Diagnosis and Treatment of External Dental Fistula
External dental fistula(EDF) is one of the forms of chronic odontogenic infections. When chronic apical infection of the tooth extends to the adjacent tissues, it often appears as a fistula in the skin surface. However, since EDF could be found anywhere in the face surface with lacking of the dental symptomes, those patients tend to visit medical clinic instead of dentist. In this paper, three different cases of diagnosis and treatment of EDF were reported. Especially, usefulness of ultrasonic imaging and dental X-ray taking were emphasized. High points of the indication and technical consideration of the EDF surgery was also presentated for physicians.
Key word:external dental fistula, medial ocular angle, skin tumor, ultrasonic imaging, surgical method

Yoshihide Ota,D.D.S.,Ph.D.
Department of Oral Surgery, Tokai University Hospital Bouseidai, Isehara City, Knagawa 259-1100,Japan

Tretinoin Tocoferil Ointment Combined with Polymyxin B Sulfate Powder for Cases of Burn Ulcers
Tretinoin tocoferil ointment (Olcenon ointment) was reported to promote granulation tissue formation and wound healing. We tried to apply the combined drug of this ointment and antibiotic polymyxin B sulfate powder to three patients with bum ulcers. The combined drug showed no change in the description and potency. The combined drug accelated the healing of the burn ulcers and exhibited an antibiotic effect against Pseudomonas aeruginosa.
Key words: bum ulcer. external medication, tretinoin tocoferil ointment. polymyxin B sulfate.
Pseudomonas aeruginosa

Tsunaaki Sakakibara, M.D., Kunihisa Ito, M.D., Muneo Miyasaka. M.D. Akihisa Yamazaki, M.D., Ryuzaburo Tanino, M.D. and Mitsuhiro Osada, M.D.
Department of Plastic and Reconstructive Surgery, Tokai University School of Medicine Boseidai. Isehara, Kanagawa 259- 1193. Japan

A Prospective Trial Hydrocolloid Dressing with Lyophilised Porcine Dermal Skin for Skin Graft Donor Sites
The aims of dressing for skin graft donor sites are pain relief and early epithelization. There are many kinds of dressing for donor sites, but it is not known which dressing is most suitable for donor sites. The purpose of this study was to investigate the best dressing for donor sites. In this study, three donor sites were treated with hydrocolloid dressing combined with lyophilized porcine dermal skin. Following two weeks of observation, the results suggested that this combination method has advantages in reducing exudate and pain as compared with each dressing alone.
Key words: donor sites, hydrocolloid dressing. Iyophilized porcine dermal skin

Toru Murashita. M.D, and Yoshiki Miyachi, M.D.
Department of Dermatology, School of Medicine. Gunma University 3-39-22 Showamachi. Maebashi. Gunma 371-8511. Japan
Tomoharu Kiyosawa, M.D. and Yoshio Nakayama, M.D.
Department of Plastic and Reconstructive Surgery, Institute of Clinical Medicine University of Tsukuba 1-1-1 Tennoudai. Tsukuba. Ibaraki 305-0006, Japan

Paronychia and Panaritium Occurring in the Patients with Progressive Systemic Sclerosis
We reported two cases of panaritium of the hand fingers in the patients with PSS. These patients demonstrated finger atrophy and nail deformities as well as sclerodactylia. One patient was treated with prednisolone. Panaritiurn in these patients demonstrated prolonged course until cure. We think the patient with PSS is susceptible to paronychia or panaritium due to finger atrophy and nail deformities. Once paronychia or panaritium occurs in the patient with PSS, it tends to become severe and show prolonged course due to local circulation disturbance and administration of systemic steroid. Surgical procedure and treatment with antibiotics are necessary, In addition systemic administration of PGEI is needed for the improvement of circulation disturbance. We also emphasized the importance of the 'finger care' in the patients with PSS.
Key words: panaritium. paronychia, collagen disease, PSS

Toshio Demitsu, M.D.*, **, Tomoharu Kiyosawa, M.D.* Youichi Kobori, M.D.*, Maki Kakurai. M.D.* Michiko Hiraga, M.D.*, Tomoko Yamada, M.D.*, Hideo Yaoita, M.D.*
*Department of Dermatology. Jichi Medical School 3311-1 Yakushiji, Minamikawachimachi, Kawachigun, Tochigi 329-0431, Japan
**Department of Dermatology, Akita University School of Medicine l-1- I Hondo, Akita 010-8543, Japan

Multiple Squamous Cell Carcinoma Arizing from Solar Keratosis: A Case Report
Five skin lesions which had been growing for 17 years were excised from the face of a 91 year old female. She had a long history of farn work. Histopathology showed that two of the skin lesions were a hypertrophic and a bowenoid type solar keratosis, and three were well differentiated squamous cell carcinomas which were continuous with surrounding solar keratosis. In elderly people, Iong-duration solar keratosis can suddenly develop into squamous cell carcinoma. Thus, early treatment and thorough follow-up are necessary.
Key words: solar keratosis, squamous cell carcinoma

Taeko Koyano, M.D., Yukiko Hisamatsu, M.D., Akiko Yokoyama, M.D.
Division of Dermatology, Toride Kyodo General Hospital 2- I - I , Hongo, Toride. Ibaraki 302-0022, Japan
Tadashi Umeda, M . D.
Departrnent of Dermatology, Tokyo Medical and Dental University School of Medicine l-5-45, Yushima. Bunkyo-ku, Tokyo 113-0034. Japan

A Review of Management of Ingrown Nails
Ingrown nails bring a troublesome and unpleasant problem for the patient. Trauma from tight shoes against the lateral edge of the nail plate mainly causes the symptoms. Incorrect cutting of the nails accompanied with poorly fitting shoes aggravates the nail incurvation. In general, the suturing method after lateral nail wall resections containing nail matrix and soft tissue provokes postoperative severe pain especially in walking and the toe deformity. For the purpose of alleviation of these complications, we prefer the simple method that resects only the incurvated nail structure without suturing and preserves the contiguous soft tissues.
Key words: ingrown nail, open treatment, importance of fitting shoes

Kushio Higashi, M.D.
Higashi Clinic for Dermatologic and Plastic Surgery 5th Floor, HiHi-Town Building 6-3-3 1 , Uehonmachi. Tennouji-ku. Osaka 543-0001 , Japan

Aromatherapy: - Present Situation and Prospective Problems -
Aromatherapy is now remarkable for relaxation, health and beauty in stressful society. But it has unclear things. This paper introduces the history and the background of growth about aromatherapy, and consider the present situation and prospective problems of aromatherapy in Japan.
Key words: aromatherapy, essential oil, perfume, relaxation

Shuji Suzuki
Research Laboratories. Nippon Menard Cosmetic Co., LTD. 2-7. Torimi-cho, Nishi-ku, Nagoya 451 -0071. Japan

Dermatopathology for Dermatologic Surgery Foreign Body
Foreign bodies could be seen in the skin when they were injected or implanted accidentally or artificially Histopathologically, some cavities, slits. granulomatous changes or knife marks suggest the possible presence of foreign bodies I have described here foreign bodies which could be divided into two groups, ones have peculiar structure and the others don't have any structure, and the inflammatory changes which may occur accompanied with certain substances. To distinguish the substance of foreign bodies, careful observation. special stains, and above all the accurate clinical information will be needed.
Key words: foreign body. foreign body granuloma, pathology. skin

Ayako Takeuchi, M.D.
Department of Dermatology, The Jikei University School of Medicine, 3-19-18, Nishi-Shimbashi. Minato-ku, Tokyo 105-0003, Japan

A case of Fournier's gangrene
A 36-year-old man (traveler from Sri Lanka) noticed small vesicles on his whole body accompanied by a fever and general fatigue. He was diagnosed as having varicella and the therapy with acyclovir was started. The administration of an antibiotic (CFZ) was also applied since the secondary infection was observed on his scrotum. However, the lesions of skin infection rapid]y extended to bilateral Iower abdomen with the aggravation of his general conditions. Then, the emergent debridement was done under the diagnosis of Fournier's gangrene and the set administrations of antibiotics (ASPC and IPM/CS) were used additionally. The operation was successful and his general conditions got better, so that the suture of the open wounds was performed I 2 days later.
Key words: Foumier's gangrene, debridement, administration of antibiotics

Takao Tachibana, M.D., Sawako Higuchi, M.D., Eiko Toichi, M.D., Satoshi Kore-eda, M.D., Aklhiro Imura, M.D., Norihisa Matsuyoshi, M.D., Ken-ichi Toda, M.D. and Sadao Imamura. M.D.
Department of Dermatology, Graduate School of Medicine, Kyoto University 54, Kawahara-cho. Shougoin, Sakyo. Kyoto 606-8507, Japan

Phenol Cauterization for Ingrowing Toenails
A phenol cauterization is a popular therapy for ingrowing toenails. We present a review of our results and compare the result of previous reports. The regrowing rate of cauterizated nails was high but the recurrence rate of free symptoms was low. Furthermore, the period of wound healing was short. A short cauterization time may account for these results. It seems hard to explain why the symptoms should no recurrence. These results suggest that a long time phenol cauterization done in the previous reports may not be necessary for the treatment of ingrowing toenails.
Key words: phenol cauterization, ingrowing toenails, therapy

Toru Murashita, M.D., Osamu Ishikawa, M.D., Yoshiki Miyachi. M.D.
Department of Dermatology, Gunma University School of Medicine 3-39-22. Showa-machi. Maebashi 37 1-0511 . Japan
Norio Tokita. M.D. Konan Hospital 48-1 , Nagatsnka. Shimotsuma 304-0056. Japan

Two methods of nasal reconstruction in our clinic
Two methods for covering nasal defect were reported. It was thought that bilobed flap was useful to cover nasal defect because of the effect of reducing the cutaneous contortion. Full thickness skin graft with adipose tissue was also useful to elderly patients because of its easy technique.
Key words: nasal tissue defect. nasal reconstruction, Iocal flap. skin graft

Yoshiyasu Itoh, M.D., Manabu Harada, M.D., Masahiko Ishikawa, M.D.and Akira Ishibashi, M.D.
Department of Dermatology, National Defense Medical College 3-2 Namiki, Tokorozawa, Saitama 359-0042, Japan

Acinic Cell Carcinoma of the Parotid Gland in Childhood
A case of acinic cell car cinoma of the parotid gland in childhood (14 year old girl) was reported. This tumor usually occur after the middle age. but 37 children cases are reported in literature.
Key words: acinic cell carcinoma, parotid gland

Eiichi Matsuura, M.D. and Katsuyuki Arai, M.D.
Department of Plastic and Reconstruction Surgery National Self Defense Medical College 3-2 Namiki, Tokorozawa, Saitama 359-1583, Japan
Yoshio Nakayama. M.D.
Department of Plastic and Reconstruction Surgery Tnkuba University, Medical College 2- I - I Amakubo. Tsnkuba, Ibaraki 305-0005, Japan
Shigeyuki Asano, M.D.
Department of Pathology lwaki Kyouritsu General Hospital 16 Kuzehara, Mimaya-cho, Uchigo. Iwaki 973-8555, Japan