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ABSTRACT: We report a case of febrile ulceronecrotic Mucha-Habermann disease (FUMHD) in a 21-year-old man. This disease is a severe form of pityriasis lichenoides et varioliformis acuta (PLEVA) and is characterized by the sudden onset of diffuse ulcerations associated with high fever and systemic symptoms. It is sometimes lethal especially in elderly patients. In the present case, intense generalized maculopapular erythematous plaques with central necrosis developed progressively in association with a high fever. Initial treatment with systemic betamethasone had been unsuccessful and the skin lesions, which covered about 50% of the body surface, became severely ulcerated. Although the development of new lesions had ceased spontaneously, widespread ulceration of the skin remained. Debridement of the necrotic skin and skin grafting using cultured epidermal autografts and meshed allografts of cadaver skin led to prompt reepithelization.
British Journal of Dermatology 01/2003; 147(6):1249-53. · 3.67 Impact Factor
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ABSTRACT: In parallel with the popular usage of topical ketoprofen, the number of reported cases of ketoprofen-induced photoallergic contact dermatitis has been increasing. It is clinically important to know the cross-reactivity of ketoprofen in order to avoid cross-sensitization caused by several structurally similar non-steroidal anti-inflammatory drugs (NSAID) on the market.
To evaluate the spectrum of cross sensitization, photopatch testing was performed on five patients with ketoprofen-induced photoallergic contact dermatitis using ketoprofen and other structurally similar chemicals, such as oxybenzone, tiaprofenic acid and suprofen.
All five patients reacted positively to ketoprofen or ketoprofen plaster on photopatch testing. All four patients photopatch tested with related chemicals showed cross-photosensitization with tiaprofenic acid and suprofen. However, none of the patients reacted positively to oxybenzone.
Either the diphenylketone moiety or a structurally similar tiophene-phenylketone moiety is important as the antigenic determinants of ketoprofen photoallergy. The arylpropionic acid side chain would not be involved.
Photodermatology Photoimmunology and Photomedicine 03/2001; 17(1):26-31. · 1.30 Impact Factor
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ABSTRACT: The amount of nocturnal scratching can be an indirect correlate of itch in pruritic dermatoses. We have previously used an infrared video camera to measure nocturnal scratching in atopic dermatitis (AD). Although this is a reliable method of measuring nocturnal scratching, it is not suitable for routine monitoring in clinical use.
To find a simplified way of monitoring itch.
We tried using a wrist activity monitor (ActiTrac) for the measurement of nocturnal scratching in patients with AD. ActiTrac is a wristwatch-shaped device that contains a piezoceramic sensor to measure and record limb movement over a pre-set time interval. The acceleration signal produced by motion of the hands is stored and downloaded into a personal computer. The average value of acceleration (AVA, 10(-3) g min(-1)) was calculated and compared with total scratching time as a percentage of total recording time (TST%) measured with the use of an infrared video camera in 63 recordings of 21 patients with AD. For 261 recordings in 29 patients with AD, the AVA was measured and correlated with disease severity, and compared with the AVA of five non-itchy controls.
There was a significant correlation between the AVA and TST% (r = 0.91, P < 0.001), and a regression equation of y = 0.44x - 2.5 was obtained. The AVA correlated well with the severity of AD and definitely differed from the results observed in normal controls. The AVA (mean +/- SD) was 44.4 +/- 19.1 for 115 recordings in patients with severe AD, 23.2 +/- 10.9 for 89 recordings in patients with moderate AD, 8.9 +/- 6.0 for 57 recordings in patients with mild AD and 4.1 +/- 1.9 for 25 recordings in five normal controls. The units used here are arbitrary units min-1 with a range of 0--250, which corresponds to 0-75 x 10(-6) g min(-1).
A wrist activity monitor is able to measure nocturnal scratching. However, further methods of analysis should be sought to select scratching activity exclusively.
British Journal of Dermatology 02/2001; 144(2):305-9. · 3.67 Impact Factor
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R Kamide
Photodermatology Photoimmunology and Photomedicine 09/2000; 16(4):192. · 1.30 Impact Factor
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ABSTRACT: We report a patient with pemphigus vulgaris (PV) successfully treated with single filtration plasmapheresis. A 40-year-old man with PV was started on therapy with prednisolone (PSL). Although the dosage of PSL was doubled, and both cyclosporin A (CyA) and pulse therapy were added, the disease was not controlled. After single filtration plasmapheresis began, most of the eroded lesions on the trunk reepithelialized. A switch to double filtration was followed by recurrence. Finally, additional treatments with single filtration plasmapheresis were required to obtain remission. To evaluate the efficacy of the treatment, circulating antibodies were measured by immunofluorescence (IIF) and enzyme-linked immunosorbent assays (ELISAs) using recombinant desmoglein (Dsg) 3. IIF titer and the ELISA scores correlated with the clinical disease activity. It is suggested that ELISA was more sensitive than IIF.
The Journal of Dermatology 07/2000; 27(6):380-5. · 1.49 Impact Factor
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ABSTRACT: Patients with atopic dermatitis (AD) are known to suffer from nocturnal itch, and the resultant scratching may worsen the skin lesions. We observed nocturnal scratching for 112 nights in 35 adult patients with AD, using an infrared video camera system. To quantify the amount of scratching, we counted scratching bouts lasting more than 5 s and calculated the duration of all the scratching bouts (total scratching time, TST). The percentage of TST in the total recording time (TST%) was used as an index of nocturnal scratching. Mean +/- SD TST% was 14.3 +/- 13.9 for patients with severe AD, 6.2 +/- 3.7 for those with moderate AD and 0.7 +/- 0.4 for those with mild AD. The higher TST% in the severely affected group was attributed mainly to a longer duration rather than a higher frequency of bouts. Patients scratched more in the first third of the night than in the later two-thirds. Both the group of patients whose disease distribution pattern was generalized and those who showed a head-neck-shoulder type distribution scratched their heads, faces and necks for longer than other parts of the body. Repeated measurement performed on individual subjects resulted in a similar TST% when there was little change in skin lesions. TST% reduced by 15 +/- 21% when the patients showed marked improvement. The measurement of nocturnal scratching helps to evaluate the severity of itch in AD. In addition, the infrared video successfully detected the location and nature of nocturnal scratching in AD.
British Journal of Dermatology 08/1999; 141(1):82-6. · 3.67 Impact Factor
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ABSTRACT: We report a 56-year-old man with Paget's disease occurring near the left areola without any underlying breast carcinoma. Histologically, there was no evidence suggesting continuity with a lactiferous duct, accessory breast, or microscopic gynecomastia. We review previous case reports of Paget's disease occurring in unusual sites and discuss their nomenclature from the histogenetic point of view.
The Journal of Dermatology 05/1999; 26(4):248-52. · 1.49 Impact Factor
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ABSTRACT: Skin responses to ultraviolet irradiation in patients with atopic dermatitis were studied to evaluate the role of sunlight in the exacerbation of atopic dermatitis. A total of 15 patients, seven males and eight females, with atopic dermatitis who complained of exacerbation of their dermatitis after sun exposure were examined by photo testing with UVB and UVA irradiation and photopatch tests. Nine out of 15 patients showed abnormal skin reactions. Lowered minimal erythema doses (MEDs) to a single exposure of UVB, papular or erythematous responses after single or repeated exposures to UVB or UVA and positive photopatch test reactions to sunscreen ingredients and fragrances were found. There are apparently multiple mechanisms of photoexacerbation in patients with atopic dermatitis.
Journal of Dermatological Science 07/1998; 17(2):101-7. · 3.72 Impact Factor
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ABSTRACT: We investigated the effect of nitrazepam on nocturnal scratching in 10 adult out-patients with atopic dermatitis (AD) using a double-blind placebo-controlled crossover method. Patients were given either nitrazepam (Benzalin tablets containing 5 mg nitrazepam) or a placebo on 3 successive nights, with a washout interval of 4 days. We used an infrared video camera to identify bouts of scratching lasting more than 5 s. These were counted and the duration of all the bouts of scratching (total scratching time, TST) was calculated. The percentage of TST to total recording time (TST%) was used as an index of nocturnal scratching. The frequency with which bouts of scratching (bouts/h) occurred was reduced by 10 mg nitrazepam (7.7 +/- 3.6 with nitrazepam vs. 9.6 +/- 3.6 with placebo, P < 0.05). However, the mean duration (s/bout) of the bouts of scratching was longer with 10 mg nitrazepam (32.3 +/- 23.4 with nitrazepam vs. 19.1 +/- 10.0 with placebo, P < 0.05). As a result, there was no significant difference between TST% (6.5 +/- 4.2 with nitrazepam vs. 5.4 +/- 3.8 with placebo, not significant). All the above values are mean +/- SD. The degree of itching and the condition of the AD did not change during the 2 weeks of the study. We conclude that taking 10 mg nitrazepam is not an effective way of reducing the total duration of nocturnal scratching in AD patients, although it decreases the frequency with which bouts of nocturnal scratching occur.
British Journal of Dermatology 04/1998; 138(4):631-4. · 3.67 Impact Factor
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R Kamide
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ABSTRACT: As post-transfusion graft-vs-host disease (GVHD) has poor prognosis, early diagnosis by skin biopsy is essential. The histopathology of the skin lesion includes a lymphocytic infiltration to the dermo-epidermal junction associated with vacuolization of the basal layer. Dyskeratotic or necrotic epidermal cells are scattered through the epidermis. Some of these necrotic cells are surrounded by a few lymphocytes (satellite cell necrosis). These histopathological findings are referred to as a lichenoid tissue reaction, but is not specific to GVHD, and can be seen in some types of drug eruption (toxic epidermal necrolysis type and erythema multiforme type). Final diagnosis will be confirmed by the clinical symptoms, such as liver dysfunction, diarrhea and pancytopenia.
Nippon rinsho. Japanese journal of clinical medicine 10/1997; 55(9):2259-61.
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ABSTRACT: We used an infrared video camera and video tape recorder system to record and analyze nocturnal scratching in seven patients with atopic dermatitis (AD) and three non-itchy healthy controls. The patterns and the locations of scratching were successfully observed. Scratching bouts lasting more than 5 sec were counted, and the summation of the duration of all the scratching bouts (total scratching time, TST) was used as an index of nocturnal scratching. TST in patients with AD turned out to be some hundreds to ten thousands of seconds; the TST in controls was between zero and a hundred seconds. The infrared video camera system measured nocturnal scratching simply and reliably without disturbing the patients' sleep.
The Journal of Dermatology 04/1996; 23(3):153-5. · 1.49 Impact Factor
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Journal of the American Academy of Dermatology 03/1995; 32(2 Pt 1):277-8. · 3.99 Impact Factor
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ABSTRACT: We reported a case of photoleukomelanodermatitis (Kobori) type drug eruption due to afloqualone (Arofuto). The patient was given afloqualone and imipramine hydrochloride (Chrytemin) for cervical spondylosis from November of 1990. Edematous erythema with slight itching appeared on the sun-exposed areas in December of 1990. As drug eruption was suspected, drugs were ceased, and the cutaneous lesions almost disappeared but pigmentations and depigmentations developed in spots in sun-exposed areas in March of 1991. Photopatch and oral challenge tests were positive.
The Journal of Dermatology 07/1994; 21(6):430-3. · 1.49 Impact Factor
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ABSTRACT: A newly developed fluoroquinoline, Q-35 (8-OCH3), in which a methoxy group was substituted at the 8 position of the quinoline nucleus, was very stable under irradiation with long-wave UV light (UVA). Derivatives, a fluoroquinolone with no substitution (the 8-H analog) and one in which a fluorine was substituted (the 8-F analog), were degraded in their solutions by the UVA irradiation. The phototoxic inducibility by these derivatives was further studied in a murine model. When mice were dosed orally with 800 mg of Q-35 (8-OCH3) per kg of body weight, the maximum dose given, and exposed to the UVA light, no inflammatory lesions were observed in their ears. Ear redness was marked in mice given more than 12.5 mg of the 8-F analog or 200 mg of the 8-H analog per kg. Histopathological changes, edema, and infiltration of neutrophils were also observed microscopically in groups receiving the 8-H or 8-F analog but not in groups receiving Q-35 (8-OCH3). Similar inflammatory reactions were observed to occur in a dose-dependent manner with other available fluoroquinolone antibacterial agents such as lomefloxacin, enoxacin, norfloxacin, ciprofloxacin and ofloxacin. These results suggest that the introduction of a methoxy group at the 8 position of the quinolone nucleus is important for the reduction of phototoxicity.
Antimicrobial Agents and Chemotherapy 11/1993; 37(10):2217-23. · 4.84 Impact Factor
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ABSTRACT: An 80-year-old Japanese woman with temporal arteritis was treated with systemic recombinant human interleukin-2 (IL-2) (1 x 10(6) unit/day for six weeks). The presenting symptoms of headache and skin necrosis and abnormal laboratory findings, such as an elevated erythrocyte sedimentation rate and CRP, promptly improved without any serious side effects. Although the pathogenesis of temporal arteritis and the mechanism(s) of the beneficial effect of IL-2 on it still remain unknown, this preliminary study highly encourages further investigations.
The Journal of Dermatology 01/1990; 16(6):487-91. · 1.49 Impact Factor
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ABSTRACT: A double-blind study was performed in 305 patients to compare ketotifen capsule and clemastine tablet. Ketotifen alleviated eruption and itching to a significantly greater extent than clemastine. The utility rating of ketotifen was significantly higher than that of clemastine.
Annals of allergy 05/1989; 62(4):322-5.
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Dermatologica 02/1989; 179 Suppl 1:124.
