Epidemiological survey of foot diseases in Japan: Results of 30 000 foot checks by dermatologists

There has been no epidemiological survey of foot diseases in Japan. In this study we determined the prevalence of foot diseases, especially tinea pedis (TP) and tinea unguium (TU) in Japan. We conducted a randomized survey of outpatients who visited a dermatologist during the third week of May in 1999, 2000 and 2006. The most frequently reported condition was “fungal infection” in 8737 (40.0%) of 21 820 patients in 1999/2000, and 3848 (49.4%) of 7783 patients in 2006. The patients who visited a dermatologist for reasons other than superficial fungal infection but were diagnosed with TP or TU comprised 18.6% of the study population in 2000 and 24.1% in 2006. Of the patients with TP or TU, 63.2% used topical medication only. This survey showed that often patients are not aware of fungal infections and that their treatment is sometimes insufficient. Dermatologists should actively examine and treat patients with TP and TU.     

Perspectives on phantom boarder symptom

Phantom boarder symptom (PBS) is a hallucinatory and delusional syndrome that tends to occur in the elderly, in which the patient imagines that someone uninvited is living in their home. This article provides an overview of the historical background that has led to the current focus on PBS as a single symptom, from its classification as late paraphrenia to its being recognized as a type of misidentification, and discusses classification problems and PBS subclassifications. In addition, the results of our own investigation of PBS, which focused on PBS in senile dementia, support the findings of previous studies, such as the absence of a relationship between dementia severity and the occurrence of delusion. The discussion therefore focuses on the psychosocial factors that serve as the mechanism of PBS onset, and directions and possibilities for therapy are suggested.     

Photosensitivity induced by fleroxacin

A case of photosensitivity induced by fleroxadn (FLRX) is reported. A 71-year-old man had erythema on sun-exposed areas after 5 months FLRX treatment for prostatitis. The minimal erythema dose to UVA was reduced at the initial examination and became normal 4 weeks after he stopped taking FLRX. Oral photo-challenge with FLRX 100 mg was positive, but photopatch testing was negative.     

Exanthem subitum (roseola infantum) with vesicular lesions

Summary We report a 7-month-old boy who developed vesicular lesions during the course of exanthem subitum. Human herpesvirus-6 (HHV-6) DNA was detected both in the skin lesions and in the throat, by polymerase chain reaction. IgG and IgM antibodies against HHV-6 were 1:10 and <1:10, respectively on the tenth day of the illness, and >1:640 and 1:10 on the twenty-second day, respectively. These results suggest that this was primary HHV-6 infection.     

Endoscopic Findings of Acute Intestinal Graft-versus-host Disease after Bone Marrow Transplantation

Abstract: To clarify the endoscopic findings of intestinal graft-versus-host disease (GVHD), we reviewed the endoscopic findings of 19 patients who underwent colonoscopy because of abdominal pain, watery diarrhea or bloody stool among 196 bone marrow transplant (BMT) recipients between 1986 and 1997. BMT had been performed for treatment of various hematopoietic disorders. Eleven patients were diagnosed as having intestinal GVHD, based on the pathological findings of biopsy specimens. Although the grade of inflammation differed among cases, the terminal ileum was most vulnerable to GVHD, based on our observations. Compared to the ileum, findings in the colon tended to be mild. Therefore, evaluation of intestinal GVHD requires observation of the terminal ileum when the colorectal findings are mild. The findings consisted of shallow ulcerations, erythema and easy bleeding. However, there were very few specific endoscopic findings of intestinal GVHD. Since intestinal GVHD and cytomegalovirus (CMV) enterocolitis share several clinical characteristics, including preferential involvement of the ileum, biopsy is indispensable for the final diagnosis.     

Expression of cathepsin D and B in invasion and metastasis of squamous cell carcinoma

To determine the involvement of proteinases with hydrolytic activity towards extracellular matrix and basement membrane, in invasion and metastasis of tumour cells, the expression of cathepsin D, an aspartic proteinase, and cathepsin B, a cysteine proteinase, was studied. Formalin-fixed paraffinembedded specimens from 13 patients who had squamous cell carcinomas (SCC) with local recurrence, skin and/or lymph node metastasis were examined. Cathepsin D stained intensely as a granular pattern (mature enzyme) in tumour cells of 69% of primary lesions and all the secondary lesions of the patients with SCC. Cathepsin B stained more intensely in SCC cells of all of the primary and secondary lesions than in normal epidermis: staining patterns were almost diffuse (procathepsin B). Granular and diffuse patterns (mature enzyme of cathepsin D and procathepsin B, respectively) appeared in the outer and inner parts of tumour islands, respectively. The presence of the active mature form of cathepsin D and procathepsin B in metastatic skin lesions of SCC was confirmed by Western blotting analysis. The presence and localization of the active mature form of cathepsin D suggests that activated cathepsin D may be involved in the invasion and metastasis of SCC.