73
Original Articles
(Abstract)
Longitudinal Pigmented stripe in the Nail*
by
Akira Shiratori, Tadahiro Takada and Juro Goto**
A 16-year-old boy was firstobserved in July, 1957. He had firstnoticed a fine brown-
ish-black longitudinal stripe at the base of the nail of the left fourth finger in 1953.
This gradually progressed to the distal margin. grew deeper, and during following few
years identical pigmented stripes appeared in all fingernails except for the left fifthone。
He had never had a pigmented mole in any other part of his body. His nails had always
・developed normally. `
Findings on physical examination were essentially normal, except for brownish-black
pigmented stripes in the fingernails. These were various in width and deepness of color.
extending from the base of each nail to its free edge (Fig. 1 and 2).
Microscopic sections of the nail showed pigment granules in the nail cellscorresponding
in extent and position to the area of the pigmented stripe. They were scattered throughout
the entire thickness of the nail. with a tendency to be more dense in deeper layers than
in the superficial.
The family history revealed that his father and two elder sisters have had similar
pigmented nails (Tab. 1).
The mass examination of 1,826 persons lead the authors to the following conclusions :
1) Longitudinal pigmented stripes in the nail were found in 1.6% (male 1.3%, female
2.2%) of apparently normal persons (Tab. 2).
2)The frequency.of appearance of the pigmented stripe was found to be high in the
following descending order; thefirst.the second, the third. the fourth and the fifth finger
(Tab. 3). This finding would indicate that there eχistsa resembrance in distribution
between the pigmented stripe in the nail and ephelides inversae Siemens.
3) There might be no papers reporting family occurrence in the literature, except for
the abo▽ementioned case. and there was also no family history of a similar pigmented
nail in the cases observed in our mass examination.
4) Persons with pigmented nails were not so mach pigmented in other part of the
body (Tab. 4).
* Full-lengthreport: Japanese section pp. 399~404
** Department of Dermatology (Director: Prof. Yusho Miura), Facu!ty of Medicine, University of
Hokkaido, Sapporo
74
The Effect of P32on the Function of the Reticuloendothelial
System in Rabbits with Late Syphilis*
by
YaichiTsubaki“
As the distribution of radioisotope P32within the body closely resembled that of
treponema pallidum, Miura et a1. assumed that administration of P32 to patients afHicted
with incurable latent syphilis would develop biotropisme of treponema pallidum by
its radioactivity, and the antiluetic treatment instituted oχlthis (jccasion would lead to the
cure of syphilis. It was proved clinically and experimentally in animals that the antibody
titer became unstable after administration of p32 but the mechanism of this phenomenon
is still obscure。
Considering the theory that the production of antibodies mainly relies on the function
of the r゙eticuloendothelial system. Tanaka's modification of Oh's chicken erythrocyte
phagocytic test was applied to examine the effect of p32 on the function of reticuloendo-
thelial system in rabbits with late syphilis。
Experimental material :
Nichols, Tani or Kojimachi strains of treponema pallidum were innoculated into the
testis of rabbits 助d those that had a positive luetic reaction after 100 days or more were
subjected to the experiment. P32 was prepared in the form of H3P32O4 C15A-P in the catalogue
of AEC) and Ca45 as万Ca≪C12 (P-2, Oak Ridge National Laboratory) and stored in ampoules.
each containing l me in 2 cc of distaied water aT1万dwere sterilized before the administration。
The results of the experiments are as follows :
1)The chicken erythrocyte phagocytic function was tested in 3 rabbits with late
syphilis and the test was performed once daily for 5 days in succession ; the vanishing
of chicken erythrocytes occurred at a minimum time of one hour 45 minutes and at a
maximum time of 3 hours 30 minutes. and these values ■were regarded as the controls。
2) 0.05 me/kg of p32 was administered to rabbits with late syphilis and the vanishing
of chicken erythrocytes was observed from l hour to 13 days. From l to 3 hours after
the administration of p32 the vanishing of erythrocytes occurred at l hour 45 minutes
in l case and at 2 hours in 4 cases. which showed a relatively low value in comparison
with the controls. From 6 hours to l day after the administration of P32, the time for
vanishing of erythrocytes was l hour 45 minutes in l case. whereas it was 3 hours 30
minutes in 3 cases. 3 hours 15 minutes in 2 cases which presented relatively high figure
within the limit of the controls. After 2 days to 6 days the time tor vanishing of erythro-
cytes was l hour 45 minutes in l case. 3 hours 15 minutes in 2 cases. and in U cases
* Full-lengthreport: Japanese section pp. 405~411
** Department of Dermatology (Director: Prof. 0. Miura), Nihon University Hospital, Tokyo
75
tested 17 times the time for vanishing was from 2 hours 15 minutes t0 2 hours 45 minutes.
Furthermore, 7 to 13 days following the administration of 戸2 the time for vanishing was
from 2 hours to 3 hours in all of the cases (Tab. 2)。
3) When 0.05 me/kg of Ca*5, whose distribution in the body resembles that of p32
was administered to rabbits, the time for vanishing of chicken erythrocytes of l hour to
13 days following the administration appeared more or less dissimilar to that observed
with P32,but remained within the nm北of the control values (Tab. 3)。
From the foregoing results, fluctuation of titers of the luetic antibody in rabbits induced
by administering 0.05 me/kg of P32 did not produce an alteration in the function of the reti-
culoendothelial system in cases with late syphilis. Therefore, the use of Tanaka's modi-
ficationof Oh's method of determining chicken erythrocyte phagocytic time as an indicator
to demonstrate the function of the reticuloendothelial system did not provide a conclusive
interpretation of the experimental results obtained by Miura。Nakajima, Mizumoto and
Hayashi that P321fluctuates the luetic antibody titerand Ca^s does not have this function.
This functional process may have to be investigated by further study of other factors
involved.
76
A Case of Skin Metastasis (Chorioepithelioma)
of a Teratbid Tumor of the Testis*
by
Riichi Kojima, Shigeo Ikeda, Hisashi Nishida and Keiji Mizuoka*゛゛
Skin metastasis of teratoid tumor (chorioepithelioma) of the testicle is very rarely-
observed. Statistically there occurred only 3 cases of skin metastasis among 775casra of
chorioepithelioma (reported in Japanese gynecological societies. 1945-1954). While among
109cases of teratoid tumor of the testicle, 9 cases had a tissue of chorioepitheliotna in a
part of it. 万a万ndonly in one case the skin metastasis occurred. The paper presented here
reports a case we have recently observ‘ed.
Our patient was a student 18 years of age. He was struck on the right testicle in
Judo training about 4 months ago. Thereafter it grew gradually, but there existed no・
subjective sufferings. Since several days before he visited our hospital, however, he had
had pulling pain in the testicle (Fig. 1). Soon after the admission, the right orchidectomy‘
was done (Fig. 2). By histological examination it was revealed to be a teratoid tumor and
there was shown a tissue of chorioepithelioma in a part of it. Just after the surgical
1. intradermal form 2. subcutaneous form
ヅニ匹
Clinical Findings
Prominently protruding above theskin surface. at times burstingand forming a scab.
Slightly protruding above theskin. surface. though more
protruding when situated onsomething hard.
Ruby red (typicalform). Blue, similarto subcutaneoushematoma.
Histological Findings
Clumping of tumor cells. Few tumor cellsin hematoma.
Consisting mainly of tumor cellsonly in early metastasis.
*
**
Full-length report: Japanese section pp. 412~431
Department of Dermatology, (Director: Dr. R. Kojima) Sanraku-Hospital, Tokyo
77
operation, Nitromin injection and x-ray therapy were begun. Three months later. there
appeared a small redヽtumor under the right breast, and it grew rapidly (Fig. 3), ItwaS・
certifiedas metastasis of chorioepithelioma by means of biopsy (Fig. 4,5). Day by day. small
tumors increased in number. Some of them were as large as a walnut. blue and slightly
protruded. Others were red like a ruby and more protruded than the blue tumors. His-
tologically the blue one was the subcutaneous form and the red one the intradermal form.
We classifiedthem as the figure in P. 76.
Gynecomastia was observed on both sides (Fig. 6).・ Many shadows. t03 cm in・
diameter, were observed in the χ一犬rayfilm of the chest (Fig. 7) and bloody sputa were
ejected. Friedman's reaction of the urine was strongly positive. Successive injections of
Nitromin, Azan, Testoluton Forte, produced no effect. The patient died 5 months after
the surgical operation. Autopsy disclosed main metastasis had been hemategenously brought
about. Measurements of sexual hormones at several times are demonstrated on figures
(Figs. 10, 11, 12). From these findings. we concluded that the swelling of the breast
was caused not by hyperestrogenism but the imbalance of the ratio between androgen and
estrogen.
78
Keto-acid Formation by Dermatophytes and Candida albicans*
by
Kenichi Shimbo**
The formation十〇f keto-acids by ,dermatophytes and Candida albicans in liquid media
containing glucose and amino adds (glutamic acid or aspartic acid) was studied in this
でpaper. The keto-acids in the culture fluid were purified as 2,4-dinitrophenylhydrazone
according to the procedure of Haway and Thompson (Biochem. J. 53: 340. 1953). The
melting point of the hydrazone was the same as that of 2,4-dimtrophenylhydrasone of
authenticα-ketoglutaric acid and pyruvic acid(m・p. 219°C:a-ketoglutaric acid ;m・p,222°C :
pvTuvic acid) and also the samples were identified withα-ketoglutaric acid or pyruvic
acid by means of paper chromatography (Table 1, Fig. 1). Furthermore, the concen-
tration of these keto-acids in the culture fluid was measured by the method of Shimizu
(J. Biochem. 37: 421, 1950) (Table 2,Fig. 2),
1)The concentration of α-ketoglutaric acid was higher than that of pyruvic acid in
the culture fluid of dermatophytes.
2) Pyruvic acid was produced more than α|一犬ketoglutaricacid by Candida albicans in
the culture fluid.
3)α-Keto-adds was formed more in the culture fluid containing glutamic acid than
in the ciilture fluid containing aspartic acid by both dermatophytes and Candida albicans.
It is considered that these keto-acids may be chiefly formed from glucose following
the pathway of Krebs" cycle. ‘
* Full・length report: Japanese section pp. 432―435
** Department of Dermatology (Director: Prof. Dr. H. Tanaka) Niigata University School
ofMedicine, Niigata
79
Transaminase in Dermatophytes and Candida albicans?゛
by
Kenichi Shimbo**
The extract of dermatophytes and Candida albicans free from those cells was found
to catalize the transamination reaction in various amino acids and keto-acids. This
transaminase activity was studied as follows. The十enzyme was prepared by grinding
lyophilized cells, after the alternate freezing and thawing. Glutamate formed from a-keto-
glutarate was detected by paper chromatography (ascending method) using water-phenol
as the s01▽ent. The density of the ninhydrin spot at the glutamate locus was measured
with the aid of the densitometer. Alanine formed from pyruvate was similarlystuぷed.
1) The transaminase of Trichophyton interdigitale working between a-ketoglutarate
and several amino acids such as aspartic acid, alanine, glycine and phenylalanine was found
to be high in acti▽ity(Table 1,Fig. 1). ^
2) By the extract of Candida albicans glutamate was formed from α-ketoglutarate
with aspartic acid. alanine, phenylalanine and. toa lesser degree. with glycine. ormithine.
‘valine, t3ri"osine,・andleucine(Table 1).
3)The transaminase of Trichophyton interdigitale working between pyruvate and the
following amino acids such as glutamic acid. glycine, and aspartic acid showed the high
activity (Table l).
4)By the enzyme obtained from Candida albicans alanine was formed from pjmivate
with leucine. aspartic acid. glutamic acid and. to a lesser degree, with phenylalanine.
glycine, and valine (Table 1),
5) The optimum PH for these transannnases was in the range of 6.2 to 6.6 (Table 2).
6) It was found that salicylic acid, and undecylenic acid have no appreciable effect
cm the transaminase, but on the other hand. merzonine (mercury compound), zinc sulfate,
methylviolet, and iodine showed inhibition of the enzyme (Table 3).
It was thought that the fungistatic effect of merzonine and methylviolet on these fungi
may be partially attributed to the inhibition of the transaminase which is indispensable
for the synthesis of cell protein of these fungi.
* Fulllength report: Japanese scetion・PP- 436~442
** From the Department of Dermatology (Director: Prof. Dr. H. Tanaka) Niigata University
School0fMedicine, Niigata
80
statistical Investigation of Skin Carcinoma*
by
Taro Kawamura, Katsuo Nishiharaでand Hiroo Nakajima**
Keijiro Tsuchikawa and Nobuo Nakai***
Ryiiji Mizumoto and Itsuo Miyazaki↑
Masamichi Nakamura and Shinya Tajiri↑↑
Minoru Terada and Yoshikazu Kubo#
Kaoru Taniguchi and Kiyoshi Shiooka祚#
The authors made some statisticalinvestigation on skin carcinoma, with the cooper-
ation of the following climes : the Section of Dermatology and the First and Second Sections
of Surgery in Kanazawa University Hospital, and the Sections of Dermatology of Toyama
Prefectural Central Hospital, Toyama Municipal Hospital and Takaoka Agriculture Co-
operative Hospital.
1) Clinical records of n2 cases of skin carcinoma, 31cases of penis carcinoma and
n cases of precancerosis were collected.
2) In the six clinics the percentage of skin carcinoma patients among the out一犬patients
varied from 0.02% to 0.12%, and the percentage of penis carcinoma patients from 0.01%
t0 0.04%・
3)The age bracket which showed the highest percentage was the seventies for skia
carcinoma and the Siχtiesfor penis carcinoma.
4) The frequency of skin carcinoma was higher in the male than in the female
(68 : 44).
5) As to the origins of skin carcinomas, the commonest was scar. being responsible
for 26.8%. Most of these scars were those resulting from burns (21.4%). Such a high
rate of burn carcinoma is characteristic of Hokuriku district,where the 丘replace
and firebox (Irori and Kotatsu) are necessary ,for a longer time and the chance of people
getting burnt is higher, especially for children.
*Full-length report: Japanese section pp. 443~449
**Section of Dermatology (Director: Prof. T. Kawamura), School of Medicine, Kanazawa
University, Kanazawa
***First Section of Surgery (Director: Prof. Dr. M. Urabe), School 0fMedicine, Kanazawa
University, Kanazawa
↑Second Section of Surgery (Director: Prof. Dr S.Kumanomido), School 0fMedicine,
Kanazawa University, Kanazawa
↑↑Sectionof Dermatology, Toyama Prefectural Central Hospital (DirectorごDr. I.Taga"
Toyama
JtSection of Dermatology, Toyama Municipal Hospital(Director: Dr.B,Adachi), Toyama
##Sectioii of Dermatology, Takaoka Agriculture Cooperative Hospital (Director: Dr. B,
Toyoda), Takaoka
81.
6) Skin carcinomas were predominantly found on the head and the face (53.1%)・
This figure. however, is lower than most other Japanese repwrts. Only one case was・
found to have arisen from xeroderma pigmentosum (0.9%). This seems to be due to the・
general cloudiness in Hokuriku district.ヽ
'7) There were more cases of squamous cell carcinomas than those of basal cell
carcinomas among・ skin carcinomas (62: 13), as well as among penis carcinomas・(30: 1)・
8) Phimosis seemed to have close connection with the occurrence of penis carcinoma。
being found 25 0f 31 cases(80.6%)・
9) Surgical operation generally brought about very good results in both types of
carcinoma, but those cases which could not be treated surgically invariably. proved fatal.
Thus it is clear that early diagnosis is most important in skin and penis carcinoma aS。
well as in tumors of other organs.
10)And 6 cases of melanoeplithelioma observed in the Section of Dermatology of;
Kanazawa University Hospital were described.
82
A Case of Porphyria C!ongenita゛゛
by ’
Kihei Tanioku, Yasuhiko Saida. Sosei Nakayama** and Gunpei Urata***
.A girl aged 14,whose parents were consanguineously married had attacks of blisteron
the dorsa of the hands and on the face since the age of2months. The lesionsincreased in
number with years, moreover ulcers and deforming scars developed. Subsequently she had
deformity ・of the nose and fingers. Physical and biochemical examinations were carried
out and following results were obtained.
Irradiation by sunlight. ultraviolet rays and sollux ultrared rays gave rise to no reaction
and she had no reaction to mechanical irritation. The liver and spleen were not palpable
and their function was in normal condition. The renal discharge of the 17-ketosteroidswas
high. Blood count showed high degree of anemia. eχistenceof normoblasts and augmen-
tation of reticuloerythrocytes. Sternal puncture showed increase of erythrocytic cells and
red fluorescent erythroblasts. In serum iron value decreased with high copper rate and
β-globulin fraction in blood plasma increased with low level 0f albumin fraction. The
urine was free of porphobilinogen as well as δ。aminolevulinic acid. but uroporphyrin and
small quantities of coproporphyrin were demonstrated by paper-chromatography analysis.
The patient excreted 10-20mg of porphyrin per day. We presumed that metabolic
disturbance of iron and unbalanced adrenocortical function coeχistwith porphyric dysmeta-
bolism in the patient suifering from porphjTia congenita.
* Full-lengthreport: Japanese section pp. 450~460
** Department of Dermatology and Urology (Director: Prof. K. Tanioku),
Facultyof Medicine, Shinshu University, Matsumoto
*** Department of Biochemistry, Institute of Public Health, Tokyo
Society Transactions
The 42nd Meeting, Tokai Society
Mie PrefecturalUniversity,Tsu
September30, 1956
NorthisaNozofei: A Case of Papillomatose
confluente et reticulee.
A male, aged 18, had had small papules on
the abdominal region since two years, which
later spread to the chest, back, lumbal region,
neck, axillar regions, face and upper and
lower extremities. They were closely simu-
lated to the clinical picture seen in pityriasis
versicolor clinically. The cutaneous lesions. how-
ever, showed a slight elevation on the normal
skin surface. accentuation of the normal skin
marking, brownish or reddish-brown in hue and
’no pityriasic scaling. Histologically, there were
moderate hyperkeratosis and papillomatosis in
the epidermis. and atrophy of the hair follicles.
sweat glands and sebaceous glands could be
observed. This was believed to be the similar
case reported as second group of cutaneous
papillomatosis by Gougerot and Carteaud in
1932.
83
HiroshiNarita: Three Cases of Nenroder-
matitis Linearis。
Three cases of neurodermatitis linearis
were reported here. They were being treated
with the oral administration of antihistaminics
and the local injection of prednisone.
D幻
cylic
losa
Demonstration of Clinical Sildes
Pityriasislichenoides chronica
Drug eruption due to para-amino-sali-
acidr^ /■~-\ /--^
CO ■* in
0乃司㈲
10)
Pityriasis circinata Toyama-Matsuura
Cutis marmorata
Dystrophic form of epidermolysis bul-
Hair folliclenevus
Urticaria pigmentosa
Naevus sebaceus
Poik・ilodermiavascularis atrophicans.
Seven cases of leucoderma due to
local application of M.B.E.H.
The 43rd Meeting, Tokai Society
NagoyaUniversity,Nagoya
December23, 1955 Tadashi Koto and KaisufeeNogucfii: A Case
of Poikilodennia Vascularis Atrophicans。
A female aged 47 noticed diffuse reddish
swelling and edema On the face and extremities
on May 1955. Since spring in 1956, she has had
dryness and atrophy of the skin of the face and
exposed area, subsequently weakness and fatiga-
bility developed. The cutaneous lesions showed
atrophy, telangiectasis and hyperpigmentation
mixed with 8potted depigmentations. Marked
atrophy of muscles in the back and the shoulder
was noted. Differential diagnosis between der-
matomyositis and poikilodermia vascularis atro-
phicans was discussed。
KeftsMro Sasada and Htrobutni 7Wo?・れ A
Case of Peutz-Jeffhers゛ Syndrome。
A female aged 22 has ‘tad numerous small
pigmented spots on her lips. oral mucous mem-
brane, soles and palms since long years. Multiple
polyps in the intestinal tractus were revealed
.by χ Γay examination. The details will be
published elsewhere.
Todoshi Kato and Tafeeo Ono: Treatment
of Aloepcia with Cepharanthin.
Fourteen cases of alopecia areata including
alopecia maligna and three cases of juvenile
alopecia were treated with oral, parenteral and
topical administration of cepharanthin. The
results obtained were as follows: Excellent in
3, effective in 6, slightly effective in 3, no benefit
in 5 cases.
Yusみo OIα。Zennos認知 Kosugi, Masakiko
Nogura and Jiro Yofeotafee: A Fatal Case of
Purpura.
A girl aged 13 was admitted to the hospital
on last August, because she 蛍aS complaining
of epistaxis. After the admission, she died
from brain-hemorrhage. The detail autopsy
records were reported.
Yaiuhiko Saida, Yosuafei Tofeuda, Yoslitya
Yamada and召lioski Murata:1) A Case of
Nylon Dermatitis. 2) A Case of Montr's
S4
Disease。
1)A 58-year-old man, had developed der-
matitis due to nylon socks on both feet. The
:following 8 kinds of patch tests were carried
・out, and the positive reactions were recognized
ニin the (3), (4) and (5) tests. (1) penicillin G-
vaseline (10,000u/g), (2) 2% procaine・vaseline.
expected。
Hideo Kofeei and Masahikりj面剋タIQ: Two
Cases of Acanthosis Nigrricans。
1)A patient of gastric cancer. has de-
"veloped typical eruptions≪of acanthosis nigricans
in the axillae since 3 months after the gastro-
tomy was performed. The histologic picture was
also typical。
2)A man, 65 years of age, has developed
verrucae on the dorsa of the hands and feet,
■erosionand rhagades on the lips. dark brown
pigmentation on the face, in the axillae and
inguinal regions, and a tumor (presumably
gastric cancer) in the・abdomen.
A specimen
taken from the axilla showed the typical his-
tologic picture of acanthosis nigricans。
Discussion; Noboru Yano: A woman over
50, had had minute senile verrucae and brow-
nish pigmentation almost over the whole body.
and eruptions simulating acan thosis nigricans on
the patellae, but not in the axillae. Therefore,
the diagnosis was very difficult. Later, however.
she died of gastric cancer。
Toshio Kobaysoski aild Yutaka Norito ・. The
Use of Biotin in the Treatment of Various
Sermatoses。
Forty cases of inflammatory dermatoses
were treated with Biotin, and the clinical data
-were presented。
Eisufee Mitsuタa, Yast