Keisatsu Ｈｏｓp.)／

　　Ａ woman aged 34. Fold-formation of the

trunk　and　annular　granulomatous keratotic

lesions of extremities were observed.