Search PubMed⌕ Search

Biomedical subjects

Y Kurumaji

Publications and source records attributed to Y Kurumaji.

15 recordsLinked to original sources

Treatment of reticular erythematous mucinosis with a large dose of ultraviolet B radiation and steroid impregnated tape.

To date, there are no successful treatments for reticular erythematous mucinosis (REM) other than antimalarial drugs such as chloroquine; these have many adverse side effects and are prohibited for use in Japan. We report a case of REM improved by a large dose of ultraviolet B (UVB) radiation and a steroid impregnated tape. The large dose of UVB radiation improved the erythema after 5 weeks. Application of steroid impregnated tape to a lesion where a large dose of UVB had been given produced an additive clinical effect. UVB radiation and steroid impregnated tape are considered to be effective treatments for REM.

Combined Modality Therapy↗

Photo Koebner phenomenon in erythema-multiforme-like eruption induced by contact dermatitis due to bufexamac.

A photo Koebner phenomenon following contact dermatitis due to bufexamac is described. A 52-year-old man presented with dermatitis on his buttocks and an erythema-multiforme (EM)-like eruption near the original lesion and on sun-exposed areas. He had been using bufexamac ointment (Anderm(R)) around and inside the anus for a few weeks before he noticed exacerbation. On patch testing, he exhibited severe contact sensitivity to bufexamac. Phototesting performed on his first visit showed that he had an abnormal reaction to UVB. An EM-like eruption similar to the original lesions developed around the irradiated sites. In this case, photosensitivity does not seem to be a drug-induced photoallergy due to systemic or topical use, but rather a photo Koebner phenomenon.

Administration, Topical↗

Chronic actinic dermatitis: a clinical and photobiological study in 6 Japanese patients.

Chronic actinic dermatitis (CAD) has distinct clinical features different from polymorphous light eruption (PLE). In order to clarify the difference between CAD and PLE, not only in clinical histories and findings but also in photobiological and histopathological reactions to phototests, we investigated 6 Japanese patients with CAD and performed provocative phototests which are our standardized methods in diagnosing PLE. On provocative phototests in CAD, pruritic papules were reproduced with smaller doses of UVB, at longer hours after irradiation (48-72 h) and they lasted for more days than in patients with PLE. Our study demonstrated that although milder cases of CAD and severe cases of PLE could not be distinguished clearly based on photobiological reactions alone, typical cases of CAD showed completely different provocative phototest results from those of PLE.

Adult↗

Drug-induced solar urticaria due to repirinast.

We describe the first case of drug-induced solar urticaria due to repirinast, an antiallergic drug developed and introduced into the market in Japan in 1987. The patient was a 72-year-old woman who had been on repirinast for 1 year and 8 months. She developed urticaria immediately after an irradiation with 1.5 J/cm2 of UVA, and the provocation test confirmed that repirinast was responsible for the urticarial reaction. The action spectrum of the urticarial reaction was deduced to be 320-350 nm. Passive and reverse passive transfer test results were both negative. However, intradermal injection of patient serum, obtained while she was on repirinast and irradiated in vitro with UVA, demonstrated positive reactions both in the patient and in a normal volunteer. Our findings suggest that nonallergic mechanisms are involved in the reaction. However, the rarity of the phenomenon also suggests an association with some allergic mechanisms.

Aged↗

Photosensitivity in atopic dermatitis: demonstration of abnormal response to UVB.

It is a well-known fact among clinicians that sunlight may exacerbate atopic dermatitis (AD), but little is known beyond that. In a preliminary study investigating this phenomenon, 19 patients with AD were selected for phototests. All of them had a normal minimal erythema dose (MED). However, 3 patients (15.7%) demonstrated abnormal cutaneous responses 24-72 h after provocation with ultraviolet light B (UVB). None of the patients had a positive response to pure ultraviolet light A (UVA) irradiation of up to 9 J/cm2. The photobiological results of this study confirm the existence of photosensitivity in AD and indicate that UVB wavelengths are responsible for it.

Adolescent↗

Scarified photopatch testing in lomefloxacin photosensitivity.

We report the results of scarified photopatch testing in 3 patients with photosensitivity to lomefloxacin, a new quinolone antibacterial agent introduced onto the Japanese market in April 1990. The patients developed pruritic eczematous lesions on sun-exposed areas 5 days to 3 weeks after they had started taking lomefloxacin. 2 cases reacted positively to lomefloxacin on scarified photopatch testing down to 0.1% pet., and 1 patient down to 10% pet. One of them also showed positive reactions on conventional photopatch testing. Scarified photopatch testing with 7 other pyridone carbonate derivatives in 2 of the 3 cases, however, did not show any positive reactions. Patch and scarified patch testing were negative in all patients. The clinical course, clinical and histological findings and results of skin tests in these patients suggest that photoallergic mechanisms are involved. This is the 1st report of positive reactions on scarified photopatch testing, which appears to be a useful method of detecting the causative drug in drug-induced photosensitivity.

Aged↗

Allergic photocontact dermatitis due to suprofen. Photopatch testing and cross-reaction study.

We report 5 cases of photocontact dermatitis due to suprofen, a nonsteroidal anti-inflammatory drug introduced to the Japanese market in 1989, and available as a 1% ointment. The patients developed pruritic eczematous lesions after applying the ointment for from 2 weeks to 3 months. All 5 patients reacted positively to photopatch testing with ultraviolet A (UVA) and suprofen down to 0.1-0.01% pet., and 3 patients showed positive reactions with ultraviolet B (UVB) and suprofen down to 1.0-0.1%. Moreover, all patients showed a cross-reaction with tiaprofenic acid, which has a very similar chemical structure to suprofen. However, there was no cross-reaction between suprofen and ketoprofen. Prescribers should be aware of the existence of photocontact sensitivity due to these drugs.

Adolescent↗

Tiopronin-induced lichenoid eruption in a patient with liver disease and positive patch test reaction to drugs with sulfhydryl group.

A 62-year-old woman suffering from liver cirrhosis developed lichenoid eruptions after 2 years of treatment with tiopronin. The lesions healed spontaneously within a month after withdrawal of the drug. In patch testing, the patient reacted positively, not only to tiopronin, but also to captopril and D-penicillamine, neither of which she had ever taken before. The provocation test was positive only to tiopronin, and its histological findings revealed lichenoid reaction. It is suggested that the sulfhydryl group may play a role in the etiology of tiopronin-induced lichenoid drug eruption.

Drug Eruptions↗

A quantitative study of the interaction of ultraviolet A and ultraviolet B in producing delayed pigmentation.

The interaction of ultraviolet A (UVA) and UVB in producing delayed pigmentation was quantitatively studied on the backs of 19 healthy Japanese subjects. The minimal pigementation dose for UVA (MPDA) and UVB (MPDB) was first determined using narrow-band radiation of 360 nm and 290 nm respectively. The average MPDA and MPDB was 16.4 J/cm2 and 32.9 mJ/cm2 respectively. In experiment 1, fractional doses of 0.2, 0.4, 0.6 and 0.8 MPDA were first irradiated on 4 sites each. Immediately following each exposure, fractional doses of either 0.2, 0.4, 0.6 or 0.8 MPDB were superimposed on the same sites, resulting in each exposure site receiving a different combination of fractions of MPDA and MPDB (A + B). This was repeated with the sequence of exposure reversed (B + A). The results demonstrated that the wavelengths interacted via photoaddition in producing delayed pigmentation, irrespective of the order of exposure. When a 3-h time interval was allowed between exposures in experiment 2, there was again no evidence of deviation from photoaddition with either order of exposure. This study shows that subthreshold doses of UVA and UVB interact additively in the production of delayed pigmentation.

Adolescent↗

The interaction between narrow-band radiation of UVA and that of UVB on erythemal reaction in Japanese subjects.

The interaction between ultraviolet A (UVA) and ultraviolet B (UVB) on erythemal reaction was investigated on the skin of the backs of 24 healthy Japanese volunteers, using narrow-band radiation. The minimal erythema doses (MED) for UVB (MEDB) and UVA (MEDA) were determined and UVA and UVB were both applied to the same site in immediate combination with 2 orders of exposure (A + B, B + A). In experiment 1 the interaction between suberythemogenic doses of UVA and UVB to produce a visible erythema was examined; the sum of the fraction of MEDA and the fraction of MEDB was at most equal to 1 for 3 different doses of UVA (1, 2.4, 4.9 J/cm2) with either order of exposure. This interaction is considered to be photoaddition. In experiment 2 a fixed dose of UVB (1.7 MEDB of each subject) was applied in combination with 4 different doses of UVA (1, 2.4, 4.9, 7.4 J/cm2); the erythemal reaction was compared with the grading scale erythema produced by UVB alone and allotted a score of 1 to 7. The total number of MED irradiated was calculated for each combination exposure and the score obtained was compared with the score expected on the basis of that number of MED. The scores for A + B practically coincided with the expected values, whereas those for B + A were decidedly smaller than the expected values. This suggests photoaddition for A + B and photorecovery for B + A in the bright erythema dose range. The relationship between the Japanese skin type (JST) and the waveband interaction was also examined. In experiment 2, when UVA irradiation was followed by UVB, the subjects in JST group III showed photorecovery for high-dose UVA.

Adolescent↗

A case of secondary syphilis with a solitary pulmonary lesion.

This study describes a case of secondary syphilis with a papular eruption and penile ulceration. A chest roentgenogram showed a solitary lesion in the left middle lung field. Histological examination revealed epithelioid cell granuloma in both the penile ulcer and the lung lesion. After antisyphilitic treatment, the lung lesion shrunk remarkably and at the same time the skin eruption and the systemic symptoms also improved.

Amoxicillin↗