Invertebrates Excretory Systems Protonephridia Metanephridia Malpighian Tubules.
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Original Articles
(Abstract)
Supplementary studies on Pigmentation in Nevoid, Neoplastic,
andother Diseases of the Skin゛゜
1
By
Hiroshi Tanaka**
Pigment anomalies of the foetal skin and of diseased skin were studied by means of
the dopa reaction and other routine stains, in an attempt to find some explanation for the
increase and decrease of pigments in different diseases. The results are as follows :
1. In the foetal skin, a well-defined picture of the melanocytes is visible without
recourse to the dopa reaction, because their cytoplasm is filled with abundant melanin
granules. It is characteristic of the foetal skin that the melanocytes are situated at the
same level as the basal cell layer or at the somewhat higher level。
2. The hyperfunctional conditions of melanocytes : In Addison's disease. the me^ano-
cytes are shown to be in a stimulated condition by the increase of their reactivity. their
hypertrophy in size. and the increase of their number as disclosed by the dopa reaction.
The author found that the normal rhythm of the pigment formation is maintained in this
disease, a fact endorsing Lerner-Shizume's view that the pigment formation in Addisonタs,
disease is caused by the hypersecretion of MSH. A similar phenomenon was observed
in a patient who had received prolonged treatment with Prednisolone.
3. The findings on the pigmented nevus, nevus spilus, the pigmented macules of Reck-
linghausen's phacomatosis. and pigmented spots on palms and soles were studied from
the etiological point of view. In the pigmented spots on palms and soles, the difierences・
between nevoid and non-nevoid pigmented spots were pointed out.
4. The findings on Mongolian spot and their allied conditions were described. and it
was shown that the pigmented macules in pigmentovascular phacomatosis (Ota) coincide
with Mongolian St)Ot.
5. The relation between the proliferation of Malpighian cells and the amount of
melanin was investigated. In melanoepithelioma, both the number of ]Malpighian cells and
the amount of melanin increased together. But in the precancerous condition and actual
cancer, the co-existence of ・Malpighian cells and melanin is disturbed. and the decrease or
disappearance of melanin and the decrease, shrinkage or disappearance of melanocytes
are observed. In hard nevi, the epidermal pigment sometimes increases and sometimes
decreases, apparently owing to different types of proliferation of Malpighian cells.
6. Aphenomenon common to incontinentia pigmenti (Bloch-Sulzberger) and histological
pigmentary incontinence including fixed drug eruption, multiple macular hyperpigmentation。
2
and Riehl's melanosis. is the decrease of epidermal melanin notwithstanding normal or even
enhanced production of the pigment, accompanied with the increase of dermal melanin.
These diseases show complicated histological pictures. due to the difference in degree or
phase of the above mechanism, aad the changes proper to each of the diseases.
7. Depigmentation : In vitiligo. the melanocytes are seen to suffer suppressed func-
tion and degeneration. In some cases. however, large amounts of melanin was observed
in the dermis. It may be a vestige of past pigmentary incontinence. Leucoderma centri-
fugum acquisitum (Sutton) is also caused by the same mechanism, with pigmented nevi
in its center. so the nevus cells suffer the same changes・
8. We have hitherto had only scanty description of the leucoderma in Morbus Harada
and sympathetic ophthalmia. The author carried out histological studies on each one case
of the two diseases. and noticed their resemblance to vitiligo.
9. In nevi depigmentosi, partial albinism and albinoidism, the melanocytes show
pathologic changes in proportion to the degree of their depigmentation. In albinoidism.
however, it was found, contrary to expectation, that the enzymic activity of melanocytes
was still maintained.
10.1t is generally thought that there is an eti ological resemblance between Addison's
disease and systemic scleroderma. Leucoderma in the both diseases may be considered as
the result of exhaustion of melanocytes caused by the excessive stimulalion of MSH.
1L The findings on leucoderma in Bourneville-Pringle's phacomatosis and dyschroma-
tosis hereditaria symmetrica (Toyama) were described.
12. Mongolian cells were found histologically in the skin from two adults and the
significance of the cells was discussed.
* Full-length report: Japanese section pp. 1~59
** From the Dermato-Urological Clinic (Director: Prof. T. Kawamura), University of Kanazawa,
Kanazawa
3
ACase of Para-anthrax*
By
KiheiTanioku, Fujitaka Zenisaka and Masashi Murata**
A35-year-old farmer was referred to us with the appearance of slightlypruritic,raised。
dark-purple lesions on the extensor surface of right wrist and arm on January 8,1957.
The present skin disorder began in December, 1956. Physical examination revealed good
general health without significantfindings. The lesions consisted of Siχ nodules, which
were sharply demarcated, round, varying in size, 0.5 to 3.5cm in diameter, and were
markedly raised above the skin surface, elastic softon palpation. There were some
vesicles on each nodule.
Bacteriological and histological studies―Material was obtained from one nodule.
Cultures in simple agar showed a pure culture of a different colony among the colonies
of staphylococcus albus. The organism was observed to be a gram-positive large rod.
It was definitelymotile. There was no capsule noted. Spores were formed with energic
and irregular characteristic. It produced acid, but no gas, in glucose, maltose and
saccharose. Growth in broth resulted formation of sediment but no pellicule。 The rod
did not produce hemolysis on blood agar. There was no pathogenicity for mice. The=
biopsy specimen from one nodule exhibited thin epidermis, slightly edematous superficial
layers of the corium and some large rods in the area from the basal layers of epidermis
to the superficiallayers of corium. These rods is most likelyB. anthracoides.
Treatment and course―All cutaneous symptoms had completely subsided by the
symptomatic treatment two weeks later.
Itwas felt that from these characteristics the organism could best be classifiedヽas
Bacillus anthracoides.
Acase of para-anthrax due to Bacillus anthracoides was reported. The difierentiating
features between anthraχ and para-anthrax were briefly discussed.
*Full-length report: Japanese section pp. 60~67
** From the Department of Dermatology & Urology (Director: Prof. K. Tanioku), Faculty of
Medicine, Shiushu University, Matsumoto
4
Society Transactions
The 362nd Tokyo Society
Universityof Tokyo
September21, 1957
Fumiyuゐj Ishihara ; A Case of Unilateral
Pringle゛s Disease。
The patient was a 23-year-old woman, who
had typical lesions of Pringle's disease on the
right side of the face alone. This was proved
to be the fourth case of unilaterally appeared
Pr ingle's disease reported in this country. ca-
nicai and histological studies on Pringle's dis-
ease referring to literatures have also been
done.and several diagnostically important facts
were pointed out. ∧
S力inichiルlitsuhashiand YoshiWsoYamazaii: A
Case of Urticaria Caused by Ingestion of
Flour。
The patient is a 55-year-old man. who de-
velops lesions of urticaria when he takes food
containing wheat flour. in these 20 years. By
means of patch test and intracutaneous iniec-
tion using several kinds of flour, it was con-
eluded that the component, responsible for the
provocation of the disease, was g】uten.
KunioHanaiand Ma加加 Waianabe: Venereal
Diseases fro皿the standpoint of Public
Health Center.
lUuroOtaand UdtaKato:A Case of Throm-
boangitis Obliterans. `
The patient was a man, 42 years of age,
who complained of cold sensation and dullness
in the extremities, and was lame in the right
leg. The pulsation of the right posterior tibial
artery. dorsal artery of the right foot. and right
brachial artery were faint or not perceptible.
however, no necrotic lesions were observed on
the skin. Biopsy of the right posterior tibial
artery showed thromboangitis. Etiological factors
in this case seemed to be the habit of smoking
and syphilis.
Araia Maisui and TanefitroSatio: Enzymatic
Debridement by Local Applicaation of
Trypsilin stick。
The effect of Trypsilin Stick (prepared by
Mochida Seiyaku Co.), consists chiefly of poly-
ethylene glycol containing 10,000 units of trypsin
per cc, was studied both chemically and clin-
ically。It was found that the effect of Trypsilin
Stick lasted for a longer time than trypsin
powder. Proteolytic action of Trypsilin Stick
on egg albumin. casein, and gelatin were also
demonstrated experimentally. When inserted
into the wounds of acute pyoderma and ulcer,
it facilitated markedly the debridement of
necrotic lesions and the secretion of pus.
Noboru Isfttz≪fei and Kazuzo Satoご Studies on
Chrome Dermatitis。
Six patients with contact dermatitis due
to chrome were observed. Three of them were
printers and the other three were dye workers.
all having subacute eczematous dermatitis on
the exposed area. such as hands. forearms
and face. Positive patch test was observed in
printers゛group with ammonium bichromate
and in dye workers with sodium bichromate.
Discussion:(rtichiro Harada:l have often Ob-
served similar cases of contact dermatitis in
printers. For the detection of the etiological
factor in these cases. l believe the series of
patch test using various kinds of chromates are
the most valuable, because bichromate is the
very irritating substance in itself.
Kihei Taniofeu, Ryuzo Maisuyama,YoswMfeo Saida。
YMfetO Nis恒常mra.Kozwhiro Tsurumi and Afejo
Kaw心μ揖i: studies on Skin Metabolism
(Fifth Report)。
The changes of the contents of Sodium,
Potassium, Calcium, Magnesium, Glucose,
Glycogen, Vitamin C,Vitamin B2,Biotin, Panto-
thenic Acid, Niacin and Cholinesterase in the
skin of rabbits. irradiated with infra-red rays,
were studied. The irradiation was carried out
for five minutes on the clipped skin of one side of
the back, and the other side was used as the
control. Lamp skin distance is about 12 cm.
The measurements were performed at inter-
vals of o min., 1 hr., 2 hrs., 3 hrs., 5 hrs.,
8 hrs., 12 hrs., and 24 hrs. after the irradia-
tion. The changes of their contents in the
skin were observed at period from o min. to
12 hrs. after the irradiation. These observa-
tions were different from the experiments in
which the ultraviolet irradiation on the rabbit-
-skin was employed.
Discussion: TatsuroMasw竹lizM:l should like to
ask you that what a different reaction between
an ultraviolet and infra-red irradiation on the
small vessels of the skin could be observed?
J?yMzoMafSMyama:Theinfluences of ultraviolet
and infra・red irradiation on the blood vessels
have been uncertain・, but l would say that the
infra-red rays reach the deeper tissue of the
・skin, the heat ray of infra・red irradiations
causes the reaction more earlier and the reac-
tion subsides more faster than the ultraviolet
irradiation.
AlsushiKuhita:studies on Melanin Formation。
with Special Reference to Tyrosinase
Activity of Hair Melanocytes。
The tyrosinase activity of hair melanocytes
in the various colored human hairs (black.
red, grey and hairaof albino) and in the chick-
embryos of three different breeds (White Leg-
horn, Rhode Island Red and Black Australorp)
was determined with an autoradiographic tech-
nic using radioactive C14 tagged tyrosine pre・
viously described (Science, 121, 893, 1955; J.
Invest. Dermat・, 26, 173, 1956). Active tyrosin-
ase activity was detected in melanocytes in
black, red and blond hairs. The degree of the
activity was found to be high in the following
5
descending order: blond hair, red hair and
black hair. No tyrosinase activity was detected
in melanocytes in the grey hair and hair in
albino. In the chick-embryos. no tyrosinase
activity was detected in the melanocytes of the
feather daring the embryonal development of
White Leghorn, but dopa-oxydase activity was
found in melanocytes at the limited period of
the embryonal life (11 day to 15 day). Both
tyrosinase and dopa oxydase were detected at
the limited period of the embryonal life (10
day t0 14 day) in the embryos of Rhode
Island Red and Black Australorp, however, the
activities were not detected in the successive
embryonal life.
Tosfitwfei FunabasM andSadahiko Haれat:A Case
of Acanthosis Nigricans。
A 57-year-old male having acanthosis nigri-
cans with no evidence of associated malignancy
was reported. The study on pathogenesis of
this case will appear elsewhere.
R泌垣 Koiima and His(IShi Nishidn: Small
Nodular Lesions on the Skin。
Six cases with small nodular lesions were
reported. All cases were examined histologi-
cally, and their diagnoses were as follows :
granuloma having necrosis, thrombosis, epi-
thelial cyst, lesion resembling calcifying epi-
thelioma, granuloma pyogenicum, and capsulat-
ed neurofibroma.
尺anehiko Kiiamu?72: The Eleventh International
Congress of Dermatology。
See this journal, 67 : 723. 1957.
Demonstration of Clinical Cases
Melanoleucoderma and Poliosis observed in
Carbon Binder Worker (Yamaiiashi Kenritsu
Hospital)。
This patient,carbon. binder worker, was a
38-year-old male, who had adiffuseredness and
fever-sensation on the upper part of the chest
and the back of the feet on the firstday of his
employment. On the neχtday. the lamellar
6
desquamation and depigmented lesions were
noticed on the upper part of the chest and
back of the feet. Four or five days after that,
numerous freckle-like pigmented spots appeared
in the depigmented lesions, and the lanugos
on the lesions, hairs on the scalp, mustache
and eyelashes started to grey・
Discussion: Koicht Nishida-. l have observed
different kinds of pigmentary disorder in the
other workers of the same factory.
Basal Cell Epithelioma treated with Purified
Vaccine Lymph (Yokohama City University).
A patient, 38-year-old woman, was given
local injection of P.V.L・,1 cc a day, for 18
days. The necrosis of the tumor was noted
two days after the treatment was started.
and subsequently the size of the tumor was
reduced.
Discussion: YoihikuniNogwchi; The principle
of this treatment is thought to be due to the
epidermotropic action of small pox virus, and
also the excellent results have been obtained
in the treatment of verruca with the same
mode of P.V.L. administration.
Lichen Pig皿entosus (Yokohama City Univer-
sity).
A 45-year-old male has had pigmented
pruritic eruptions on the lateral surface of the
neck, forearms and back of the feet of two
years' duration. Recently the pigmentation of
the lesion hds increased. Histopathologic exam-
ination: Although there was a band-like infiltra-
tion of round cells in the upper part of the
corium in the specimen taken from the dorsum
of the feet, no diagnostic characteristics of
lichen planus were found in the lesion of the
side ・of the neck.
Discussion: KαれehifeoKUa俳話ra:l have observ-
ed frequently the cases of lichen pigmentosus
which have no diagnostic characterstics in the
histological examination like those of Riehl's
melanosis.
Case for Diagnosis (Yokohama City Univer-
sity).
A 15-year-old girl has had a well-demar-
cated, elevated, erythematous lesion on the left
cheek for siχ months. The redness of the
lesion is increased by the exposure to the sun.
Biopsy was performed, and showed atrophy of
the epidermis, homogenization of the collagen
and loss of the elastic fibers.
Discussion:尺挽≪! Tanioku: l think this patient
has dermatitis atrophicans maculosa idiopa-
thica. KaiashxYo恥部■mo'.l would agree with Dr.
Tanioku゛s opinion. I think the lesion shows
atrophy of the skin clinically, which helps
establish this diagnosis.
Urticaria Pigmentosa in Adult (Branch Hos-
pital, University of Tokyo)。
A 17-year-old woman has had numerous
flat pigmented spots on the chest. and lower
extremities for several months. Recently the
number of the lesions has been increasing。
however, her subjective symptoms are slight・
Blood examination for syphilis was positive.
Histological examination revealed small num-
bers of mast cells (Rona type)・
Connective Tissue Nevus (Tokyo Medicodental
University)。
A 22-year-old woman first noticed milium一一
to rice-sized, white, soft papules distributed
on her breasts, upper abdomen, back and
lumbar region two and a half years ago. NO・
subjective symptoms are complained. Micro-
scopically, the lesion showed swelling and
diminution of the elastic fibres.
Discussion: KoMefiifeoKi拠単瓦ya: l wonder if
the course of two and a half years is enough
to diagnose this lesion as a nevus. Giicfiiro=
Harada: l think this case is nevus tardus.
Case for Diagnosis (Juntendo University。
Tokyo)。
A 42-year-old woman suffered from caries.
of the femur two years ago. The present
lesion occurred as a hen-egg-sized induration
on the upper part of the left leg about one
year ago. The lesion thereafter has spread
to the surrounding skin. At present time, the
lesion shows an ill-defined, firm, pigmented
macule covering the entire left leg. Histological
・examination revealed edema and perivascular
lymphocytic infiltration of the subpapillary
layer, and proUferation and homogenization
・of the connective tissue in the corium.
Discussion: 召7,・aki Miyazaki: If it is a case
of vasculitis, the distribution of the lesion
should be arranged bilaterally・
A Case of Leucoderma (University of Tokyo)。
A 17-year-oId girl has had greying of
eyelashes of two months' duration. and f0ll0V7-
ing the sea-bathing this summer, the we11-
demarcated, numerous depigmented spots appe-
ared mostly on the exposed regions, the fore-
head, cheeks, sternal region and extremities.
They vary in size from that of a rice-grain to
a hen-egg. and have irregular, round or oval.
and annular shape. In the lesions on the
forearms and lower legs. the spotty or reticular
normal skin is left which shows a monstrous
picture.
Porokeratosis Systematica (University of To-
kyo)。
This patient is a 26-year・old man. The
present skin lesions appeared shortly after his
birth. At present. there are numerous, irregular,
milium- to broad-bean-sized. pigmented lesions
scattered on the chest, the upper abdomen,
and on the flexor surface of the left upper
extremity. Some of them are confluent. form-
ing irregular plaques. The small lesions are
dark-purplish or brownish in hue, slightly
elevated with sharp demarcation. and the larger
lesions have elevated borders and depressed
centers, having normally colored skin or brow-
nish pigmentation. The lesions show linear
Con丘guration and tend to affect the left side of
the body rather than the right. Microscopic・
ally, the typical changes of porokeratosis
were observed in the epidermis.
7
Precancerosis (University of Tokyo)。
Aman, aged 33, has had gradually develop-
ing lesions for 10 years. Extremities, espe-
cially forearms, eχtensor aspect of thighs. and
popliteal regions showed well-demarcated,
round, pale pinkish or dark brownish pea-
to coin-sized, slightly scaly lesions. Histology
showed some anaplastic cells in the epidermis.
but no clumping cells.
Discussion:KatasW Yokoyama; Wehave experi-
enced a case of Bowen's disease with multiple
lesions, which had been diagnosed clinically as
psoriasis. I believe the case presented here
is essentially the same as ours.
Parapsoriasis en Plaques (University of To-
kyo)。
A girl, aged 15, has had the present con-
d皿on for 4 years. Coin- to palm-sized erythema
with pityriasic scales scattered on both thighs
and on the trunk。 Not pruritic. Histological
findings: Hyperkeratosis, destruction of the ba-
sal layer, exocytosia at the lower part of the
epidermis, spongiosis of the slight degree in the
prickle layer. and perivascular lymphocytic in・
filtration in the corium.
Weber-Christian's Disease (Hitachi Hospital)。
A woman, aged 54, developed the edematous
erythematous swelling on the face in winter,
15 years ago, which resulted in the formation
of the marked depression of the skin after-
wards. In fall 1956, she suffered from vertigo,
and palpitation, and at the same time subcuta-
neous nodular lesions appeared on both shoulders
which gradually extended to chest and upper
arms. The center of the lesions again became
depressed progressively. She was afebrile dur-
ing the course of the disease. Panniculitis is
a predominant feature histologically・
Discussion: Hitoshi 召''atano: Among various
types of idiopathic lipogranulomas, Rothman-
Makai゛s syndrome is thought to be a favorite
diagnosis because of the absence of marked
general symptoms such as high fever.
8
Sqamous Cell Carcino皿a of the Lip (Nippon
University)。
A 65-year・old man. 3 years d゙uration. Mi-
liary to bean-sized papules with rough surfaces
were grouped on the right half of the lower
lip, forming a papillomatous, hard, tender no-
dule. Submandibular and submental lymph
nodes were swollen. Histologically, nests of
tumor cells with dark-staining atypical nuclei
were found.
Case for Diagnosis (Poikiloderma Atrophi。
cans Vasculare?) (Nippon University)。
A60-year-old man had developed labial and
perioral pigmentation after the topical applica-
tion of an ointment for probable cheilitis.
Later, pruritic erythema a耳d pigmentation had
appeared on the flexor surface of arms and
thighs. Clinical features when the patient was
presented were violaceous pigmentation of the
face, telangiectasis,pigmentation, and atrophy
on the trunk and extremities. Histology:
The epidermis is atrophic. Narrow zones of
pigmentation and depigmentation are observed
in the basal layer. Subepidermal band-like
infiltrationare also found in some parts of the
cutis.
Xantho皿a Disse皿Inatuin (Okubo Hospital, To-
kyo).
A 14-year-old boy has had the lesions on
axillae for l year, which gradually increased
in number and became generalized. Thirst
and polyuria were observed. Yellowish brown
papules, with size of a pin-head to a grain of
rice, are located on the face. head, neck, trunk.
genitalia, and thighs. Some of the papules
tend to coalesce forming pea-sized lesions. Con-
sistency is elastic firm. Total cholesterol in
serum: 173 mg/dl. Specific gravity of urine :
1,001. The lesion was found to be typical
xanthoma histologically・
Squamous Cell Carcinoma and Cutaneous Horn
(OkuboHospital, Tokyo).
Coincidental occurrence of both dermatoses
in a 79-year-oia man.
Familial Benign Chronic Pemphigus? (Kanto
Teishin Hospital, Tokyo).
Alopecia Areata, Vitiligo and Arsenical Me-
lanosis (Kanto Teishin Hospital, Tokyo).
Lupus Erythematosus Discoides Chronicus
(Kanto Teishin Hospital, Tokyo).