Eccrine poromas in a patient with mycosis fungoides treated with electron beam therapy.

We describe a 72-year-old man with mycosis fungoides (MF) followed up at our hospital for more than 20 years, who has developed 14 eccrine poromas (EPs) in the past 12 years. Twelve of these tumours were ascertained as EP histopathologically without any findings of malignancy and the other two were clinically diagnosed and are not yet resected. To our knowledge, this is the first case report of MF complicated with multiple EPs. In our patient, all EPs arose in skin areas previously irradiated with an electron beam for the treatment of MF, suggesting that electron beam irradiation might have an effect on the development of EPs.

[Treatment of four cases of B-cell lymphoma].

Four cases of B cell lymphoma, seen at the Department of Dermatology, Miyazaki Medical College, for the previous approximately 10 years, were reviewed. Case 1 was characterized by a localized tumours lesion on the head; the histologic picture was of the follicular, medium sized cell type. Complete remission for 8 years has been obtained after electron beam therapy and surgical removal of the tumor. Cases 2 and 3 had a histologic picture of diffuse, large cell type and were assumed to have a bad prognosis with standard chemotherapy. In addition to conventional chemotherapy, they were placed on noncross-resistant alternating combination chemotherapy with medium dosages of MTX, VP-16, VDS, PCZ MXT, PEP and ACR, so as not to develop cross resistance. Case 2 has been in complete remission for 11 months and case 3 for 7 months. Case 4 was a nodal lymphoma with skin lesions. This patient was treated mainly by local radiation therapy, but later died with leukemic changes and renal failure. Cutaneous B cell lymphoma should be treated vigorously and carefully, since it has a poorer prognosis than that of lymphoma of lymph node origin.

Vertically growing ectopic nail. Nature's experiment on nail growth direction.

The cul-de-sac in which the nail is formed determines that it should grow outward instead of upward according to Kligman. This view was questioned by Baran based on clinical observations and review of the literature. A case of vertically growing ectopic nail of congenital origin indicated that the cul-de-sac was directed to the skin surface and the nail was growing vertically to the skin. The anatomy of the cul-de-sac, which may be influenced by local factors, appears to determine the direction of the nail.