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Notes: Background/aims: The depth of experimentally inflicted superficial/partial dermal burns and deep dermal burns were non-invasively evaluated using a 30 MHz B-mode high-frequency ultrasound scanner.Material/methods: Superficial and deep burns were produced in 10 Harley female albino guinea pigs. Ultrasound scanning was performed immediately after, and 24, 48, 72 and 96 postbum. Specimens for histology were obtained after 72 h.Results: The echo reflection at the dermis-subcutaneous interface was easily defined 2 days after burn infliction in all superficial/partial dermal burns, whereas it was disturbed and not detected in any deep dermal burn.Conclusions: It is concluded from our study that the ultrasonography of the deep dermis, especially the dermis-subcutaneous interface, is of major importance in the diagnostic and prognostic evaluations of burns.

Notes: Chemical and ultrastructural studies were conducted to define the relationship between type of melanogenesis and fine structures of melanosomes in normal human epidermal melanocytes. Chemical analysis of epidermal melanin demonstrated that the ratio of eumelanin/pheomelanin varied individually, ranging from 1.31 to exclusively eumelanic. Ultrastructural analysis of fine structures of melanosomes revealed that spheroid melanosomes were frequently observed in melanocytes of the epidermis whose eumelanin/pheomelanin ratio was less than 5. Conversely, ellipsoid melanosomes predominated in melanocytes of the epidermis whose ratio was more than 10.On the basis of these findings, it seems reasonable to conclude that 1) normal human epidermal melanocytes synthesize both eumelanin and pheomelanin and 2) pheomelanin synthesis may be characterized by the presence of spheroid melanosomes whereas eumelanin synthesis is ascribed to ellipsoid melanosomes.

Notes: A 31-year-old Japanese man presented to our hospital in December 1990 with swelling of the lower lip and cheek which he had noticed 8 months earlier. Before his first visit to us, systemic corticosteroids had been administered for a week. This treatment resulted in remarkable improvement of the swelling of both sites; however, after discontinuation of these corticosteroids, recurrent episodes of the swelling occurred. Our examination revealed an enlarged, soft, nontender lower lip and a swollen cheek (Fig. 1). Bilateral hilar lymphadenopathy was not found by a chest radiograph. Computed tomography of the abdomen was normal. Laboratory investigations disclosed that lactic dehydrogenase was 195 U/L and that angiotensin converting enzyme (ACE) was 29.4 IU/L. The antibody against HTLV-I was negative and a biopsy of the lower lip revealed a relatively dense infiltration of the inflammatory cells composed mainly of lymphocytes and histiocytes. Atypia of lymphocytes was not prominent and some muscle fibers showed degenerative changes (Fig. 2). A skin biopsy of the cheek disclosed a dense lymphohistiocytic infiltrate in the dermis. Based on the clinical findings, we tentatively diagnosed this case as cheilitis granulomatosa and reinstituted systemic corticosteroid therapy.In December 1991 the patient was admitted for evaluation of muscle weakness of the forearms. Electric myography revealed a myogenic pattern. He showed neither a heliotrope eruption nor Gottron's papules. Laboratory investigation showed that the white cell count was 14 600/mm3 (lymphocytes 27%), creatinine phosphokinase (CPK) was 679 U/L, and ACE was 28.0 IU/L. A biopsy of the deltoid muscle disclosed muscle atrophy and a dense atypical lymphocytic infiltrate around the muscle fibers (Fig. 3). Immunohistochemical findings revealed that most of the Infiltrating cells were CD3(+) and CD4(+). Although molecular biologic investigation did not disclose the monoclonality of the gamma T-cell receptor gene, this time we diagnosed the case from the histologic findings as T-cell lymphoma. Needle biopsy of the bone marrow suggested the infiltration of lymphoma cells. In January 1992, chemotherapy of MACOP-BV (MTX, doxorubicin hydrochloride, CPA, VCR, prednisolone, BLM, and etoposide) was started, but we were unable to prevent the progression of muscle weakness, and in April 1992 the patient died of pneumonia. No autopsy was performed.

Notes: A 12-year-old Japanese boy presented with asymptomatic, multiple annular, erythematous, infiltrated lesions on his left upper arm and right knee as well as the lateral side of the right ankle joint. He had noted these erythematous lesions five days after bacille Calmette-Guerin (BCG) vaccination. The lesions gradually enlarged and increased in number. Topical corticosteroid therapy for several weeks failed to improve the lesions. There was no familial history of pulmonary tuberculosis.Physical examination revealed extensively disseminated, round, erythematous plaques and papules. Some plaques showed an annular configuration, varying in diameter from 5 to 45 mm, on his left upper arm, right knee and the lateral side of the right ankle joint (〈link href="#f1-1"〉Fig. 1). One month after BCG vaccination, reddish-brown, infiltrated erythema with crusts was observed at the BCG vaccination site (〈link href="#f1-2"〉Fig. 2). Tuberculin test showed an erythema with induration measuring 2.5 cm in diameter at 48 h. Routine laboratory tests including complete blood cell count, erythrocyte sedimentation rate and biochemical analysis were within normal limits. Serum glucose level and GhbA1c were also normal.〈figure xml:id="f1-1"〉1〈mediaResource alt="image" href="urn:x-wiley:00119059:IJD1248-2:IJD_1248_f1-1"/〉Annular erythematous lesion on left lateral malleolus〈figure xml:id="f1-2"〉2〈mediaResource alt="image" href="urn:x-wiley:00119059:IJD1248-2:IJD_1248_f1-2"/〉Multiple, grouped, erythematous papules with crust, exactly corresponding to previous multipuncture BCG siteHistopathologically, a biopsy specimen obtained from an annular erythematous plaque on the lateral side of his right ankle joint revealed marked pale staining, well-circumscribed degenerated collagen bundles surrounded by palisading histiocytes and lymphocytes in the dermis (〈link href="#f1-3"〉Fig. 3). Alcian blue stain was positive among degenerated collagen fibers. An immunofluorescence study revealed IgG and C3 deposits in dermal vessels. These histologic features were consistent with granuloma annulare.〈figure xml:id="f1-3"〉3〈mediaResource alt="image" href="urn:x-wiley:00119059:IJD1248-2:IJD_1248_f1-3"/〉Area of degenerated collagen surrounded by palisaded histiocytesTwo months later, the margins of the erythematous lesions had spontaneously faded and, within 7 months, had completely resolved. Reddish-brown erythema at the BCG vaccination site had not disappeared.

Notes: One hundred and ten cases of an unusual type of naevus, which we have called naevus fusco-caeruleus zygomaticus were studied. The naevus presents as a bilateral speckled discolouration of the skin of the face principally in the zygomatic region. The condition usually does not become apparent until the second decade of life, and is much commoner in females. No association with any other abnormalities was found.Light and electron microscopy of the speckles showed the presence of dermal melanocytes mostly in the upper dermis.A survey was also carried out to determine the prevalence of this naevus in the general population.