The incidence of tick bites is not rare in the farming and mountain villages in this country. The bite often makes a swelling as big as a large soybean. After the tick attached to the skin is removed, a small red spot appears at the very site of the bite. Then the red lesion starts expanding distally.
In 1987, we reported seven such cases of erythema migrans (formerly called erythema chronicum migrans) in a paper entitled “Statistics of Ixodid Tick Bitesand Ixodiasis.” Incidentally, Baba et al. came up with a report of a case of Lyme disease which was developed after bites of Ixodes persulcatus in Myoko Heights. This report attracted attention becauseit was the first case ever reported in Japan. Since then, we have continued to investigate the incidence of the tick bites and Lyme disease in this country. The following is a summary of our findings thus far.
Up until 1999, there were a total of 165 cases of ixodiasis, of which 16 were diagnosed as Lyme disease marked by erythema migrans. The year 1994 saw the largest number of victims of tick bites with 18. June was the peak month in which the largest 135 cases was registered. Age-wise, those aged 10 years or under were most proneto tick bites, accounting for 33 cases, followed by those in their 50s with 32 cases. The most common site of the bite was the abdomen with 99 cases. The back and the breast came second with 39 cases each. In 56 cases, the ticks were extracted by physicians; in 94 other cases, the removal was done by picking ticks out of the skin by the victims themselves or their family members; and in seven other cases, the ticks simply dropped off before the victims realized it. The species of ticks identified include Ixodes persulcatus in 56 cases and Ixodes ovatus in 26 cases.
We also report here the results of a questionnaire survey of employees at district forestry offices, a cohort at high risk of tick bites, and measurements of anti-Lyme disease Borrelia antibodies in serum.

Pesticide-related dermatitis has a high rate of incidence in rural communities, adversely affecting the health and livelihood of farmers. The important task we should take upon ourselves is to find out how to reduce exposure to agricultural chemicals directly injurious to the health of rural people.Especially, regarding those skin disorders characterized by chemical burns due to severe irritation or allergic contact dermatitis that develops as a result of sensitization reaction to chemicals, the mainstay of prevention is identification of allergens and substances causing skin disturbances and avoidance of exposure to them.
From this standpoint, we made clinical and epidemiological studies in a total of 380 patients who were treated for pesticide-related dermatitis at the Department of Dermatology of Saku Central Hospital, Nagano, during the period of 23 years from 1975 to 1997.
As a result, the following points were made clear as features of dermatitis associated with exposure to agricultural chemicals over the past 10 years:(1) The number of severe cases that require medical treatment has been on the decrease;(2) there has been a tendency to increase in the incidence of chemical burn type dermatitis by irritantagents such as Dazomet, Glyphosate and methyl bromide; and (3) the occurrence of chronic and solar type dermatitis has been declining.

As part of our investigation into the allergic conditions that frequently plague farmers, we have conducted surveys on the prevalence of the skin disease which erupts probably as a result of allergic reaction. The findings are as follows:
1. Of the outpatients, 7.29% were suffering from contact dermatitis. Among the causarive agents closely related with agriculture were pesticides, chrysanthemums, lettuces, Primula obconica, melberries, rice plants, fertilizers, quicklime, celery, parsley etc. These were responsible for 17.2% of the cases of contact dermatitis.
2 Pesticide-induced dermatitis was found in 0.41% of the outpatients and 5.64% of the cntact dermatitis cases. Among the major offending pesticides were Des (DDVP), Difar (Zineb), Lannate (Mesomil), Maneb Dithane (Maneb) and Salithion.
3. The skin disease that seems to have occurred due to the exposure to sunlight accounted for 1.41% of the outpatients. Five of the dermatitis patients were victims of both sunlight and pesticides.
4. A patch test showed that Daconil, Difolatan and Altanon cause a strong, primary irritation, but their sensitizing effect is moderate when compared with Triazine and DDVP. The test also indicated that Topsin-M (Thiophanate), Salithion, Diazinon, Maneb Dithane and Dithane Stenless (Amobam) more or less render individuals sensitive.
5. A physical examination of farmers engaged in pesticide spraying revealed that 27.9% of the examinees have early signs of dermatitis on the back of their hands.
6. A follow-up survey of the patch test participants showed that most of them do not take proper measures against dermatitis caused by pesticides.

In recent years, an increasing number of researchers have warned that depltion of the Earth's ozone layer by chlorofluorocarbons allows extra ultraviolet radiation from space to strike our planet, causing a rise in the incidence of skin cancers and precancerous dermatoses worldwide. This motivated us to perform a series of screening for skin cancers on the inhabitants at age 40 and above of the Saku District, Nagano Prefecture, where the intensity of the sun's harmful ultraviolet radiation is thought to be relatively high.
The first screening was carried out from 1993 through 1995. The number of subjects totaled 7, 528-2, 658 men and 4, 870 women-which represents 7.4% of the populace. Of the total, 67 people had a histopathological examination. The result revealed that there were four cases of malignancy and 45 cases of precancerous dermatosis. The malignant cases were made up of one case of malignant melanoma and three cases of basal-cell carcinoma, while the precancerous cases were one case of Bowen's disease and 44 cases of solar keratosis.
The follow-up examination was conducted in 1996 on 93 subjects (40.6%) of the 229 examiness who had been found to need to be watched in the first screening. Biopsy was indicated in five subjects. Treatment was suggested to 11 subjects. A visit to the department of dermatology at Sake Central Hospital was recommended to 10 people. Further observation was needed in 24 cases.
The screening project for skin cancers under a long-range plan would raise awareness of the diseases among the people and contribute to the early detection, treatment and prevention of various forms of skin cancer. It could also serve the purpose of protecting the environment from deterioration on n global srnle.

This paper describes the results of clinical and epidemiological studies of pathogen-carrying madani tick bites and the vector-borne diseases. The studies were conducted by a group of researchers specially organized by the Japanese Association of Rural Medicine.Questionnaires were sent out to JARM-affiliated 108 medical institutions to collect information about cases of ixodiasis, Lyme disease and Japanese spotted fever. It was found that during 2002, there were 151 cases of Ixodes tick bites (67 males and 84 females) and 17 cases of Lyme disease (13 males and 4 females). The incidence of Japanese spotted fever was zero.The survey also found that before that year, 24 out of the 108 medical institutions had treated tick bite cases and 13 handn’t. No reply came from the rest. As to Lyme disease, six hospitals had experienced in treating this vector-borne disease, 31 hadn’t and the rest did not reply. Japanese spotted fever was confirmed by one hospital. Thirty-three hospitals said they had not encountered this disease. The remaining 74 facilities did not respond. It was regrettable that more than a half of the 108 institutions did not respond to the survey. Considering that new types of infectious diseases caused by new forms of pathogens are raging nowadays, we, professionals affiliated with the Japanese Association of Rural Medicine, must keep careful watch on these diseases.
Japanese language ; Ticks ; Genus: Ixodes ; Clinical ; Lyme Disease

This is the second report of the findings of the clinical and epidemiological studies on pathogen-carrying madani tick bites (ixodiasis) and the vector-borne diseases conducted by a study group of researchers specially organized by the Japanese Association of Rural Medicine. The report covers the period from January 1 through December 31, 2004.The same questionnaires that had been prepared in the previous survey were sentto 80 JARM-affiliated medical facilities and 11 non-member medical institutions to collect information about tick bites and resultant infections.It was found that during 2004 there were 134 cases (67 for men and 67 for women) of skin lesions caused by ixodid tick bites, 14 cases of Lyme disease (7 for men and the same for women), and none for Japanese spotted fever. These ixodiasis cases did not show any speciffic difference from those reported previously. All the Lyme disease patients developed erythema migrans which characterize stage 1 infection.As there is still plenty of catching up to do in terms of coping with the tick bite problems in Japan, we referred to some literature on the control of ixodid ticks, serologic testing techniques for Lyme disease, administration of prophylactic antibiotics and therapeutic methods.
Ticks ; Clinical ; Lyme Disease ; seconds ; Japanese language