179

　　　　　　　　　　　　　　　　　　　　　　Original Articles

　　　　　　　　　　　　　　　　　　　　　　　　(Abstracts)

　　　　　　　　　Demonstration of Tyrosinase in Melanocytes using Carbon-14

　　　　　　　　　　　　　　　　　　　　　　　labeled Tyrosine*

　　　　　　　　　　　　　　　　　　　　　　　　　　　by

　　　　　　　　　　　　　　　　　　　　　　　Atsushi Kukita゛゛

　　　Since ａ histochemical determination of melanin formation from tyrosine was carried

out in the case of normal white human skin irradiated　with ultra-violet radiant energy,

many attempts have been made on the demonstration of tyrosinase activity in melanocytes

of various kinds of tissue for the study of melanin formation. It has been known, however,

that ａ histochemical technic is inappropriate to determine　tyrosinase activity, because

it is rather difficult to distinguish whether the melanin granules were present previously

or　were formed from tyrosine when ａ pigmented material is used. Toward this difficulty.

we have developed cover slide method for microquantitative determination of the tyro-

sinase system　and　an　autoradiographic　histochemical method that utilizes C-14　labeled

tyrosine as the substrate.

　　　I) Cover slide determination of tyrosinase

　　　The cover slide determination of tyrosinase activity utilizes homogenates or cell suspen-

sions on ａ １８χ18 mm　glass　cover slide. The tissue sample is placed in ａ chilled mortor

and ground with firm pressure until a tissue mince is obtained. The tissue mince is then

placed on clean. dry cover slides, then the cover slide with tissue is set in ａ specially designed

plastic cover glass .holder and　dried.　The　tissue　is　丘xed with IWo alcohol, which in-

activates cytochrome ｏχidase but not tyrosinase.　The fixed, dried tissue on the slide

is removed　from the　cover　slide holder, and　placed on specially designed wire loop for

the incubation with radioactive tyrosine solution。The tissue on the wire is then incubated

in radioactive tyrosine solution for six and twenty-four hours at 37°Ｃ. The cover slide is

then washed in running water for eight hours, dried and counted.　The amount of radio-

activity　remaining　on the cover　slide thus indicates the presence　of　radioactive　C-14

labeled melanin formed　from　radioactive C-14　labeled　tyrosine　in the reaction mixture.

The total net counts represent the activity of the tyrosinase with the　melanocytes (See

Fig. 7,8).

　　　II) Autoradiographic determination of tyrosinase

　　　In addition, the　tyrosinase reaction　is ideally suited for an autoradiographic technic.

The conversion of water-soluble tyrosine to insoluble melanin on the surface of the melanin

granule presents an unique opportunity for utilization of an in vitro autoradiographic

　＊

＊＊

Full-length report: Japanese section pp. 915～959

From the Department of Dermatology (Director: Prof. K. Kitamura), Faculty of Medicine,

University of Tokyo, Tokyo.

180

method.　Tyrosine labeled with C-14　is incubated　with　the tissue；　and　in those cells

containing an active or functioning tyrosinase system, labeled tyrosine　is　converted to

labeled melanin. The labeled melanin is attached to the melanin granule allowing for an

excellent opportunity for recording ａ photographic image of the melanin granules within

cell. Since radioactive tyrosine is　soluble in water and radioactive melanin is attached

to the melanin granules. it is possible to free radioactive tyrosine from the incubated tissue

and record the images of only the radioactive melanin. Tissue slices, 1 t０２ mm thick,

were immersed in 2.2 ml 0f 0.１Ｍ phosphate buffer at pH ６.8 which contained 0.３(ｘＣof

DL-tyrosine-2-Ci* and 3,000 units of crystalline penicillin G. Incubation　was carried on

こfor24 hours at 37°Ｃin ａ Dubnoff shaker. As ａ control, slices from the same specimen

Avere treated identically. except that, in addition to the substrate, ａ tyrosinase inhibitor.

sodium diethyldithiocarbamate (O.OIM), was present. The inhibited specimen was necessary

to detect traces of unreacted radioactive tyrosine that might not have been removed from

the tissue slices by washing.　Following incubation, the tissue slices were 丘xed in 10 per

cent formalin for ｌ hour and washed in running water for ８ hours. To prepare the tissue

for autoradiography. the specimens were dehydrated, cleared in toluene, imbedded　in

paraftin, sectioned at 4 microns, and mounted directly on Eastman Kodak １×3 in. NTB3

（25μ) nuclear　track　plates.　　After　they were air-dried, the sections　were　thoroughly

deparaftinized by immersion in two changes of xylol for 10 min. each. The autographic

slides on which the sections were mounted were stored in black, light-tight slide boxes, sealed

with photographic masking tape. and exposed for 2 weeks. Following exposure, the slides

were developed in Eastman D-19 developer, fixed in 20 per cent sodium hyposulfite. washed.

and dried in air. The tissue was then stained with lithium carmine｡

　　Ill) Experiments

　　Using these methods. melanin synthesizing enzyme, tyrosinase activity in melanocytes

of the skin, hair and eye in the human and animals was investigated｡

　　i) Demonstration of tyrosinase in the skin

　　The normal human skin, benign and malignant pigment-cell neoplasms, pigmented

uevi and malignant melanoma, and melanocytosis, mongolian spot and nevus of Ota were

subjected for this study. Both technics provide evidence for the existence of varying state

of tyrosinase activity in normal melanocytes of normal human epidermis, pigmented nevi,

blue nevi, melanocytosis and malignant melanoma｡

　　In the cover slide method, it has been shown to exsist ａ markedly accelerated tyrosine

uptake only in malignant melanoma cells and less tyrosine uptake in other pigmented nevi

and mescellaneous tumors (See Tab. II～VI). In the autoradiographic method, tyrosinase

activity has been found in the malignant melanoma cells. nevus cells of proliferating nevus.

compound nevus in children and　blue nevi (See Fig. 11～15). Active tyrosinase system

was not demconstrated in melanocytes of the normal human epidermis, pigmented nevi,

junctional, compound and dermal nevus, and melanocytosis (See Fig. 10， 17, 18).

　　ii) Demonstration of tyrosinase activity in the hair

181

　　　Embryonal feathers of three breeds of chicken. White Leghorn, Rhode Island Red and

Black Australorp, various stages of the hair follicle during hair cycle in black mice C-57

and black, red, blond, grey hair and albino hair in man were used and autoradiographic

method was employed for this study。

　　　No tyrosinase activity was detected in melanocytes in the embryonal feathers of White

Leghorn, while dopa-oxidase activity was demonstrated in the melanocytes in the period of

n day t0 15 day embryonal life.　Both tyrosinase and dopa oxidase activity were detected

at the limited period of the embryonal life (10 days t0 14 days) in the melanocytes　of

feathers in the embryos of Rhode　Isia万nd　Red and Black Australorp, and the activities.

however, were not detected in the successive embryonal life (See Fig. 20～24). Also the

changes in tyrosinase activity during melanocytes proliferation in the hair cycle of black

mice C-57 were investigated. During the first three days after plucking (anagen ｌ and ＩＩ）

both the tyrosinase and dopa-0χidase activity were absent. Four days after plucking (an-

agen Ill) the first pigmented dendritic melanocytes appeared in the hair bulb. At this time

ａ low tyrosinase　activity is detectable, while the dopa-oxidase is slightly higher.　０ｎ the

sixth, eighth and fourteenth days after plucking (anagen IV, ｖ and VI), large numbers of

melanocjrtes are seen in the hair bulbs and both the tyrosinase and dopa-oxidase activity

are high.　Twenty-four days after plucking (telogen) the tyrosinase and dopa-oxidase activity

are not detectable (See Fig. 26～32, Tab. VIII）｡

　　　In man, active tyrosinase activity was demonstrated in melanocytes in black, red and

blond hairs. The degree of the activity was found to be high in the following descending

order; black hair, red　hair　and blond　hair.　Corporation of　labeled tyrosine does not

occur　in the　grey hair and albino hair matrix melanocytes which lack the enzyme tyro-

sinase (See Fig. 33～37）｡

　　　iii) Demonstration of tyrosinase in the eye

　　　For this study, chick embryos of three breeds of chicken, White Leghorn, Rhode Island

Red and Black Australorp, black mice C-57 embryos, ５ month human embryo and primary

malignant melanoma of the eye were subjected. For the determination of tyrosinase and

dopa-oxidase activity　of the pigmented retinal epithelium of chick embryo, an autoradio-

graphic technic and Becker's method were employed respectively. Ten dozens of fertilized

egg of each breed were incubated with moisture at 37.5 C. The experiments were carried

out at the period from three days t0 21 days after incubation. Several eggs were sacrificed

each　day　to obtain　embryos to　be tested.　The embryos were washed in chilled pH ６.8

buffer solution, then incubated with radioactive tyrosine solution for 24　hrs. at 37°C. and

the autoradiographes were made. In the pigmented retinal epitheliurt! of ３ day embryo

of White Leghorn, tyrosinase　activity　was not detectable while dopa-oxidase activity was

higher.　During the period from ４ days t０７ days after　incubation, both tyrosinase　and

ｄｏｐａ-ｏχidase　activity　were　detected, tyrosinase　activity　then ceases in the successive

life. The results obtained from the experiments of Rhode Island Red and Black

were similar to those of White Leghorn's experiment (See Fig. 38～40).

182

　　　Inmammalia, black mice C-57, tyrosinase activityin the pigmented retinal epithelium

was detected in the almost whole embryonal life（8～21 day embryo) (See Fig..41)｡

　　　In　man, an　active tyrosinase activity was demonstrated in the　pigmented retinal

epithelium of　５　month embryo while no tyrosinase activity was observed in that of the

adult.　Both　the　cover　slide　method and autoradiographic　method were　employed　for

the demonstration of tyrosinase activity of　primary, malignant melanoma　of　the　ｅyｅ･

Seven malignant melanomas were subjected for this study.　Using the cover slide method,

the activity was detected in 5 out of seven cases. and on the other hand the activity wa&

autoradiographically demonstrated in 6 out of seven cases (See Ｔａｂ。IX, Fig。43）｡

　　　From the results obtained, so far, the chemical elaboration of melanin from the colorless.

amino　acid　tyrosine by ａ tyrosinase enzyme system has been demonstrated in the melano-

cytes in the skin, hair and eye of man, black mice and lower vertebrates. And it has been

found that the enzymic activityin melanocytes of the different t･egionshowes the charact-

eristicfluctuations during the development : the unchangeable activity throughout the life･

in　the normal　skin, cyclic changes in the hair and high activityin the embryonal lifein

the ｅｙｅ｡

　　　Inpathological conditions, the high activity has been shown to exist only in malignant

melanoma cells in the skin as well as in the eye, relatively 10ｗ activityin blue nevi and

proliferating pigmented nevi｡

　　　Based on these results it seems that tyrosinase activity is related to the melanocyte

proliferation.

study on Fixed Drag Eruption*

18ぶ

　　　　　　　　　　　　　　　　　　　　　　　　　　　by

　　　　　　　　　　　　　　　　　　　　　　MinoruYamada**

　　During the last several years 107 cases of 丘xed drug eruption have been observed　and

investigated immunologically and clinically.　Sex and age of the patients shown in Table １.

and the causative drugs were listed in Table ３. 18 out of 58 cases of the patients patch-

tested with the causative drugs were iound to be positive. The results of patch test for

the causative drug in　the affected skin were compared with those in the normal skin ia

eight cases respectively, and the specificsensitivityfor the drug were observed not only in

the affectedskin. but alsoin the normal skin (Table 4)。The sera of１４cases with fixed drug

eruption were tested with diazonium causative drugs coupled with human serum, and the

positive reaction　of the precipitin test were observed in ７　cases of these cases　tested

(Table 5). In addition, using drug-sensitized collodion particles prepared by the method of

Cavelti (1947), the agglutination test to sera of the patients were performed. The positive

aggulutination test was obtained in all tested cases who had had　fixed drug eruption, the

titerof sera. howe∇er, was lower than that of the contents of the cutaneous blisterinduced

by the'application of cantharides.・

　　It is considered, therefore, that antibodies in the skin would transfer to the contents-

of the cutaneous blister. Also it was found titer of antibodies in the both contents of the

cutaneous blisterin the affected skin and the normal skin of the patients was the same.

It is assumed the spcific sensitivity to the drug is present in the both areas (Table 9)，

The results obtained from the study of Naegeli and his co-worker (Immersion of skia

specimen into allergen solution) ha▽e been influenced by many unspecific factors and it i＆

unreliable to demonstrate the existence of the specific sensitivityin the skin. The local

sensitivity of the skin for the drugs has been shown toｅχisiteither in the epidermis or

in the neuro-vascular structure of the cutis by the experiment of auto-transplants･Whea

the skin from the lesion is grafted to the normal skin of the same individual. the both

specific sensitivityand unspecific reactivity to the causative drugs may be transferee! t{}

the dorated site with explant.

　　The histopathology in the early stage of fixed drug eruptions are shown in Fig.10. The

most remarkable changes are seen in the papillary layer of the cutis.in where the capill-

ary vessels are dilated and the vessel wall cells are swollen and these changes are sur-

rounded by severe edema and the round cellinfiltration. The pathologic changes in the-

epidermis are considered to be due to secondary changes as ａ result of the extension of

　＊　Full-lengthreport: Japanese section pp. 960～984

＊＊　From the Department of Dermatology (Direct or Prof. Ｇ. Harada), Tokyo Medical and

　　　DentalUniversity, Tokyo

184

severe edema in the corium. No intensive changes are　seen　in the deeper　corium, but

the blood vessels in the upper subcutis are prominantly dilated and the leucostasis is

･observed. The same　changes of　the　vesselsin the deeper cutis are seen in the post-

inflammatory stage of the lesions (Fig. 14,16)｡

　　　SinceNaegeli, it has been generally believed that the sites of insect bite, healed zoster

and dcatrics are of the predilection　for　themanifestation of fixed drug eruption. But,

in the few cases. the cicatricslocated in the center of fixed eruption in　where the　blood

~･circulationis diminished do not react when the relapse of the disease occurred in the other

:parts of the body (Fig. 19,20)｡

　　　From the　results obtained from　this study, it 。may　be　concluded　that the　specific

‘sensiti▽ityto the causative drugs as well as the non-specific factors, such as the amounts

しof blood circulation and the changes of blood vessels may be played an important role for

the manifestation of fixed drug eruption.

Uber die Epithelfasern der Haut゛

　　　　　von

IVIakusu Mori**

18５

　　Die Epithelfasern der Haut wurden einerseits an normaler Haut. andererseits an Spi-

tzenkondylom, Verruca vulgaris, Stachelzellenkrebs, Eczema acutum, Pemphigus vulgaris-

u.s.w. mittels der Unnaschen　Wagserblau-Orcein-Eosin-Farbung　sehr　Sfhon　dargestellt.

Dabei waren die hauptsachlicher Resultate wie folgt:

　　(1) Die Eigentumlichkeiten der Epithelfasern in jeder Schicht der normalen Haut sind

folgenderweise :　In der Basalschicht liegen Herxheimersche Spiralen und Epithelfasern

beisammen. Unter den letzteren bemerktこman viele longitudinale Fasern sowie manche

quere Fasern. Es ist besonders in der Stachelschicht merkwiirdig, daB einzelne Faser-

bUndel aus den einander parallelverlanfenden Epithelfasern bestehen. Die Epithelfaserbiindel

verlaufen hier nach alien Richtungen, doch findet man am meisten die　longitudinalen

Biindel. Die meisten Epithelfasern bilden innerhalb der einzelnen Zellen eine flache, nach

dem kern kovexe Kurve. In der Kornerschicht sind viele longitudinale und nur wenige

quere Epithelfasern vorhanden. Auch in der Aehl'scher Schicht findet man die longitudi-

naler Epithelfasern, wogegen das Vorhandensein der queren Fasern nicht　festzustellenist.

Die Zellen der Hornschicht enthalten longitudinale. schrSge und quere Epithelfasen. Doch

herrschen die ersteren hier auch ｖｏｒ｡

　　(2) In der Stachelschicht findet man hier und dort Briickenknotchengruppen, namlich

Querschnittsbilder .der Epithelfaserbiindeln, ober-oder　unterhalb des Zelleibs liegend. Da

sind die Verteilungen der Fibrillen in Epithelfaserbiindeln ganz genau　zu　beobachten　und

die Fibrillen in jeden Biindel zu zahlen.　Bei der Anschaung des Querschnittsbildes von

Epithelfaserbiindeln findet man einzeln liegende Briickenknotchen nur sparlich, wahrend

die meisten Knotchen in derselber Biindeln je zwei Oder je drei dicht nebeneinander liegen.

Wir konnen aus den obiger Beobachtungen sicher folgendes erkennen :　In jedem Epithelfa-

serbiindel ziehen nur spSliche Tonofibrillen einzeln unahhSngig, aber die meisten Fibrillen

laufen je zwei Oder Je drei nebeneinander｡

　　(3) Die Zahl der Tonofibrillen in einem Faserbiindel ist an der normalen Haut etwa

40, bei Spitzenkondylom etwa 50, bei Verruca vulgaris etwa 30 bzw. 50, ausnahmsweise

etwa 100, bei Stachelzellenkrebs in den groBeren Zellen etwa 100, in den kleineren etwa

45. Die Zahl steigt ungefahr im Verhaltnis mit der GroCe der Stachelzelle｡

　　(4) Beim ZerreiBen der Interzellularbriicken fallen die Zellen meistents am Grenz:-

punkt zwischen den Briickenknotchen und den Bruckenfasern auseinander.

　＊

＊＊

Siehe das Original auf Japanisch: ｓ 985～Ｈ（）I

Aus dem dermatologischen Institut (Vorstand: Prof. Dr Kanehiko Kitamua)

Tokyo Universitat, Tokyo.　　　　　　　　　　　　　　　　　‘

186

　　(5) Die pathologischen Veranderungen der Epithelfasern lauter folgendermaBen :　Bei

ヽSpitzenkondylom sind die iedes Bundel bildender Epithelfasern etwas mehr als bei normaler

Haut. Die Epithelfaserbiindel　∇erlaufenin den　verschiedenster　Richtungen, deshalb ist

keine Hauptrichtung des Verlaufs zu bestimmen. Bei Verruca vulgaris sind keine Verand-

　erungen der EpitCelfasern zu bemerken. abgesehen von der Zahl der ein Biindel bildenden

Epithelfasern. Bei Stachelzellenkrebs befinden sich die ungeschlangelten, namlich scheinbar

:gespannten Epithelfasern im allgemeinen mehr und anderseits die geschlangelten, nSmlich

scheinbar schlaffer Epithelfasern weniger als bei der normalen Haut und den gutartigen

Hautgeschwiilsten. Aber ausnahmsweise丘nden wir viele geschlangelte　Epithelfasern in

der Gruppe mancher langen Stachelzellen (Photo 25)｡

　　Die Epithelfasern finden wir bei Stachelzellenkrebs auch in der Umgebung der Hornperle

■deutlich. Hier sind manchmal in den Interzellularraumen nur die Bruckenknotchen deut-

lich und die Briicke�asern kaum zu erkeruien. Beim Stachelzellenkrebs konnen die

BriickenknOtchen Kegen nicht nur in der Mitte der Briicke, sondern auch am Ende. Bei

Eczema acutum zeigen manche Epithelfaserbiindel sich sehr dicht dadurch daU die in

einem Bundel sich ｂｅ丘ndenden Fasern Zusammengedriickt werden. Die Epithelfasern,

welche mit solch einem dichten Biindel innerhalb des zelleibes sich kreuzen, sind meistents

in den Interzellularraumen zerrissen. Bei der Blasenbildung in der Stachelschicht des

Pemphigus vulgaris finden wir die verdickten Epithelfasern, welche sich nicht nur tief,

sondern auch abnorm farben lassen. In den Stachelzellen der Wand der Blase degenerieren

die meisten Epithelfasern (Photo 44) und bei den in dem Inhalt der Blase frei schwebenden

Stachelzellen fast alle Epithelfasern. Es ist fast zweifellos. daB bei Pemphigus vulgaris

die Degeneration der Tonofibrillenzuerst im Zelleib denn in der Interzellularbriickeauftritt.

Histological studies on Epidermal Melanin Distribution in

　　　　　　Various Inflammatory Skin Diseases*

187

　　　　　　　　　　　　　　　　　　　　　　　　　　　by

　　　　　　　　　　　　　　　　　　　　　　　　ItsuroOhta゛“゛

　　The distribution of melanin in the epidermis during acute inflammatory skin disease

has been studied.

　　The methods used for this study were as follows；

　　1) Haematoxylin-Eosin staining.（ＨＥ stain)

　　2) Dopa staining.

　　3) Masson-Zimmermann ammoniacal silver nitrate staining（Ｍ-Ｚ stain)

　　Ｅｘｐｅｒｉｍｅｎtｓ.

　　In order to study the change of melanin distributionof various stages of the inflamma-

tory skin diseases, atopic dermatitis (6 cases), erythroderma (2 cases), psoriasis (4 cases).

seborrheic dermatitis (1 case), lichen vidal（ｌcase), and acute contact dermatitis（１case)

were investigated histologically･

　　The irradiated skin by ultravioletradiation was also investigated on the 1st, the 4th,

the 7th, and 14th days after the irradiation.

　　The following results were obtained.

　　1) In acute lesion in which hyperkeratosis. parakeratosis. and acanthosis or spongiosis

were seen, melanin granules were completely abscent within the epidermal cells. ０ｎ the

contrary, dendrites and perikaryon of melanocytes were well developed and the activity of

dopa oxidase intensively increased.

　　As the inflammatory process subsides after various methods of treatment, the moderate

numbers of　pigment granules were present within the basal cells as well as in the inter-

cellular spaces.

　　On the other hand. the size, the length of dendrites and the size of melanocytes were

gradually reduced. When inflammatory process was almost subsided, the pigment granules

within the epidermal cells were abundant and arranged in｡form of “ supranuclear caps ”

which are characteristic of the distributionin the normal skin.

　　Namely, the activity of melanocytes may be related to the stage of inflammatory

process and also intimately related the melanin amount in the basal cells. As the melanin

amount of the basal cells reduced, the activity of melanocytes may increase automatically.

　　2) This fact also was shown on the irradiated skin by ultravioletradiation.

　＊

＊＊

Full-length report: Japanese section pp. 1012～1036

From the Department of Dermatology (Director: Dr. Ｔ. Kobori) Tokyo Teishin Hospital,

Tokyo,

188

　　3) The melanin precursor which　seems　to be produced in the melanocytes Was not

visible in HE stain, but visible with　M-Z　stain when　this substance migrated into the

dendrites and or 垣tｏthe basal cells, this melanin precursor became as ａ yellowish-brown

granules which is called as mature melanin｡

　　4) Extracellular small collectionsof pigment granules were sometimes seen ａ short

distance from some of the dendritic process.　This probably represents ａ process first

described by Ranvier known as clasmatosis｡

　　In inflammatory skin diseases by unknown mechanismus. the melanin granules disappear

from the Malpighian cells. and the activity of melanocytes may increase subsequently

without deposit　of　melanin　granules in　the basal　cells　until　theinflammatory process

subsides and the basal cell activity restores to normal condition.

189

　　　　　　　　　Clinical Effects of Oxsoralen and TTG on Vitiligo Ｖ�garis*゜

　　　　　　　　　　　　　　　　　　　　　　　　　by

　　　　　　　　　　　　　　　　　　　　　　Itsuro Ohta**゜

　　Therapeutrc effects to vltiligo vulgaris of 8-Methoxypsoralen and TTG were evaluated.

TTG is an extracted component of nonpathogenic bacteria Pseudomonas fluorescens. The f

methods used were as follows ；　　　　　　　　　　　　　　　　　　　　　　　　　　　　　.

　　A) Oxsoralen

　　　a) Oral administration

　　　1. Daily intake of oxsoralen capsules followed by　exposure to ａ dependable source

of urtraviolet radiation.

　　　2. Oral dose

　　　Adults―Two capsules （20 mg) at one time per day.

　　　Children｡―1 to 6 years of age, one capsule （10 mg) per day。

　　　3) The lesion is irradiated with ultraviolet ray exactly two　hours after ingestion of

the capsules.

　　b) Simultaneously use of oral and local administration of Oxsoralen. Namely, ＼%

Methoxypsoralen dissolved in alcohol. aceton, propylen glycol and water is applied locally

immediately and ｅχpose to ultraviolet radiation once ａ week. At the same time, the

capsules of drug are administrated by mouth.

　　Ｂ）ＴＴＧ

　　　1) At first, the ultraviolet ray is irradiated to the lesion at the distance of ３５Ｃｍ。

for 5 minutes.

　　　2) Then, the local-intracutaneously injection of TTG to the lesion is performed twice

or three times ａ week.

　　　　　　　　　　The Comparison of the Results of Treatment with TTG. and

　　　　　　　　　　　g-Methoxypsoralen. Duration of Treatment within 1 1/２Years.

TTG OχsoralenTotal 30 ９

Excellent 11 ２

Moderate 16 ２

Slight １ ４

Poor ２ １

Excellent Moderate Slight Poor

TTG37％　1　54％

　　91％

３％ ６％

Oxsoralen22％　1　22％

　　44％44％ 12％

　　TTG treatment on vitiligovulgaris has revealed to be more effectivethan that of

Oxsoralen, however, TTG treatment was practicallyimpossible to treat of the patient

with the generalizedform of vitiligovulgaris.

　＊　Full-lengthreport: Japanese section pp. 1037～1045

＊＊　From the Department of Dermatology (Director: Dr. Ｔ. Kobori), Tokyo Teishin Hospital, Tokyo.

190

　　　　　　　　　UrticariaSolare*

　　　　　　　　　　　　　　　by

Chiyaki Shimoda and Ryuzo Hasegawa**

　　　The fifth case of urticaria Solaris in Japan was reported. The patient was　a 42-year

０１ｄmale. The familial and past history were negative for allergic and photosensitive

diseases. Three years ago the patient noted that the skin exposed to direct sunlight soon

became erythematous and itchy。 The sensitivity to sunlight gradually increased　and the

whealing　reaction　appeared　at　the　irradiated　sites.　Later　sunlight　passing　through

ordinary　window　glass　also　caused　whealing　response.　In　several instances general

symptoms such as malaise, nausea and headache accompanied the eruption｡

　　　Physical exammation revealed no abnormality except chronic pharyngitis and sinusitis.

The results　of　laboratory tests　including blood　count, liver　function　test　and　serum

でprotein fraction were normal. The absorption spectrum of the serum　revealed　no　abnor-

mality.　Porphyrins in the urine were negative in several occasions｡

　　　The results of the light sensitivity tests were :　Sun-tanning reaction was normal. No

whealing reactions occurred by irradiation using mercury vapor lamp and sollux lamp as

the light sources. By using photographic filters and aqueous solution of 5-nitro-2-furfur-

ylidene aminoguanidine, which cut off the rays shorter than ４００ｍμ in wave length as the

filter,it was noticed that the patient was sensitive to the longer than ４００ｍμin wave length｡

　　　The passive transfer was positive in three cases　out of eight healthy persons tested.

The passive transfer “ in reverse ”，however, was negative. The patient ｒｅ▽ealed marked

dermographism and the intrac utaneous injection　of acetylcholine solution caused marked

and persistent erythema similar to that seen in cholinogenic urticaria. The pharmaco-

dynamic reaction to pilocarpine was strongly positive｡

　　　The treatment consisted of desensitization, medication of antihistaminica and Resochin.

No definitive effects were obtained by any of these methods｡

　　　After discussing the theories concerning the pathogenesis of solar urticaria, the authors

maintained the allergic tｈｅｏさthat was the most plausible one.

　＊

＊＊

Full-length report: Japanese section pp. 1046～1050

From the Department of Dermatology (Director: Prof. Dr. S. Iijima), Fukushima Medical

College,Fukushima

191

　　　　　　　　　　OnSignificance of Autoantibody in the Case of Syphilitic

　　　　　　　　　　　　　　　　　Paroxsymalcold Hemoglobinuria^

　　　　　　　　　　　　　　　　　　　　　　　　　　by

　　　　　　　　　　　KiheiTanioku, Masami Nakahira, Yuichiro Koizumi**

　　　A 18 year old girl has complained of episode of dark-red hemoglobinuria during the

past 5 years.　Hemoglobinuria was observed continuously in cold season and occasionally

when her ｅχtremities were ｅχposed to cold water　or　air. Serological　and　immuno-

hematological data obtained were as follows:

　　　Wassermann's reaction (十), Murata's reaction (十), Kahn's reaction (十), Donath-

Landsteiner's reaction (十), Rosenbach's test (十), Coombs' test； direct test(十), indirect

test (士), Cryoprotein in serum (-), Auto antibody to renal pelvis (十). After antisyphilitic

therapies extending over 5 years, the paroχysmal frequencies of hemoglobinuria and the

color of urin decreased. but titerof Wassermann゛ｓ reaction did not change.

　　　We discussed the significance of autoantibody such as hemolysin, antibody showing

positive Coombs' test,auto-antibody to renal pelvis in the Case of the paroxysmal cold

hemoglobinuria and the relation between theee auto antibody and Syphilis.

　＊

II＊

Full-length report: Japanese section pp. 1051～1062　　　　‥

From the Department of Dermato-urology (firector: Prof.Ｋ. Taniku), Faculty of Medicine,

Shinshu University, Matsumoto